HomeMy WebLinkAboutBldg Permit 04-01047
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
9- Z8. 04-
1_ White
2 Pink
3 Yellow
File
City
Applicant
I PERMIT NO. 04-. } 04-7 I
(Please type or print and sign at b , .. ...<.)
ADDRESS 13<gS3 K~~
ZONING (office use)
12/
LEGAL DESCRIPTION (office use only)
,
LOTS BLOCK' ADDITION ~ ~-<I,.;
PID z..5. 4/3. ()()5. 0
OWNER . ,
(Name) ~~J t1y '- ~:':' f:: · - (Phone) CJ.5 ~ :J,.g,,(., L 76' '/
. (Address) J 4lJ3~~ L~; ~ ./JlL/-.s-~.3 /g'
BUILDER 1Ii::!it ;t;J~
(CompaoyName) n______ ' . -"<)J (Phone) .!1..("~. ~~~ fi:"'i!f
(Contact Name) _ _ _~ ~ (PhOne)~!{~?q~-(?'1'i-R-
(Address) ) LI__~ J J E:..I~ a\(. - . S . ~ ~J ^<7V--':1~~J I ()] A-J .~ <'~~
~. . IILJ.LIA-f!- I J" {.:-
TYPE OF WORK 1s(New Constru~tion ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
'tJAddition OAlteration DUtility Connection D Misc.
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
IIIIVVA
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE $ -I-1r. ~
(excluding land)
I hereby certify that I have furnished mformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authof!zed agent for the
above-menl1oned property and that all construction will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
:fi2 Z~ cause FlIlthermore I ere~y agree that the city official or a desa }ay~teson the property to perform needed mqec:n~ J -D
Sign"at\1r Contracfor'sLicehse No. . ' Date Y
I Permit Valuation 11~.t!JOO. 00 I Park Support Fee # $
I Permit Fee $ L l.tll. So I SAC # $ ~. ~5'"{). O~
I Plan Check Fee $ '.1)(.(". 'lB I Water Meter Si1~;1"; $ ;l~,~
I State Surcharge $ . . I Pressure Reducer $
'tf .t'?o "b,OC
I Penalty $ I Sewer/Water Connection Fee # $ 1.:lCJO. 00
Plumbing Permit Fee $ I Water Tower Fee # $ ,
lro .~o 700. CJO
Mechanical Permit Fee $ 100.00 I Builder's Deposit $ / < <"O'l. t9~
Sewer & Water Permit Fee $ 3a .3S.~ Other $' - ~
Gas Fireplace Permit Fee $ Cf (') . (J f') TOTAL DUE t1~ 10. (1.04- $8.1 Z 7. 913
/) /1 ,
IZ' comes Your Building Pennit When Approved I Paid XIcJ.'/, C/i' Receipt No. i/!;t;; ?f~
Oc~ lief I Date I b- Itg-- l./ By ~. ,
Build 19Ofticial
ThIS IS to certify that the request in the above applical10n and accompanymg 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
iSSUj:? ~ /O/S-/6cr
Planning Director ' Date 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
Thr (.tnlrr of Ihe take ("ouArry
White - Building
0it,f1sry - ~nalneenncr;,
t"ink -=- Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
\ 'Vi I f' ii'" "\ i i ('" ...., j',
V " \j _.~j \\ ',-/ U L...)
L - (0" i '.... ,,:-
" I..) r- I t/ .~~-
('1 -7 ~;::;,
. ~.... t,,......
'1-..-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,/" --, ,./..., , ' - -'---7" " I
K,,_ f. I\jj i 1\1 (::')J I \.) (" j
I
I
I h~':' C' E5 ~~3
._,-............,
/\VE:
l.l~:-~
.t;p....
-~..
Accepted
()(
Accepted With Corrections
Denied
Reviewed By:
I1i9tJ
Date:
k:)--/2 -0'1
Comments: See Reverse Side for Additional Information!
See Attachments: 1) Gradine 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."
White - Building
~ - ~n ineering
. - Plannm
~ .
Tht ('("nler of Ihe t.kt Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
\\ I i 1\ ( ( I
, ; , V \ \; ... \.. L..--i
~..r.' .- ,'-
. / ~\ i !
. i II c.-
....-., f.
-:....(
Ii
I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
l-_
61
I
r :
.~~ r\ V t:.
Accepted
Accepted With Corrections Y
/...-"
Denied /
(I I
Reviewed By: / r
I ,f,J ~
, {I, /
Date:
lil/O((
Comments:
f. ~{(!Ci ,S
'7 . /,100, e.
0' C\
o +1 ~1 ( L'C.Qb( 1-/(( <~ c\ (j. Y'c,
i li\ c>:~( {. (en i
t +,Cf'
o
Ccl~1.), ..,:;
c.UV..."'r
uJt Ci. VJ
"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."
Tht Ctnftr of fht L.kt Country
<(White. -Buil~
Canary:l:ngineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
WIND wOOD .- OM6S
Cl.2B.o4-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/3553 I(eNS~IUN AVE
Accepted Accepted With Corrections Y
Denied /l fi j
Reviewed By: Wf ~~
Date:
J(J/~Io~
/ -j .
~~mL ~ a~ ~~_~
L. l4oor;~ W~ ~~t-/'l'1VI \-~. l..tJ;,,~~ ~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."
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
Date Rec'd
I () . ZS-.. 01-'
.
(Please type or print and si~ at bottom)
ADDRESS
J :s g r s IL 6~ oS L..v a ro,Jl'Il/.€:. .
I. Green File PERMITNO! 't~
2 Yellow City . _ JA I.
3. Gold Applicant V
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) iV ~ /) v-JO o{) \-.\ OM ~~
(Phone)
(Address)
(Address)
(City)
(Zip Code)
APPLICANT
(Name) 0 /l E f tl6d., f X-C .
(Address) I' Il ~ .r 0 P L- r;."J vJ tt-(
(Address)
(Contact Person) a 1.1\. T c IJ.
APPLICANT SIGNATURE ~ ~ \J ~
Q
(Phone)
LU--iJL-.
(City)
q J';l, -- l' 1 ). -- '" ~ D~
s-:ro L[<.{
(Zip Code)
(Phone)
DATE -J 0 / JoT! () L/
APPLICANT PLEASE COMPLETE BELOW
Size of water service J ;, inches.
Location of any couplings from structure - feet.
Type of sewer pipe. 0 ABC i ~ PVC 0 Cast Iron
Estimated length of sewer line jJ 0 feet.
Clean out (if required) located at - feet from structure.
Residentia] sewer and water line connection
Sewer connection only
FEE SCHEDULE
$35.50 Industria], Com'l & Multi-family ]% of job cost with a $39.50 minimum
$17.50 Waterconnectionon]y $]7.50
SEWER AND WATER PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
fJ~
?~\O (V .
~LP
."l>
Estimated Cost $ q 0 0 '
Building Permit #
BUild;;Z;1 w;n Approved
/ I Dale
. Paid
. Receipt No.
Date
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
MATTHEW DANIELS,INC.
423 3017
P.03
Uate Rec'd
CITY OF PRIOR LAKE PLUMBING PER.t~IT
(Pleoue CVFe or tnint and siQJ1 a.t bottom)
ADDRESS 02. ..... ,,,,d._, n \
1.385"-d I)~ ~
V
LEGAL DESCR..Lt' L LON (offiCI: u!e ol\ly)
I. 8lue Pile I PERl"IIT lNO~.11P1
Zo. wi~ C\t'1
J. Vellow ^1'9Iican!
. ZONING (office usc)
l LOT S BLOCK I ADDITION)~ ~
OWNER . 1/ . ...1. _ '\
(Name) .)(~ ~
~ (l.u.. ~::
(Address)
Quantity
,a....
I
I
.~
I
I
I
.?.
Pro
I~II
(Phone) ~95!)' . ~. 'i#f
~\ ~ .s-o.:l31
Type of Fixture
FEE SCHEDULE
Industrial. Commercial & Multi-family 1% of job cost with a. $39.50 minimum Rl:Sidc:ntial. New One &. Two-Family $99.50
Residential, Additions &: Alterations $39.50
APPUCANT. J : '~
(Name) ~-rl'1 DJ;) /1/1 J d..{j ). ~J/. tJ.. (Phone) bSl. 4.2.3- -4"l~n
(Address) L~ &JJt..A-lJ Xl 8 4. -J0 ~h . ~1 I"i LA I J r. \...tJ ;; ..s-s-~b8
(Address) V J (City) (Zip Code)
(ContaCt Peoon) ~ I; J J , l:. '- 4, d~ ') (Phone)' "5"1. ..,&, . ~
APPLICANTSrGNATURE }hJ{'"J"-rJ. --~~A.l.m~~ DATE fk1-: If[; ~
- I U
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity I
Bath Tub with or without shower fo Rough-ins
Dishwasher I Water Heater
Floor Draip ) N..L- Water Softner
Lavatory (Bathroom Sink) I Stand Pipe (Washing Machine)
j Laundry Tray (lor 2 compartment sink I Sewage Ejector
Shower Stall Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) I I Other
Estimated Cost S
PLUMBfNG PERMIT FEE
I ST A 1E St1RCHARGE
TOTAL PERMIT FEE
(Omce Use Only)
This Application Becomes Your Building Permit When Approved
Buildinc Official
Date
Building Permit #
$ ~..:..-:'
I~'.. .'. _1~F\~~~
!!~~.'di!:= 1.11\ ill"'1.~',', - e.
I I I '-1 \.) ~ I l.l \,- ..
\ ) '-- .-
jDllfJe T '-%-Zoo I I, <; 1\'\1
:1 \ tJ ~ I il) .
24 hour notice for an inspections (95%) 447 ~O. fax (951) 447-4245 ..,
. L-', 'I ~--_._._--
,
NO. 831
P. 6
JJ1ue Rcc'd
Cl'I~a3 L'(rx:. or minI IIItI sian ac bClllom)
AQqRESS
'\ ~ ~ S) K t",Sl ~ \ ~~Y1 A-J.(.
~. ~~~" ~i~y II)ERMIT NO. 1.1_/1)- IJln
l. Yell.w ^I'pll<ilJl( ~ . .,,~ /
.- ZONiNc; (arlie, u.e)
L~G{\.L DBSCRIPTION (oUlee use only)
tOT S BLOCK \ ADDITION \...l~' " ~l \- \: s-\.. "
PID
OWNER
(N!\111c)
\\ " f\ ~ 'v~ I~)~~ ~~~.)
\
\ '\ ~ \. \ .f.. ,,~ 'I '" \ (.\ \l ,_. ~
(Phone) <!\ ~~... ~ t\ ~'-~ "\\.\ R
~)v...""Y"\ Ia \ \, \ \t s s ') () la
. (^~ldfess)
AFP[,..ICAN l' '^ I --\_.. C S' ~ \ \ \ \:l\ - \I
(Nar~lc) "\<\~~ (\) ''''', r-- -\- n l, (Phone) ~ ~ ;~. '1 '"'\ -1- ~ ~ '\
(A~dl'CS!l) \ ~ c\ ~ lJ \J ~ \ l (.)~ 1\ V \..... (l c \ () - \..L, \ u.. {'\~.J ,S s ~.., -d.
(Adcl1-eu) (City) (ZIp Code)
(ClJlllact I'cl'son) t\ L\ V\ L- \/ S t.",-, ~ \... \ \. (Phonc) 9~.),' "\ \-'I,. ~ \ \) \-\
Af1Pt,lCANT SIGNATURE .__~~~;b_ ~~, . _.. _ DATE
--"..- - .'._'--"-~- - -- - --.........-~-_.._-- ._.., --""- .._-~._--
APIJLICANT }'LEASE COMPLETE BELOW
'.(JNEW CONSTRUCTION 0 REPLACEMENT tJ ALTERATIONS
rU~~'}/ACE MAKE AND MODEL C ~""'A ~ h V r - ~O- ~() FUEL j[ 44-.._
FLlJa SIzn ~ \/ c..... RETURN OPENINOS ~ INPUT ~: ~ OUTPUTJS", 01P
TYPE OF SYSTEM HEATING OR POWER PLANT
. < g'NOl'lU Ai. Plnnt,
'DOm ily
o MccllDulenl
OAit Conditioning
~VClll. Syslem
FH~EI'LAc;E MAKE AND MODEL
OSltlllll
o Hot WOler
o Radil1tion
o Special Dcvioes
o Other Devices
"LEASI~ NOTE:
Ail' Conditilllwl' Units
Cannot Encroach il1ltl
Required Side Yard
Scthl1ck,5
J"EE SCIIEJ)ULE
1% of job cost Residential, Gns fireplace
$39.50 minimum
Re~jtle,llllll, Healing. & NC (New COII$lrllellon) .li99.S0
Re~jde,ltinl, Healiug Ollly (New COlIslrucllon) .$64.50
Estimated Cost $ ft.r 0 ~ ~
Illd\ISII lnl. <':omlllclcinl & Multi.rlnJl1iJy
$J9.50
Reslderllilll, Additlou! &. Allerallolls
Resltlentjol, AC Ouly
$J9.50
$3!:'.50
Building PcnniL #.
c. /
!-lEA TINO PERMIT I~EE
STATE SURCHARGE
TOTAL PEHMIT FEE
$
,$
$
.50
;..<'< ";~fI.'
"'-""'. .~,
""'~"l'(; ," " ,
" .(.~ <
. ti..: ,:.-.1, ,~~
(O/(lct U~C Only)
1'11j~ Appllcatll)ll DeCOIJJCII Your BulhIlllg I'ermit Whelt Appl'oved
UlllltJllIlOfflclal
fhrid[; Il "Ite:c;eipt No.
11 ~:TT : j:J : i : ", \:1
- ~e LeO : I i~~!!
VRlc _ Plj QC.U ~ 20U4-: I
:l4 hour non.. ror.11 ;"'1",11... (OS)} '47-'8t~::I9S:14':~S _. IJ
rr.
!~/U~/U4 10:27 FAX 7635530887 GUYERS BUILDERS SUPPLY
,'-.:lTY U.t' PlUU.K LAKE
HEATING/AIR CONDITI0NlNG/FIREPLACE PERMIT
@002
Date Rec'd
CPlease type or Print and sUm at bottom)
ADDRESS '
/ ?/8S~ fre Yl>~I1~+Q" fJC?> 5
~: ~~ ~~Y. I PERMIT NO.~ I M..-r
" Yellow Appl.CWSl ~ ,
ZONING (offie.use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
W, VlJ woad
(phone)
(Address)
, ~;;~~ANT. I",!, _f;?\J '! e.. \" ~ ro 0 L ! j ( l' ~ v P pi i
(AcIcU-ess) / 3 ~05 /5/'Vt J9 (/ CIl u-e
(Address)
(Contact Person) b <:;) "'"
(phone) 7~ 3 - (p 9$/ - SIC:. 6 3
jJ /Ym()cJf~ 55""!j2.j I
. (City) (Zip CocLe) -
,APPLICANT SIGNATURE
}1/1. ~ r- (phone)
~_ J7U;;~4t.thr
DATE
/;J./~/()v
</
APPLICANT PLEASE COMPLETE BELOW
t:: I ~C P (Cc. c. e ~EW CONSTRUCTION
A r ~- MAKE AND MODEL
FLUE SIZE S- [ '7 RETIJRN OPENINGS
TYPE OF SYSTEM
OWann Air Plants
OGtavity
o Mechanical
, OAir Conditioning
OVent. System
o REPLACEMENT
INPUT
o AL TERA nONS
FUEL 10 C(.. 1- 3 '<- <3
OUTPUT
HEATING OR POWER PLANT
o Steam
o Hot Wafer '
o Radiation
o Special Device!
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
I FIREPLACE MAKE AND MODEL ~ D V 4!) "J, 5' ('.../U fV7.
Industrial, Commercial & Multi-Flll1'Iily
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions &: Alterations
$64.50 Residential, At Only
S39,SO
Residential, Heating &. NC (New ConstrUction)
Residential, Heating Only (New Construction)
S39.50
S39.50
Estimated Cost $ / ~. (') ()
Building Pennie #
HEA TING PERMIT FEE
ST ATE SURCI-IARGE
TOTAL PERMIT FEE
$
$
$
.50 PAID wm-t
BU'LDING PERMIT
(Office Use: Only)
This Application Becomes Your Building Permit When Approved
Building Official
Dale
llll'aip
l:{j~c 8 2004
Receipt No.
By
24 bOllr notice for all ill3pection~ (952) 44'-9850, fax (952) 447-4245
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS _ 13853 k'~~i~ llv~
NATURE OF WORK ~")
USE OF BUILDING ~~D J I
PERMIT NO. ()4-, / ()+--7 DATE ISSUED /f)/ ~ /0 if
CONTRACTOR WI'~ ~~.l' ~ PHONi: ' 95":1.;22&. ~ 787
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
. THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR ,I
~
FOUNDATION (Prior to Backfill) I ~ I // a/cJ~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
. .
SEWER I WATER I SEPTIC JIP1- /tJ/;y/o1'
FRAMING ~'/;Z/y~'c(
INSULATION ~ /.J-~SZ:oy
ELECTRICAL I I ,L~'/dr
PLUMBING p~ ///.2/0.y
HEATING (if required) .~; /.;?/Y/4r
FIREPLACE ,. Jl /ffl /.?/le;14~
, r GAS LINE AIR TEST ~"t' 1/1 ~ f/ j~ J'~
~ ~~pVE!i-NO WOltK UNTIL ~B91E HA~ BEEN SIG~E9 _
C1\...~/~o<.e-W-e.) t:r2- <<7 I //41;7"F
I <' --, FINALS
GRADING (Prior to Sodding).. #/f
BUILDING ~#1IJ. {'O (".)I1/;/ J/~J ~
ELECTRICAL /
PLUMBING
HEATING
DO NOT
I FOOTING
DA'9= I,
/ If / ;;v / or
/..1'2 .. r-
u"/' 'Jf/!j~zttc:
J#(/ ~,..261t>s-
4t/j ~P~6.
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
<trertifitate nf @ttupantlJ
CITY OF PRIOR LAKE
~tparfmtuf of ~uil~iug JIuspttfiou
~inal Permitted 0 Conditional e.O. Expires_
This Certificate issued pursuant to the requirements of Section 110 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 04-1047
Use Classification
Bldg. Permit No.
R3
VN
R1
Occupancy Type
. Type Construction
L5, Bl. WINDSOR ESTATES
Zoning District
Legal Description
Owner of Building Site Address
WINDWOOD ~HOMES', 14311 EWING
Contractor's Name & Address .
ROBERT D. HUTCHINS // Y
j:/~ City Planner
~ BU~'ld' g Official ' ,
/0 / 7/ OS-
Date: ~ Date:
r
13853 KENSINGTON AVENUE
AVE S., SUITE 200, B'VILLE 55306
JANE KANSIER
"..........
.'~
. ~._,,~
DATE TIME
SCHEDUlE.D '~~. O~
F '"'
kt'U/h'7 ^- /Iv ~
v
~-/OY7
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/ 3 ?s-3
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
[] ~ULA TION
~~I~AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~
r_' /
r-7 rz<t {
I
.I
"
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/'
~J/
(' /fC
~ ~~
(~-; ~; ') )
\.L-..te>se /1 /~
~............. -
. ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROC ED
Owner/Contr:
Inspector: ~
V '
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNon
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYI
DATE TIME
CITY OF PRIOR LAKE .-0 /.. /
INSPECTION NOTICE SCHEDULED ~./..J/~
ADDRESS /...?JPS-.$ kHS/;"p'4' Ae.
-...L
OWNER
CONTR.
PHONE NO.
PERMIT NO.
CJ~-/cJ~7
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~L
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
MME;HTS:I' / / /J A
Z . e'~d. ~rdc5v/~ce _ "c?;~~V
dhh~/ ~c::& ~/rt7~"/
m~ y.ltpi?r,,~.. dLJ:Z .y?r?-7cY3o /~
J2Y ~~)./~,;.. ~~r~,,"", ~n.-ol' .c/p?1, /,
S"d f- -fre~s A~p~ ~Z"tA. t!?J~~...{j-~t!!
-- " "
7e~L), C,,~ c7, (/#~ /
/ /
J /
rP"///~
/ '
....,. ~./ ~ "J ~ ,
~;,.~ r/-6r +/h~/ t:A./A~~
,/ Ye~S 4r-R C~r::J k -Ie.
/
o WORK SATISFACTORY. PROCEED
rRRECT 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!
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
13gs-3
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~L
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
to --tl-o) ::z:Jo
)< ((7.~/t!51-o ~ IJ V ( r
CONTR. ~i'nktxll
PERMIT NO. DL/- IfA 7
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~LING
-11 COM'P'i:AINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
ADDRESS
Bf<D
DATE TIME
SCHEDULED {~~-
)'~'1J/~F ~h ~~I
t/
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~- /(2.~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
..a'15[UMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMIIIENTS: /' / / / /'
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,
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, - ...",.-'
/
4//c
o WORK SATISFACTORY, PROCEED
~RECT ACTION AND PROCEED
o CORRECT WOR~, r;'~r:7 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
.P.rmil"
*JobMdr_835.3 Ke"Jsl ~"ld'f(;'1
.Heating Conlr8Ctot Me I nO AIR
'TeslertlSignatur. ~
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Pressurized
Inspecled
* P.rcent COz
*Percent Oz
Finallnspeclion
.Q!!!
!.!!!!!
PERFORMANCE TEST
/" ,9""/0 'r . 1 CO
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.Stack Temp,
Pounds
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