HomeMy WebLinkAboutBldg Permit 04-0561
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Main File
Mc-.,,~ M= 1.tL
Date Rec' d
S. ;1. oct-
I. White File I PERMIT NO
2. Pink City . ^~ 05/- I
3. Yellow Applicant c.;-r- W
(Please type or print and sign at bottom)
ADDRESS .
5003 ~+ M11ld brl~;sE
LEGAL DESCRIPTION (office use only)
LOT I i BLOCK ADDITIO'N ~~'i ~lcL '0+1-
OWNER
(Name)
(Address)
BUI~ '::l
(Name) 1-):R.. ~ mIOY\ -::J:n t.--.
(Contact Nam~\~.~ ~~ou.:t k.D-.....
(Address)
TYPE OF WORK
~ew Consttuction
OLower Level Finish
ZONING (office use)
~/
PID.25 4-0/. 0/ tf, . ()
(Phone)
(PhorC;CfS~) 9~S~i8~
(PhonZ9S~~ ~ - 'i 732
./
ODeck
OPorch
ORe-Roofing
ORe-Siding
o Misc.
o Fireplace OAddition OAlteration OUtility Connection
PROJECTCOST/VALUE (exc1udingland) $ 1"59., 133 I CIJ
I
I hereby certify that I have furnished information on this application which is to the best of my knowledge ttue and correct. I also certify that I am the owner or
authorized agent for the above-mentioned property and that all consttuction 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 o. r a der.' ee may
t~teruyn the property to P~rfO!=rl~~; d tf:XY5[;5 7 ~~/ 7 ~(J Lf
~Signature - Conttactor's License No. Date
~ U ~ ,~ ..~. C1Ct
I Permit Valuation LL:. - # OC ~ Park Support Fee
fffil,u_._ J
I Permit Fee $ .f J C/O] .~-o
I Plan Check Fee $, It.[ . 8B-
I State Surcharge $?t . ~ ""()
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
$
$
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
ItJo. DO
("0 . (!) 0
.. -
30 . ~"'O
tf.() . ~ CJ
SAC
#
#
$ !!4'J. ar;
$ /.3 ~().oO
$ ,
'2 ~. t:I(;
$ 'Is- .t:JO
$ !~.t:J6
$ 700. 06
$
/,~
$
I Paid
I Date
{';t-.;.- /1'1 -:J r- ./
){.:J /01.' cJo
ft, ./ d-;:}-/ 4'
t
$ 8/572 .38
d I g'lJ7
Receipt No. 4 to '
j
By ()
()
6 -tf -(;) c..j
Dale Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
..-
Water Meter Size~\'; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
Builder's Deposit
#
#
Other
I TOTAL DUE
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
iss~ f) ();)
~PlanningDi~
See ~ain File
White - Building
~I"Y-- Engineer~
Pink ~ianmng
The e.nle, of the \.oke ('ounlFY
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
'lr:t:'crol
~
I). Jc. - Hv rt::ro ~J
S.lei.o4--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
c::: (h- '. '. . -. ro-oo;-- /".' P"
~ ..J U <:; \, ,,) I:;::S I () l\ Ie t
DK:- .
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
;yI}fly
5~~_ /l7r:./", ~/'I(
Date:
t-q-o,-!
.
Comments:
"The issuance or granting ofa 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 notbe valid."
See Main File
<.... White '- Buil~
. Canary - Engineering
Pink - Planning
The C"f'nlt"r of the L.kt Count'")
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
@ D.~.rtotlA()tJ
5.,q.04--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
500~ W5~-r OAlL P'I
D~.
Accepted
Accepted With Corrections X
Denied /l f _________
Reviewed By{L{J ~r
Comments:
~ ~ ~({e{,otJ ~~
S~ ~ M.D-~V\.Pi 0
Date:
t,-4'~'1
"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."
r.
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..
i
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See Main File
White - Building
<;aDarv - Engineering
C Pmk - t"lannjng )
The ('rnler of the Like Countf)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME'OF APPLICANT
APPLICATION RECEIVED
,4:0'"
~
L). Ie. r+c Ie ( () t-,)
,-' r 4--
-=:;;, /- I , C
...
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
S ( C I?; \ j E :~-T () f \ Ie.... PI" 0 L .
Accepted ~
Accepted With Corrections
Denied /l 'lIP tJ
Reviewed By: t:2P It:b~
Comments:
Date: ~ - c.f-c; y
"
.,,--Y-
..---'
"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."
Jun, 1.2004 5:18PM
GENZ RVAN PLUMBING AND HEATING
Cl.t. i ,OF PRIOR LAKE
SEWER AND WATER PERlVul
No.9875 p, 6/9
Date Rec'd
(Please type Of wine and sm:oae aouam)
ADDRESS
fjDDJ
i ~:f., ~.;, I PERMIT NO. J I.., c'l --
3. ~Jd A.\IPII.....1 .., .::lJQ..
ZONlNG (~ce we)
LEGAL DESCRIPTION (office use aDly)
LOT J1 BLOCK ,f ADDITION
W I ()~ pnrrlt tv _S73 '
wl211 eLJ I D-fh
;), .
Pro
OWNER
(Name) -1'9, SQ.~t~r.. ':".'O;-"'om Home,;
(Address)
.2oSDO ~i3[<"\!X:e.. C:r Sn:>JM
(Address)
(Phone) _
LaU\J i ll~
(City)
g6.2-Q8,5-t8o/\
~'E.:rJWU
J
(Zip Code)
C APPLICANT
(Name) Genz-Ryan Plumbing & Heating
(phone)
651-423-1144
I - -
55068
(Zip Code)
651-423-1144 ; i
~ (~/I /04
(Address) 14745 So Robert Trail Rosemount. MN
(Addre3s) ~ C, (City)
(Contact Person) '. r. h f2,.{ S~ 1 "\g.-[W.. (phone)
'.ICANT SIGNATURE U1J~ ~i...t',<} DATE
'".
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.
ReSIdential sewer and water line connectlon
Sewer connection only
FEE St..:t:lLDULE
$35.50 Industria!, Com'1 & Multi-fam:/1y 1% of job cost with a $39..50 minimum
$1150 Water coonection only $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE $
STATE SURCHARGE $ ,
TOTAL PERMIT FEE $
.50
~') .~
"fJ A '-''fl.?
'Yf'9 A"".,. ~l'.,
~,~ V~!'/':
.....i~ ""'vh,,?
I!...,,'t::.>~./';/
,,~'V
, "-,;./'
. '. h
f ""0j~,:,>
(Office Us~ Only)
i
.....-
Building Official
r~rr([g ~ n \TI ~ P Receipt No.
lEe ..-' ,By
, .Dm N 1 fL7nnLj
14 h... ...'" ,.. .n ,up""'" (952) 447- i ,ru (952) 447-4245
By
~
This Application Become! Your :BuHding Permit When Approved
2004 5: 18PM GENZ RVAN PLUMBING AND HEATING No.9875
CITY OF PRIOR LAKE PLUMBING PERl\'llT
.p. 7/9
vale Kec'd
1 lllue PUe
2. Gold City
J. Yellow Applic>m
I PERMlTNO''''S~J
(Please tyne o:r 'Ol'Ult and ,ilM a[ bottom)
ADPRESS
VXJD~ \! f I DC[~
PDi nt
ZONlNG (ofiiceuse)
~?S&.
LEGAL DESC:RJ..t' uON (office we only)
LOT }~LOCK I ADDmON '~f1 {2Jo( (D+Vl .
PID
OWNER
~~~ DR Horton Custom Homes
(Address)
(l?hone)
962' q;;.f:) -,lSlJ()
ZOblvO Kev1B~l ~ CO' Sre. I DO
Ut k...L V tl Ie... M.-j rJ 15 cell r..J
APPUCANT
(Name) Gen:z-~':"1 :?l"RlQirC ~, u~...t'1""8
(Address) 14745 So Roben Trail
(Contact Person)
(phone) ;, c; 1 _/.? 1_ 1 1 /, /,
Rosemount
MN
55068
(Zip Code)
OM ~if-h FaJ{ I
C),J.A '-i/)':h)
(City)
'faJ ~e) DA~51-~/;ln4-
..1",""
APPLlCANT SIGNATURE
Quantity
t'J,
I
l
~
~
I
~
APPLICANT PLEASE COMFLETE'BELOW
I Type of Fmure Quantity
J Bath Tub with or without shower
Dishwasher
Floot' Drain
1 Lavatory (Bathroom Sink)
I Laundry Tray (1 or 2 compat1lnent sink
I Shower Stall
I Sinks
J Bar Sink
I Water Closet (Toilet)
Type of Fixture
j .
~
I
Rough~i:ns
Water Heater
Water Softner
Stand Pipe (Washing Machine)
I Sewage Ejector
I Backflow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other .
FEE SCHEDULE
Indusmal, Commercial & Multl-famlly 1% of job cost WIth a S39.50 minimum Residential, New Ont: & T'wo-Farmly $99,.50
Residential. Additions & Alterations $39.50
(Office Use: Only)
'.:-~.
Building Pennit :I
;'-. ~';"h
". / '^i.{;I;'"
V<.?:fJ-vf!?
'~~0;
,~
}'J.i '}"
'i/~
Estunated Cost $
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
Building Omelal
- rffFr ffi ~ \ff-~ ~\,I Receipt No.
, ~ ) !)ate- By
- I "
. D:ate .~ JUN 1 5 ?nn4,
, ~I '
:24 hour notice for 9.11 inspections (9SZ) 447. 0, fu (952) 447-4245
4
u
This Application Becomes Your Building Permit When Approved
j
,8 Y --:;=;
-
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERl\tUT
91rt.te~~c~~
L Pirik File
2. Green City
3. Vellow Applicant
PERMIT NO, '-1'&'/
(please.typeorprint and sign at bottom)
ADDRESS
.5003 \Alesf Oak /)+.11'. S E-
ZONING (offiCe use)
LEGAL DESCRIPTION (officeu.se only)
LOT
BLOCK
ADI)ITION
PID
OWNER D R HORTON
(Nam~)_ 20860 KENBRIDGE CT
'i.< LAKEVILLE, MN 55044
~A:d,ares~)
AFBEIGJ\NT ALLIANT MECHANICAL INC
"C&a.hi.e}' 3650 KENNEBEC DR
EAGAN, MN 55122
(Address)_ 651-452-2775
(Co""'!<ltPmoh) .~j~l)lu.GiA - ."
APPLICANT SIGNATURE. \ .~ (~
(phone)
. (phone)
(City)
(Zip Code)
(phone)
')(2/3
6/lg/e4
DATE
,e:]~bWS~J.(S'fRUCTION' OREPLACEMEl-FF.. '
. FTJRNACEMAK.EANDMOPELglVO-~ -r 1S0fitAvo:U~O$O
'... . '.'C.,." ..' f
FI..DESIZE1jIJC. '~\I1IRN OPENINGS b 'INPUT <9o~nlT
TYPEORS;YS!I'EM HEATING OR POWERPLANT
[],ALTERATIO.NS
FUEL' . lYe;-
OUTPUT --TJMBJJ
. .' ,
, , '. ',' - .
',~~LIGi\.NT PLEASECOMJJJl,FlrJiJBELOW
:......:....;.'.,-.,..,::-.-,. '.'
,DWaimAirPiants
OGravity . ..., .
D Mechimical' ..
~irConditioning
Jd!'ent.SY~ern
PLEASENQTE: ,. '.
Air,Cbriditioner Units.
CannotEnci-oach intO
Required Sige Yard
Setbacks .
DSteam .
o Hot\Vater
o Radiation
o Special'E:)cvices
o Other- ])evices
,"";";""':"-',:"-:',::-,:_-.
FIREPLACE MAKEA~']),'MOE>Et .
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
$39.50
$39.50
Industrial, Commercial & Multi-Family
Residential, Heating & AlC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
; - Pt;;,7>> r,/'I""---
""''' r~. .. if, < ;i:J".a
-,-1'/1.1[;,",';')" '" Ii V 6'rJ
.,)"."~.....~"",,,
.~ 'J"~. ''''/:;'''ll'~
. ''''1';, ."U~4
"'.~'{!/I (
(Office Use Only)
Building Official
p m--~-@ ~ 0 \JJ
I It JUt
.L
24 hour notice for all inspections (952) 447-985~ fax (952) 447-4245
,By
Date
~~ ~ipt No.
B~ '
7 2004
This Application Becomes Your Building Permit When Approved
~
{t'
V
Page 1 of2
Lynda Allen
From: Christa Wegwart [WegwartC@hearthnhome.com]
Sent: Friday, July 23,20044:17 PM
To: Lynda Allen
Subject: Prior Lake Permit
(";'1::
.~. ~~D V'.~
~ rs (rU rs 0 \D \_~ 'I r' jfJ:JJi~ ;"t.~~
u l1 l.!:'J 1.1; i 1\ "~~~~"t"
Ii 4 I4W:.J~
- JUl 2 6 2004 _j . ..
CITY OF Pl~ L.~
HEATING/AIR CONDITIONING/FIREPLACE
PERMIT
D
I. Pink File
2, Green City
3. Yellow
Applicant
~1J,G7,1
PERMIT NO,
(Please type or print and si~ at bottom)
ADDRESS
ZONING (office use)
5003 W OAK POINT DR SE
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) DR HORTON
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE CORNER
2561
(Phone)
651-633-
(Address)
AVENUE
2700 NORTH FAIRVIEW
ROSEVILLE
(Address)
55113
(City)
(Zip
Code)
(Contact Person)
2561
BRENDA HUSTON
(Phone)
651-633-
APPLICANT SIGNATURE
04
BRENDA HUSTON
DATE
7-23-
APPLICANT PLEASE COMPLETE BELOW
X NEW CONSTRUCTION REPLACEMENT AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT
OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
Steam
Hot Water
Radiation
Special Devices
Other Devices
PLEASE NOl
Air Conditione!
Cannot Encroa(
Required Side'
Setbacks
7/26/2004
PRIOR LAKE
INSPECTION RECORD
Ol~ pi-
M~ t:'~
DEPARTMENT OF 1\11 0;0 File
BUILDING AND INSP!~
SITE ADDRESS 5cO:5 (JeSt
NATURE OF WORK ~
USE OF BUILDING ~1="r)
PERMIT NO. t?4--, 057P1- DATE ISSUED ~ -l/-(!J'-I
CONTRACTOR l'Jl Uc,t-~A PHONE Ys;;L""'-4,-:5l.trJi~~',
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
, .
, INSPECTOR DATE ...
FOOTING tN'/c. ~ 6ft~Y
FOUNDATION (Prior to Backfill) t.o-/t:. I . A>v/-( i ~-t;/ I {~:r '
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER/WATERISE~1.'IC ,m ~~~~
FRAMING~i (Ji~~Ii~ ~ ?P~r . #?p j-//?/"f
INSULATIONL.L d/ ~~/ftz./ /I~;'/et/~/ #~ ~~F
ELECTRICAL. . . , .
PLUMBING tJ, ~ //t1 ?h2/at/ //D-. ?P~C:7
HEATING (if required)./ l- ( ~~ i ?'# .?/61 .
FIREPLACE .;2 v/"/is.~ ~ o./iVoL.(
GASLlNEAIRTEST~/,h f~/~ ~JY~~~
,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINA,L~
GRADING (Prior to Sodding), l/ate
BUILDING ~~~ C:CJ, L447; ) /~~tI~/~V
ELECTRICAL '
PLUMBING
HEATING
9Iz3/~ .
HIP Wff/tO'
'?prU
ftt/j- /~ s1P</ .
~ /o//,f-M
. ~./
UNTIL ABOVE HAS BEEN SIGNED
NOTICE
...
DO ~OT ~CC~:Z
~r h~,-e.-( "5 )-5h,rA-t.
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
<!lrrtifiratr nf <IDrrnpanrll
CITY OF PRIOR LAKE
~tparfmtnf nf ~uil~ing JInspttfinn
"Winal Permitted 0 Conditional c.o. Expires
This Certificate issued pursuant to the requirements of Section J J 0 of the D Residential / D 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 04-0561
Use Classification
Bldg. Permit No.
Legal Description
Type Construction
LOT 14, BLOCK 1, DEERFIELD 10TH
Rl
VN
Occupancy Type
Zoning District
Owner of Building _
Site Address
5003 WEST OAK POINT DRIYE
Contractor's Name & Address D, R, HORTON
ROBERT HUTCHINS 4.8
/ Buildin~fficial v
Date: . q.; V /0 ) -'
, /~} ,
City Planner JANE KANSIER
Date:
~
, .....
~
...:._-_.-
............... .
.......
DATE TIME
?~~S-
I
SCJ03 tJes~ ~k. p,L
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:
~ /
/-/...-r ~ /
C)~ -'-S~/
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~/
C/(C
..J -~_.~_., '-'.
,.---~--- -.:'
/~;~e h/e )
~ORKSATI~CC... ~
/ ~ ~'ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR INSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETYI
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
_5003
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
...Jl-FlNAL
o SITE INSPECTION
DATE TIME
SCHEDULED ~~~~
U/~jl o~1 //
CONTR.
PERMIT NO.
~,sb/
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~CH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
~REPLACE FINAL
o GASLlNE AIR TST
o
COM8/lE~S: ~ / ~ , . /
~~P,~( ?i;;~/ ~~~ r,2Jz#l<~4
().J .~;t' ~e4:~ ~1~/; /}<Qt:
.~ f/q/;;e.s. @ ~I""L ' ~ / d
~ j /
I~~~~ ~~~( / / / ~ /J? .
(()~,:' .~X d~ rr:'5r.~~;';~.
__. ,/ / .". /i / I
~ ~~t,.~ h-~b;7 ~p1S f~ C/-e'~
~../ /' , ,- / /)/
0/ #.,e~d ~ + .p-~~s ~--rfrr
5;,~/ tteJ!;/~ ~~.P'r.r?~ /
. ~ ." // /' / JO
~t/. W G/~7;/, ///~C/~V
/ ,
o WORK SATISFACTORY, PROCEED
~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.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INmOTI
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
.f-l.J~
5"~f-~t II. fJr,
CONTR. j.~~
PERMIT NO. c;l/- S,/
o PLUMBING RI ~ING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
SCHEDULED
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDA liON
o FRAMING
o INSULATION
JB4o&NAL
o SITE INSPECTION
COMMENTS:
(7r~,t,( - ~K..
Cv(.~ &1' - 0 I(
"
5.;-1
C::~:WORK SATISFACTORY, PROCEED
o CORRECT 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!
_011
COMMENT~ / /.
///V#7 ,6/~c;..
,_/
'/
/$~~o~e h.--
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
-.50CZ]
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
-P/' / ~
C/~d?-~ /
DATE TIME
SCHEDULED ~~~~
&/.;~/- 4~ /~
CONTR.
PERMIT NO.
~0-56/
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
::.'~MBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
---- /
~~q/
- I
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-... /
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all.4'cPC'r! /f-/ru
.7 .0', /
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G/ /Le'CJ~ ~ /~/ /0/ rtr // t-..,
J
o WORK SATISFACTORY, PROCEED
rRRECT ACTION AND PROCEED
o CORRECT WO~~ff;l:9R REINSPECTION BEFORE COVERING
Inspector: ,/ // ~ Owner/Contr:
CALL :7-9850 foR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNon
Job Address 5tn3 iJ. (})4L
Heating Contractor ~ P1~
Name ofTester -.&1'tJoI\."6.
Date
Percent 02
Percent CO
Percent C02
Stack Temp
/0-18-o't'
.fA 5"' 7~
,~^-J
$t~j'O
~.~
Combustion air is adequately supplied per
UMC Sec. 606 v..R5
~Cl;OOO
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