HomeMy WebLinkAboutBldg Permit 04-0829
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Main File
(Please type or print and silVl at bottom)
ADDRESS
;1Lj{P1l)oo-r0eJJ On'0L.
White File
Pink City
Yellow Applicant
LEGAL DESCRIPTION (office use only)
LOT l { BLOCK ( ADDITI~9i dd Lft'^-
OWNER
(Name)
(Address)
(Phone)
Date Rec'
7-d--~-04
PERMIT NO. 04-. 08311
w
ZONING (office use)
fl.Z-
'/
I
PID z.~. 4-'01. 011. 0
(Phone) {g~'fJ.5S-1B~"?:>
_ (Phone) ('1~~4702...
J La.sbv1'LLL ('r)N'SSJz/L/
~
TYPE OF WORK ~ew Construction ODeck o Porch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
''''LlAddition OAlteration o Utility Connection 0 Misc. S~ ON ~tt.A.cOe; - NO 1".', t-.
PROJECT COST/VALUE $ 1(9)Ot Lf
(excluding land)
CODE: ~.R.C. ' DI.B.c.
Type of onstruction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
I hereby certifY that I have fitmished information on this application which is to the best of my knowledge true and correct. I also certifY that I am the owncr or authorized agent for the
above-mentioned properry 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 buildmg
~~u: ~~s~ urthermore, I hereby agree that the ciry off4mJ~~~;the property to perform ne1 ~E):Oy
J Olgnature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
"1 Uo OO{).t)'lJ
$ I~q, SO
$ 75lD, ( 8
$ fo~.oo
$
$
$
$
$
loo,ElO
100. DO
35".50
lfO,OD
This Application Becomes Your Building Permit When Approved I
~Ot~ SlIIr;.t01
I Park Support Fee
I SAC
I Water Meter (Siz"e ~ll";
I Pressure Reduccr
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Paid ~::J77, ,1/
Date /,;, I~ fI"
/
#
#
$
$
$
$ &.f. ~ .lJ-l)
$ , "Z...Oc!). 0 0
$ -'00, 0 0
$ I~Oo, oe
$
r"3~o.o()
2.50.00
#
#
$7/370/.192-
4'71r~
/1
Reb(pt No.
;t
ThIS IS to certifY that the requcst in the above applicatIon and accompanying documents is in accordance with the Ciry Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner copwlUtes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a CertIficate of Occupancy must be
~;:t~ ~{Ibf:! ~ o.JJ.,~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Main File
t"-" '!'...it.. _ I=\uildiria::>
Canary - Engineering
Pink - Planning
The C.,nler of Ihe Lake Counlr,..
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. 12; H Or<w1O IV
1.~~.O4-
.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
114& 7
. ,
D~6"rLFI6<-D
0f2..1 Vb
/
Accepted
Accepted With Corrections
Denied
~ ~ Date: ?III j()<./
- f , .
R~CJ ru/ ~~ '
*........ '- -
Reviewed By:
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
White - Building
Canary - En9ineering
~nk ._- PlannlnjD
Tht' Ct>nler of Ihe I.akt COunlf)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
, I' I ~', ,
.. ,~.""_,.. .....-' ( ,\ J
L. --. I (1'-.1,-, i,/
-./ 7, (, (4-
. f... r.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I --I 4 t{ 7 C l J " r I L C I~ () I c I \j C
Accepted
Accepted With Corrections
/
Denied
,..
Reviewed By:
~
~ 0-<<
~, tit:.;
Date:
?/; I ~L/
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
White - BuilcHna
I...-.J.&narv - En~ineerin9)
Pink - Planning
The ('rnfrr or Ihe takr Countr')'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
D. rZ - H C/,(./() ~\J
-"-7 z. r: C 4-
. '0.
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/"74-(17 [)EElc-FIELt) [)Jcl\)[..
, r
Accepted
x
Accepted With Corrections
Denied
Reviewed By: _
1YfJ{3
Date:
~ - '1-0,/
Comments: See Reverse Side for Adciitionallnformationl
1l1u'n fc"r.. ErOJlO V1 GJ~/ro I ;(Ic,,'l'"'\. (,' Ie
See AttachJl1eJ1h~ 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."
. .' .... .... ClriOF PRIOR LAKE. j/195t'teRec'd
.1:t,I!L4:cI;:~G/MR CONDl'l'lONING/~'.lRE.PLACE PERlVul.
~~~, IPE~TNO. O~()B70I'"
Apphcant ..... '" .'. .: .....~ I .
.-' . .'.' ", ," .........", ....~':; : ":.:-. ! . '.'.' ..' .-
Residential, lIeatiIig~' ~q~~;9)nstruction)
. Residential; Heating O~ly'W~'~oristtijction)
FEE SL;t1EDUL]!;' . ..... .'
1 % of job cost ReS(d~tia.t~ Gas Fir~lace .
$39.50minimum".':' ..:',.':.:.,' '. . . .
$9950 Residelltial, Additions & Alterations .
$6450 Residential; AC Only
. Es~ated Cost $
Building ~ermit #
. PAID. W Il'H
.soBDlLDING.
$ .UIlRMI l'
ThI f{:' (r1) Ie n iIf1 ~
~~ Em~ Lb u U l,B I Kecelpt NO. .
J D~ltt' 1 U ZUU4 j By
$
$
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes.Your Building Permit When Approved
Building Official
Date
24 hour notice for all inspections (952) 44' ~O, fax (952) 447-4245 .nn
. .n._..n.J
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
~. :~n ~~~y PERMIT NO. AIL. 64-7(/
3. Yellow Applicant ~ "'....,
ZONING (office use)
17467 DEERFIELD DRIVE S.E.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name DR HORTON
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOME
(Phone)
651-633-2561
(Address)
2700 NORTHFAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone)
651-633-2561
APPLICANT SIGNATURE
BRfNDA H(JSTON
DATE
9/27/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
INPUT
HEATING OR POWER PLANT
OUTPUT
DWarm Air Plants
DGravity
o 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
HEAT N GLO SL-750TR-D
Industrial, Commercial & Multi-Family
FEE SCHEDULE
I % 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 $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
}.:;,:r'9,~~'~ :l,"',i,i-, "i<~;~
... ,.: ';'.' .'-;" \\~} ~ '1 i If
5,....1 'H "'" ."~'G:' p-. ~"\~r'"
. \1, _to":"; . >:-].'. "" ,..,....: . ,
... ..,...~,~ i ......f..l ".'
(Office Use Only)
Building Official
Date
I Receipt No.
By
This Application Becomes Your Building Permit When Approved ] eii4l5 I ri lJ m
D~E. p 2 9 2004
24 hour notice for all inspections (952) 44' '~50, fax ~52) 447~45
- _m'.~__'_~
JU!.,30,2004 3:44PM
GENZ RYAN SERVICE,
NO, 011
p, 3
Date Rec1d
CITY OF ,PRIOR LAKE PLUMBING PERMIT
(Plc:ase ~e or llrint and ,~ at boCttlm)
ADDRESS -
11LJ'1~d lYn_w
. ~
LEGAL DESCRIPTION (office use only).! 1/7 J ~. '_n
LOT ({ BLOCK , ADDmON ~~ efav
OWNER
~~e) DR Horton Custom Homes
(Address)' ZO'b~O KeVl B~! D6e... C T S,e I DO
~::~ ~!~ IPERlVIITNO.~.O.~
l, YlJlow Applic3~1 ..,..... _ U ~ I
ZONING (olli.c~ use)
IIrh
PID
(phone)
9~2 ~ q if ,f.) .-,8[)(J
4't..uvi lie.. V\A N E mLj LJ
APPLICANT
(Nime)J;~" ", llm1;,-j,t1g t" Rc"l-~"B
(Address) 14745 So Robert Trail
1 (~ddre~s)
(Contact Person) JJ, gc
. APPLICANT SIGNATURE
(phone) 651-[,,7'1-1144
Rosemount MN
(City)
55068
(Zip Code)
/1 (Phone) 651-423-1144 .f
) '-;[r; ~.X'L DATE "1- :?O/()q
1
Quantity
~
r
t
~
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture QuaDtity
Bath Tub with 01' without shower
I Dishwasher
I Floor Drain
1 Lavatory (Bathroom Sink)
I Laundry Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
Type of Fixture
l .
12---;t:
,
Rough-ins
I Water Heater
I Water Softner
I Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow' Assembly
I Backflow Assembly Test
Lawn Sprinkler
Other
I
I
I
I
I'
I
~
FEE SCHEDULE
Industrial, Commercial &. Multi-family 1% of job case with a S39.50 minimum Residential. New One & Two-Family $99..50
Residential, Additions & Alterations ,$39.50
Estimated Cost S
Euilding Permit #
Build!"!! Ot1iclsl
DSIe
S
$
.$
I~i~ r;: ~ \1J r; ~1 Receipt No
, L I DAtJG 1 'j ZUU4 By
n. IA.''''. .,'.~.w" .."
r7'\\1"'~ \:', III
~~ul,' n~".~ '-'-I"3'.'r. t"."
. --I.C:!<......'~",;~ ,~......' :';.\t~. ~
}
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMlT FEE
(orn~e Use Only)
This Application Becomes Your Building Permit When Approved
24 hour notice for all Inspections (952) 44' ~8S0, t:lX (952) 447~24S
..1-
JUL. 30. 2004 3: 44PM
GENZ RYAN SERVICE
NO, 011
P. 2
Date Rec'd
CITy.oF PRIOR LAKE
SEWER AND WATER PERMIT
q'lease ~e or print and sign at boltOm)
ADDRES1~101 twR-nf1J. &LSG-
~ ~~ ~\~. PERMlT NO,. A.L. A.~O
J. Gold ^ppli.... ~ _ "V6II/II
ZONING (o.ffi(l:\ISC)
LEGAL DESCRJPTION (office use only) ..... (
LOT II BLOCK I ADDITION 'l/J)'2/::' e1. eX. I (m
PID
. OWNER
(Name) DR tiort"'ln ('l1il"-:-- lk-'\',:,
(Address)
2oUDo ~1/I13\<..\ tX::e Cr- Sr7 .1 Ci'
(AdclrcM)
(phone) _ q62 ~q85-7..E.1.JD
Lakt." i\ 1(0 . ,?Cry..I U
(Clcy) (Zip Code) .
APPLICANT
~ame) Genz-Ryan Plumbin~ & Heatin~
(phone) 651-423-1144
(Address) 14745 So Robert Trail Rosemount. MN
~""\=~' ~. (Ciq)
(Contact Person) -' ~ Il~...~ (phone)
'T.,ICANT SI~NATURE 1j j -. ) 1:&.f!I/1 DATE
. ..
55068
(Zip Code)
651-423-1144 /
~-~
APPLICANT PLEASE COMPLETE BELOW
Size ofwater 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,
FEE SCHEDULE
Residential sewer and water line connection S35,50 Industrial, Com'l & Multi-family 1% of job cost with a S39.50 minimum
Sewer connection only S17,50 Water connection only $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PElUfiT FEE
$
$
$
P~D YJm-t
Oti.D~NG PERMfr
(Office Use Only)
Thi. AppU"tIon B.comes Your BuUdlng Permit When App..... I) IfW ls . ~ ~ It I\~l ..~ipt No.
t- Building OIDdll1 . Datc t _ ~ 1 I 2004 ~ By
24 hour notieo for all inspections (952) , 47-9850, f:ax (952) 447-4245
,BY
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-1 or R-2 Districts
Reviewed by: ~ ~ ~ Date: · C?/t ( ;'0 '-I
Building Permit # PID: Zoning:
Address~/7<f6 '0 17'/&:,'7, !7 'I 7 (; I 'N'?3 ~ ~S:E:.
Legal:L )IZ-,. B I Subdivision: i:J._. A 'If) /IJ-I- -
/3,''1' ~
Existing Structure? YES,@) Existing Nonconforming Structure? YE~
CONFORMS TO ZONING
ORDINANCE
YES
'Yard Setbacks: NA I FAILS!(C'oMPLI~
. Front Yard (can be 20' if avg. wlln 150')
. Side Yards
Standard
25'
10'1
25' if abutting a street
. Sidewall exceeding 50' requires additional side 2n
setback for ever{ 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 ofwetland/NURP
pond .
. From OHW (Prior or Spring Lake)
10' setback +
2"/1' over 50'
25'
10' sidel
25' rear
30'
75' or setback average of
adjacent structures, but no
less than 50'
.-
~ Floor Area Ratio: NA I FAILS{eOMPLlE~
,30 Maximum
-::.
Yard Encroachments: NA I FAIL~r:~LH
.
Eaves arn:f Gutters no more than 2 feet in width and nO
closer than, 5' feet to a lot line (Easements).
AiCandother equipment cannot encroach on interior
side yards.
Standard
Tree Preservatiorrr1NA) FAILS I COMPI-IES
· TotalcaHperinches
. Permit 25% Removal
· Caliper. Inches Removed
I. Caliper Inches Preserved
I. Replacement
Standard
%:1
L: \TE1tIPLA TE\BLDGLlST .DOC
NO
Proposed
2.-'5 ' L( f
~ S I er liA,r1J~- ,
d.Ul~ /.
< .. .,:.' ~., ""~~'l-' ~i1:;.;Ji:l.
~$t~t
~ ~~~::rt;~:"
~
d-
fJ~
I . (/u 0
Proposecr"?(.i: ..; '"
r-Jd
'~~~,i1
Proposed>.\"1.~,:,::;':;l t.
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS ~ J>e:cl(. F"iE:LD 'Z>ftiV-r
NATURE OF WORK ~ ~ iOA
USE OF BUILDING S'. ~ A.
PERMIT NO. _ 0.4-. () SVf DATE ISSUED .(JO/6&/
CONTRACTOR J)&.. ~"Of.\ t-f....c.. PHON~-"'n"
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
Main Fil
INSPECTOR DATE I
I FOOTING ~ I tf //1'/ () LJ
't " f'" ,,. ;.
FOUNDATION (Prior to Backfill) ........"l J ~.:;. c/r~~ /t~~~~
PLACE NO CONCRETE'UNTIL ABOVE HAS BEEN/SIG.NED
ROUGH - INS.# 1 /,1
SEWER I WATER I SEPTIC Ift1- Jr/ J If tJ'I
FRAMING N$ , ;"bl/tft/
INSULATION M /()/~s-/of
ELECTRICAL . ...., /(7,//;;/0/
PLUMBING (/. (5, ,;111 9/f~l, # R#~ /"p//or'
HEATING (if required)'Jr4"Hs,'fe I4f f/~(,~ ~ /o/.?//6r
FIREPLACE ;" )#-;j /tJ ~/ II,/, '
GAS LINE AIR TEST~;;' I ;:1-. ~ /tJP/,h~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I
FINALS r'."
GRADING (Prior to Sodding) / 1 /. IV , > (~ ~ ~ " 644
BUILDINGt:~d. eCJ'C/H~/ cY,.k/~$-~~~" lU!l1 ql/,,/oS
ELECTRICAL." ",// _ .)' / //f "N
PLUMBING '/ff. /~?py
HEATING ~ /#J7~
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.
FOR ALL INSPECTIONS (952) 447-9850
QIrrtifirab~ of @rrnpanru
CITY OF PRIOR LAKE
~tparfmtnf nf ~uil~ing Jfnspttfinn
I Final Pennitted 0 Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 110 of the 0 Residential / 0 International
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:
SINGLE FAMILY 04-0829
Use Classification
Bldg. Permit No.
R3
VN
R2
Occupancy Type
Type Construction
L11, B1, DEERFIELD 11TH
Zoning District
Legal Description
Owner of Building
D.R. HORTON, 20860
Contractor's Name & Address MI' ~
ROBERT D. HUTCHINS
_ _ City Planner
y ~9hS9-fficial v Date:
'/ '
17467 DEERFIELD DRIVE
Site Address
KENBRIDGE COURT, #100, LAKEVILLE 55044
JANE KANSIER
Date:
.'c.
.,
I; .,J... J".".I .' ,~
Ji.tW
_. -'_.:.........'-_-=fIM
'-
ADDRESS
/7'167
DATE TIME
SCHEDULED I~~~
(fet'r~(d /!A/
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~y-- ,D 9
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
IXPLUMBING FINAL
/0 ~CH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
/?./? / I 7 . /'
#~-'7flHt ~. /?/ Tzv /- c!:J I'C
iJl./f~e(//ffTU ~7f//~~/
~~ ~ / / . /~
~ hJ"L:'s- 4 /iA~~,~/~<, 7~
,@~1~~~~7;;J:;t' d,
-
;i3/ ,r/:'/;'~' /~r~>~~ ~'~/_/
._/ / .F'/ ~ /
L&./'''ft.. & /7v//c!o~~ .h H~ (
. /~
~)ORK SATISFACTORY, PROCEED
~~RRECT 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.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/7 Lft 7
.}k(,4"l,)1
OWNER
CONTR.
PHONE NO.
PERMIT NO.
[] FOOTING
o FOUNDATION
o FRAMING
[] INSULATION
"6UJNAL
'1J SITE INSPECTION
[] PLUMBING RI
o MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL
[] MECH FINAL
COMMENTS:
G/4~(- ~/L
Cu/b /<~_J(
DATE TIME
I J - Z2-&y
Dt'.
V.l Hr//lb'/'
~->>Z~
~~LLlNG
[] CO~T
[] FIREPLACE RI
[] FIREPLACE FINAL
[] GASLlNE AIR TST
[]
I'll. WORK SATISFACTORY. PROCEED
V [] ~RRECT ACTION AND PROCEED
[] CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
A'7 _ -4 -:::?
InspectorV' /"--)I/~ ' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
I_on
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OA TE TIME
ADDRESS
/74-&'7- 17473 .oe&eHGc..,o
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
/0 SITE INSPECTION
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
?;~ ~'NAL
COMMENTS:
-
~' /
rt';f/rC".r' I
,
A/
/^//L
4--8zQ
/
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~,..-..._---_.-..
.-----"_... ..~~-,._-
/ _/
( /";>'/c..5 e
~ORKSATIS~CEED
/ ~ CORRECT ACTION AND PROCEED
o CORRECT WORK, C;./;VINSPECTION BEFORE COVERING
'",pedOC /P-f..----' Ovnte,lCootc
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
4~\~
~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSJtIOTI
DATE TIME
/4/s.~r'
/?~~ 7 .o€er;J~4 ~
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
..' ,~.. ".J
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~CH FINAL
e>1'- ~'7
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
~LcL ~.,/; d
/ -/
//~"7 /
- ./
C/~C
o ~ e/ ":>cc/f
--
// 'c.eJ
./
, "l-<,&.-'11/.
/
./10
(I, c
'I /..../
Uh(:/
n/ /
5/~a5-
~ORK SATISFACTORY, PROCEED
~, ~~RRECT ACTION AND PROCEED
o CORRECT WO~K/ c;1.J:7R REINSPECTION BEFORE COVERING
Inspector: ~ I ...,....., Owner/Contr:
- -
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTr
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIME
CITY OF PRIOR LAKE . / _/
INSPECTION NOTICE SCHEDULED /..!/ / ~7;'y
ADDRESS / 7~7 A~,,~ 1/ ,.(j,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
tf"-/ - JY~ '7
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
~,~ P UMBING FINAL
,MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
~EPLACE FINAL
o GASLINE AIR TST
o
COJVlJIIEN;5: , _ ,/ K /
7kICTl"t~.'-':/ ~~4:'./ l'1h~~ ///f~,:1
~ /1 / .......-; ./
r;~-c./J/9~e. h~4 / C7?f ."1
~ b4-~.~ tP ~fl/ '~/d
" /' ...-../ A / / /" /
~v(, hj,~/ - Rc-c~,'u"d O~f-/-:sr-
/. ,A'/e e dan" AS/::' ~ .z:;. ~/ ~,,'4,;/ ~r-
~s /1r'~~ .-IJ#~c:. r;J) ~~~;- f
e:~,~~J //' C4~;""hr.. Qr~<.J~d
'!I?..../ 0fi~ ....~ ~~- ~ RC4~
-;, r;h~ / / .
~v L':./..,,-/'t if 7'/-.,- r, 0., ~~./;1 <?
~ St>c/ + 'ff-t-t:'5, r J .
'-s:) ~ ~,J ~r-~. /~~:'Cfl' /
o WORK SATISFACTORY, PROCEED ~ / ~! 4"Jr..!'.d~
~RRECT ACTION AND PROCEED L-. q. ? "7 - .
//CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ///"-.4 Owner/Contr:
-
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNS/iOn
.
,...
APPLIANCE
PERFORMANCE TEST
Attach to gas line adjacent to regulator
Heating Contractor .4 (1:1Ik ~ .l"J:I-
Name of Tester ..Cb rJ
Date '1-2,-e?<{
Job Address (]l('7 l) u.(' ':(-lJ_
Heating Contractor ~ Malt
r ,4n.,1
\ ^ - " - (J. "/
I J.. . Jl.. t;
J tftf"",
"", r 1:#4
5b? () f
Name of Tester
Date
Percent 02
Percent CO
Percent C02
Stack Temp
Combustion air is adequately supplied per
1eS
JO, Me ~.IJ
UMC Sec. 606
input