HomeMy WebLinkAboutBldg Permit 04-0491
L
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
Main File
I. White File
2. Pink City
3. Yellow Applicant
!J ' G- 04
PERMIT NO. Ocr. d4q/
(Please type or print and sig;n at bu"uui)
ADDRESS
~ ~. CP1- rpo~d-h~ue.,sC
ZONING (office use)
I2t
LEGAL DESCRIPTION (office use only)
LOT /D BLOCK I ADDIT~~'-eJcL lOt\--
PID 25. 4-0 J. 0 i v . 0
OWNER
(Name)
(Phone)
(Address)
BUILD~ '\") I \ _ 1- .
(Name) U . \<-. <IP'---cD"h --l...ft ~ .
(Contact Nam~~ u..- ~avdkcv
'-
(Phone{ 95~)985-78 3.3
(Phone) 4! I~~ ~ -^l73 G
(Address)
TYPE OF WORK
~w Construction
ODeck
o Porch
ORe-Roofing
ORe-Siding
o Lower Level Finish
o Fireplace
OAddition
OAlteration
OUtility Connection
o Misc.
1.8.c-,
PROJECT COST IV ALUE (excluding land) $
15~ /83
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or
authorized agent for the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a JeSignee may
l/~teru~erty~:r~~;:~ons. cXCOO&&Si 5-5-0Y
) 0: Signature 1/ Contractor's License No. Date
I Permit Valuation :11/59 000,00 I Park Support Fee # $ PSa,()(}
I Permit Fee $ / ~ 0 7 . s"o I SAC # $ /3 'S (J , t) 0
I Plan Check Fee $ "J/~. Vi" I WaterMeter(""Slze~"; $ 25"0, t:'Jo
I State Surcharge $ - '7 tJ . 5" 0 I Pressure Reducer $ ~S-. () C)
I Penalty $ I City SAC and WAC # $ /ZQO. 0 "
I Plumbing Permit Fee $ lOt). t)~ Water Tower Fee # $ 70 (), Do
I Mechanical Permit Fee $ I ()t:J, 00 Builder's Deposit $ {~ao . 00
I Sewer & Water Permit Fee $ :35, S"""d lather $ . ,
I Gas Fireplace Permit Fee $ '1tf,()-t:J I TOTALDUE $ Jtf)'i~. ry
I Paid V.)"7..1.. j ,. tPtv'fJ/'
I Date 'c;;~ ~d l'
. (
This Application Becomes Your Building Permit When Approved
~ ~ ~~~y
Building Official Date
Re~Pt No.
By ...
c1
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~gf~ 5/~'{!'/ ~~ ~OOd~~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Main File
White - Buildinq
~y - Enaineering-:,
Pink - Planning
Thf Cfn'f' of thf l..kf Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
l? /2. /-ItJ/t.~.:n::JU
S. r;,. 04--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
!3C)OO ~.v 65>' ()/rjC /";17 OIL..
Accepted
K
'\.
Accepted With Corrections
Denied
Reviewed By:
M1-A
Date:
S" 2/--0(,}
Comments: See Rpvpr~p ~ide for .A.dditi~mlWRfe.rm3tion~
/YlCJ,"1\ P,'Il,
Main-We
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
Main File
White - Building
Canary - En~ering
(.,t-"mk .. - Plannli'lg:)
Thf Cf'ntt"r or Ihe Llkr Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
0. /2. /..ltJ/cTC/J
5" t:- "'I) 4--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.~~:CuO (.J E ~~I {..//Jc I-/{ 01'--..
Accellted
~
Accepted With Corrections
Denied
Reviewed By:
~ ."~
~
.......
~
aU
Date: s-4 t./ ~ ~
, (
~.
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
Main File
~hite . au~
Canary - Engineering
Pink . Planning
Thf C"f'nlrr or 1hf' Llkr Countl1"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
L?,eo /-'-/tJ~uU
S. ~. -04--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
5000 WeSt orne- pr o/Z......
Accepted
~
Accepted With Corrections
Denied
Reviewed By:
~
~~
r
~ Date: t)~/"2-%LOc./
aLf ,fio~ ~ '
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
Residential Building Permit Checklist
New Construction for Single or Two.family Dwellings in R.1 or R.2 Districts
Reviewed by: ~ ~~
Date: .S/~rft y
Building Permit #
Address: ..:5000 S""aa Z
I "
Legal: L-4-JO , B /
Existing Structure? YES@)
PID: Zoning:
,.
f)J~ C)aJv p~ ~ 5.S-.
Subdivision: ~ /tJ,g
Existing Nonconforming Structure? YE~
CONFORMS TO ZONING
ORDINANCE
. Yard Setbacks: NA 1 FAIL$?" C""PLlES"")
. Front Yard (can be 20' if av\i w/m 1 bQ')
. Side Yards
. Sidewall exceeding 50' requires additional side 2"
setback for every l' over 50' in length
I. Rear Yard
. Patio Door: provide for minimum 10' deck or sign
statement indicating no deck will be built in the future
. From 100 year flood elevation of wetland/NURP
pond
. From OHW (Prior or Spring Lake)
I Floor Area Ratio: NA 1 FAILVC6MPLIES'y
i Yard Encroachments: NA 1 FAIL~MPLlESY
Eaves and Gutters no more than 2 feet in width and no
closer than 5 feet to a lot line (Easements).
AlC and other equipment cannot encroach on interior
side yards.
1 Tree Preservation( WFAILS 1 COMPLIES
. Total caliper inches
. Permit 25% Removal
. Caliper Inches Removed
I. Caliper Inches Preserved
I. Replacement
L:\TEMPLA TE\BLDGLIST.DOC
YES
Standard
25'
10'1
25' if abutting a street
10' setback +
2"/1' over 50'
25'
10' sidel
25' rear
30'
75' or setback average of
adjacent structures, but no
less than 50'
.30 Maximum
Standard
Standard
Y:z:1
NO
Proposed
Z S · 53 '
dJ 5".9? }J I n-tw- -^ () tIr
-
~S/- 5: 8izcn.- 6+
tHr-
A.J~b
JV'i
;VA
I Ptt 0 .
Proposed
~(j,..J6
fJD ,..J~
Proposed
,p, 3/9
............ .......ec'd
(Pl~e tyPe or pf!n( and sil1J]. at bOIIl)J;D)
. ADPRESS .
1JbDO lAl ~ V?f;f( PO)' Yl+
,
i ~~~ ~~ I PERMIT NO.(J~.()U6W
3, Y.llow AppliQlllt ""!' · "1-f-'
bY2- s& I ZONING (officnsc)
LEGAL DESCRIPTION (office use only)
LOT [0 :aLOCK I ADDmON 'Jlj)~f;1 pj~ 17M nJ PID
OWNER
(Name) DR Horton Custom Homes (phone) qS2,q'i(.~ -7lS!JO
(Address)
2.O'SloD J(eVlB~l r:-:-P. Co Sre.! DO
, APPUCANT
(Name)-G':'~,:"'_Py~.::: "DJ"~'\...of ~~ 1:. t~>ntiJl.g
(Addr~s) 14745 So Robert Trail
(Address)
(Contact Person)
udu:v II Ie.. iA.A t.J .6 mLl LJ.
(phone) .....6 ~ 1 _I. ? '<_ 1 1 ~
Rosemount. MN
(City)
55068
(Zip Code)
APPLICANT SIGNATURE
,e
Quantity
1-
I
\
~
1
I
I
1-
(Phone)
651-423-1144
DATE
APPLlCAJ.~ PLEASE COMPLETE BELOW
, Type of Fixture
Rough~ins
Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
Backflow Assembly
Back:flow Assembly Test
I Lawn Sprinkler
I Other
FEE SL..tl~DULE
Industrial, Commercial & Multl-fanuly 1 % of job cost With a $3950 minimum Resjdenual, New One & l\Vo-Fwmly $99.50
ResJ,dexuial, Additions & Alterations $39.50
Type of Fixture
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 comp.... w.ent sink
Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
Quantity
,
I .
~
. I
PLlJlV1BlNG PERMIT FEE
STATE SURCHARGE
TOTAL PE:RMlT FEE
Budding Pe:mut #
$ . ..-:At\r,';\ ~.N~ir~rc ...-:r
$ ;~~~~~\\ II
$ \Oij\;~
Estunated Cost $
(ornce Use: Only)
This Application Becomes Your Building Permjt When Approved
I
D) ~~ l): u \\j ~ '":\.1 Reccipt No
I - DJffN 0 2 2004 By
Building Official
Date
24 hour notIce for all inspections (952) 44 '::98~O, fax (952) 447-4245
~y ~.
5: 10PM
GENZ RVAN PLUMBING AND HEATING
LITYOF PRIOR LAKE
SEWER AND WATER PERMlT
No.9875 p, 2/9
Uate .f:{ec'd
(please m>e or 'Pnnt and WMa.t bottom)
ADDRESS
~DO vV. VCiJt '7m Yli !JrL~ r;
i. ~='" ~~. PERMIT NOa(JIJ. (J~~~i~
3. Gald ~1l""1 ~ .. "7-{
, ZONJN"G (~ffil=ll!e)
LEGAL DESCR1PTION (office use only)
LOT I 0 BLOCK I ADDITION
~etL-hvlhS
Pro
OWNER
(Name). P? ~O&--~'.l.,:,,:,,:,~ !:!QEe:
(Ad.dt:ess)
20&00 ~1Oi<-\D6e.. Cr SW.I'\["
0cld:eS$)
(phone) _
LaJ.p__'J I lie...
(City)
ct62 ~q'65-18 6/\
.&Jet'~U
(Zip Code)
APPLICANT
~~~ Genz-Ryan Plumb~n~ & Heating
(phone)
651-423-1144
(Addr~s) 14745 So Robert Trail Rosemount. MN 55068
(\ (A~ss) C. ( (Ciry) (Zip Code)
(conu. ct PeIson) _ ~)h tei\~t7 f vt[ ~ ~ /I _ (phone) 651-423-:-114A I
. .~JCANTSIGNATtTRB 01 f~~) ~J DAn Le..l.1.-/1JL1
.. f
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure feet.
Type of sewer pipe. 0 ABC 0 PVC 0 Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at. feet from structure.
FEESL.n.EDULE
Residentlal sewer and water line connection $35.50 Industrial. Com'l & Multi~famlly 1% of job cost with a $39..50 minimum
Sewer connection only $17.50 Water connection only $17.50
Estimated Cost $
Building Pennit #
~lf'\~* ~
~~~\J~~~t
~~
,.p' ..-
J.
~
SEWER AND WATER PERMIT FEE $
STATE SURCHARGE $ .
TOTAL PERMIT FEE $
(Office Use Only)
This APPUclltion Becomes Your Building permn When Approved
.
~
Building Otndal
Date
_/
~dl0 [E 0 \!I ~ . Receipt No.
)a9UN' 0 2 2004 By
..-'
24 hour Dotice for alllnspectlons (95'2) 447.lJjo, !ax (952) 447-4245
-'--,
~' 1!tf3
CITY OF PRIOR LAKE Date Rec'd
HEATING/AIR CONDITI0NING/~'1HEPLACE PE . T
(Please ~eorprintandsign atbuu.u...)
ADDRESS
1. Pink
2. . Green
3. Yellow
File
City
Applicant
PERMIT NoJ/,II..f!l
5000
.A~~+ ()CAk pf. Dr S[
ZONING (offiCe use)
LEGAL DESCRIPTION (offic~l.iseon1y)
LOT
BLOCK
ADUITION
Pill
OWNER D RHORTON
(Name)-_ 20860 KENBRlDGE CT
LAKEVILLE, MN 55044
(:h{d:dfes~)
(phone)
APPLICANT ALLIANT MECHANICAL INC
(Name) 3650 KENNEBEC DR
. EAGAN, MN 55122
(Address) - 651-452-2775
(ContactpersonJ,A ~Y'1r.JBu. '- h~. .-
APPLICAN'TSIGNA~.~~ (~~..i!.- ~
(phone)
(City)
(phone) X ~1.3
DATE l.l/;g"~c./
(Zip Cbdi::)
~W~~"NSTRUCTION . DImPLACENiENT.
FURNACE MAKEA1'il)M8Rt~:tVY4J\*3SO M/tU O,160S0 .
FLUE SIZE ~"ff)Ci\-'~~O}>ENINGS GINPUT 80frlJ1rl
TYPE OF S1f$r.Ji'EM HEATING OR POWER PLANT
DALTERATIqNS.
FUEL A)(r
OUTPUr73.1t1 &H
...A.p.P.EI€~T PLEASKCOMP~ETEBELOW
ow arm Air piiints
OGJ'avity: .... .
I3Mechlinic8J .
~ii €bn'4i~ioning
...0Yenr\'S~st~ .
", -.,........ .... '.' '-",.
o Steam
o Hot Water
o Radiation
o Special: E?evices
o Other Devices
}>>LE^S;~!8~~:.. ".
.. Afr'Cbrtditi6ttet,l.Jnits
Gannotr:g(;t;().~chjntO
Required'Sige'r.'ard
Setbacks . .. .
.~ ", -' -' .. ' :'-; . . ".'.:: - ~ ',.......
FIR.EPLACEM.AI<E.~@,!:~~19~EL '.
Industrial, CommerciaL& Multi-Family
FEESLtlEDULE
1% of job cost Residential, Gas Fireplace
$39.50.minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ Building Penn it #
HEATING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $
."""'-. &~f'I-'
'~.;''':f" 1,7 (liL~"~'""">-.
'.. .:f' ~."I'I" "'., f j_"
~:,_.J"~ V,.-,
., i!:J~!.~~j Iftr:-::;';- fJ
~::;.~~'11"'7<1;..
.',';"1,;) r
(Office Use Only)
Building Official
Date
'~~ ag ~ U ill ~ ~ ':ceipt No.
te JUl 7 2004 ~(
(j---
()
This Application Becomes Your Building Permit When Approved
24 hour notice for all inspections (952) 447-98 &yfax (952) 447-4245
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
i ~:~n ~::y I PERMIT NO. ~ J.. ~ IQ1
3. Yellow Applicant ",' .,,-, II
(Please type or vrint and si2Jl at bottom)
ADDRESS
ZONING (office use)
5000 W. OAK POINT DRIVE
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name DR HORTON
(Phone)
(Address)
APPLICANT
(Name) ALIJED FIRESIDE DBA FlRESIl]:F': ?EARTH & HOME
(Phone)
651-633-2561
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone)
651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
6/29/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D AL TERA nONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
DWarrn Air Plants
DGravity
D Mechanical
DAir Conditioning
DVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND'MODEL
HEATN GLO SL-750TR-D
Residential, Heating & A/C (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
Industrial, Commercial & Multi-Family
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
$39.50
$39.50
I'. (::11 "
~!"o ""l;;"'?'\
I,.J~J ~.i',' ..:..J C.~I'~
~~ v';j~)
~~~
"t):~...
v.1.; v -
Residential, Additions & Alterations
Residential, AC Only
(Office Use Only)
Buildin!! Official
Date
ErE @ rE a \!J U:~iPtNo
JUL 7 2004 't>
This Application Becomes Your Building Permit When Approved
-'""'
Ii
r
24 hour notice for all inspections (952) 447-9850 fax (952) 447-4245
lBY- -~
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS .5000 WE-SI (}/1~ pO/NT 0;::'
NATURE OF WORK SPA
USE OF BUILDING Srrr
PERMIT NO. JJ~. ()44 I DATE ISSUED 5. 'ZAf--,o4--
CONTRACTOR .D /z.HO/Z.70J.-i PHONE 98b". 78.33
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I
I FOUNDATION (Prior to Backfill) ~~?.I W4// ~p I e>~~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS II
'SEWER I WATER I SEPTIC [/I Ill. (r Il-o,;\ .
~RAMING ~h-aff~~ nIL "If 7~/M I1t!f .7/J,o /py
INSULATION /H'ft' 7~~r
ELECTRICAL '7 /t.~/~'I'
PLUMBING (}(5.111/ 7/7/p<j ~ . ~(D'/
HEATING (if required) "I J!" I 'J4/~'f.
FIREPLACE I /114. I ~
GAS LINE AIR TEST !ft:h -I f ~ 7IJP!tJl!
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding) ~ /V'S
BUILDING ~4' (;(), /I"~~~ /#--
ELECTRICAL '
PLUMBING
HEATING
-
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOOTING
1Nvcr)'
//.~. 04-
.#f{
11/I/
/fLY
FOR ALL INSPECTIONS (952) 447-9850
DATE
s- - t.G -(}./
..
9110/' /QS;
-Vz/k!
f!IJfa'l
~~
~...-
QIertifirate of (IDrmpanrll
CITY OF PRIOR LAKE
~tparf1tttnf nf ~uil~ing Jf nspttfinn
f Final Permitted D Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 110 of the D Residential / D 1nternational
Building Code certifying that at the time of issuance this structure was in compliance with the various
ordinances of the City of Prior Lake regulating building construction or use. For the following:
Use Classification
SINGLE FAMILY
Bldg. Permit No. 04-0491
Occupancy Type
Zoning District R 1
_ Type Construction
Legal Description
LOT 10, BLOCK 1, DEERFIELD 10TH
Site Address 5000 WEST OAK POINT DRIVE
Owner of Building
Contractor's Name & Address D R HORTO,~h/
ROBERT D HUTCHINS ~~
Date: ~~Ik~cial '
City Planner JANE KANSIER
Date:
'.....'
'.....,. ,,__ ~'I."..._i.. :;_~ IIIIiIiIlrIii m..
--1
~ -is'
~w~__.
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED .9//.-?ftf/'
/ "11 I
~CJOQ 6d~s ~ c?~/- // a
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o~ - 7/7'/
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~MBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~_/ /
~--i?hc~~, re,
l /
r~'T
....
~~
h1<l- /1
- /'
CJ/C.
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FO EINSPECTION BEFORE COVERING
Inspector: fi.
.....
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
?lllql.P~
5000 W65T Ofrt::. PT 012-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
.....
~\ /
,y/ j/f c:e I
.. -
/
Ole
4-.9-4/
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
--------
,)
I'LOS'€-. /7 /~ /
~
/J/f" /
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
rZ:# TalE
CJ--G~ I Q, k /-/ A
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
5O~a
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
..,41...FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~CH FINAL
COMM~TS)f i -'" /'
r/crrP-C~",",,/ 4~ I do-r--e.
(j~- ~9/
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
~REPLACE FINAL
o GASLINE AIR TST
o
/ /-'
f?:/.2//GY
~ /
./7,~t'f"C~ ~J-. (
I~/ / .~./ /
/:Z..edt. .. ~ ftjl r <;;9(< /1~
/eX" ~<;.r- %JT _* C)r17~€
____./ .#I'
~h~/ c:J/c
..-~ ~ ~ ~./
/-cpYJr C': V" ~p7
, / r'l
~ / /" /1/ 1/ / ~ /
{!J/%?ed ~)odf- #e~5 t:}f7cr f{,l.fI"l ~e-
o W~RK SATISFACTORY, PROCEED ~~ V~ I
~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
,,'
cPtf
///
/t'//I"Of/ .
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE nME
CITY OF PRIOR LAKE
INSPECTION NOTICE
LI ~I.t; -0'(
ADDRESS ~ Wt,S+ OL;K II~ D/.
OWNER CONTR. D R.I-/u.r /..,,,,,
PHONE NO. PERMIT NO. fit! - '171
SCHEDULED
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
Jt.~ILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
bl"c./k- "or'
,
Culb I~,,_~ 0 K..
II WORK SATISFACTORY, PROCEED
, d CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
./7.4 / 4'
Inspector7~~/
-.....
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOn
If\ \
C\,
.
~
APPLIANCE
PERFORMANCE TEST
Attach to gas line adjacent to regulator
Heating ContractorU~;4'? A~
Name otTester 4".,L5
~
Date
Job Address
Heating Contractor
Name of Tester
Date
Percent 02
Percent CO
Percent C02
Stack Temp
.5U It/-/AIC
/14~~
~$
~k,.
1, C;-~
(p,fJ'
/ tJ7 ~
Combustion air is adequately supplied per
UMC Sec. 606
input
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