HomeMy WebLinkAboutBldg Permit 04-0905
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
Date Rec' d
7. z I. 04--
PERMIT NO. O~, OCf 05.
(Please type or print and sign at bottom)
ADDRESS L
140~Cj ~),..~~
LEGAL DESCRIPTION (office use only)
ZONING (office use)
tel SD
ADDITION ~ /tl~~
OWNER ' (""\
(Name) ~ 6.A 4.C- 1
, ....~ I . I
.(Address)~ ~,5, ~
I '
BUILDER I A A
(Name) t1.J).~ t~ ~~ -- .~ (Phone) --!11("":J. Q 25""~ 4Jt-8
(Contact Name) ~.... ~RJ ~,,~ (Phone) 9,-~~.f) 4LJ 'it)
(Address)llJ3IJ ~~-I~/Jt~ ~~, /I}/LJ s.-~~
I I . / -
LOT 10 BLOCK
TYPE OF WORK
o Misc.
~ew Construction
OLower Level Finish
ODeck
o Fireplace
PROJECTCOST/VALUE (excluding land) $~otJ, on!:)
I
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
Plumbing Permit Fee
Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
~1
~ 8trJol.O()Oc ()'(J I
$ 01;253, s.o I
$ I l{feJ &(.78'
$ , /So,oo
$
$
$
$
$
/()(). (ge
100, 00
'35:>'0
~4, ~o
~;::r4-:;/;:D?a~ l:~d
Building Official ,:I ..
PID 2.5 4-0"'. 010. 0
(Phone) 3~~ t61S~4't ~
,~~'--<~
I
I Park Support Fee
I SAC
I Water Meter Size 5/8CFr)
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
lather \
I TOTALDUE MU0'J q.~,~ $Cf, ZC,3. 7?L
)1 ""- ' ·
Paid ~~, 7tJ R~c:tJO. ~.77rCj
Date . 9./.:7.04 B(j' .
OPorch
ORe-Roofing
ORe-Siding
OUtiIity Connection
'.0
DAddition
o Alteration
/ / eP Iv'!
$
$ 13S0 , () f)
$ 30D,O~
$ 70,00
$ f 2.00. 0 e:>
$ 700,otJ
$ '<;;00, () 0
$
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
~he:d. igned by the Ci; Planner constilUles a temporary Certificate of zonin,g ;mPliance and allow.:;:truction to commence. Before occupancy, a Certificate of ~cupancy must be
~ ? I z, j /0 if ,<'JU..iJ n.li ..J""'/ ~ /:-... )
Planning Director . I Ddte i Special Condition/, if any
24 hour notice for all inspections (952) 447-9850, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~19~
Contractor's'ticense No.
#
#
#
#
~hitp - '3l1ilrliRg-->
Canary - Engineering
Pink - Planning
ThE" Cf'nlt"r of Ihf' I.akt ('oon 1 11"'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
WINDWOOD
7.2..f.04
I
.
-_ 0 H 5 s
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/4-07 q 1- A AS t-,AKE: Q.,f R-(!.,G6
I
Accepted
Accepted With Corrections
~
Denied
Reviewed By:
~~~
~~~-~
Date:
74-'3/oct
,
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."
The ('("nln of Ihe l..kt Counlrl
White - Building
Canary - En ineering
~nk - 'planmn
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT \ \ I 1\ D \, '\ C ( L)
APPLICATION RECEIVED /. Z" ( 1
I
L_/ ( ~ j ,.-- r
r-jJ it:-'
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ o~7 (? II A A '~~__ L f\lr( E l~,~ ll~ ! LE
/
Accepted
Accepted With Corrections
~
Date: :7 /.;l-.?h 0/
,,'
aJ-/ ~w
A,(!, ~ .t!.J8. -~ ~~ ~ ~ ~-
-!~ ~~,,:"t;-.~' /A~lj ,tle~_d17
J - I A
~ ~ ~ ~ t2. C11 ~~ ~..,,~
~ ~#-~ fo 7~ ~.~
Denied -.
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."
The Cf'nter of Ihf' Lakf' ('Ounln"
~ ,Allill'ling
rv . Engineerilla)
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
V\f I J\) C) V~; C
r'\
~.,
f /' j., ./'- -',
--.,- U I~' t: ~
---1 ......., ,
/. L (
[,:"1
,_, I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J 4- () 7 L? l-iA A c~) L,~f\I<E. (~( l<-~LE:
/
Accepted
Accepted With Corrections
x
Denied
Reviewed By:
#~/~.
'-.
Date:
9 - ::r-o LJ
ComrT1ents:..s~d, Rp'vp-rse Side for Additional Informi3tinnl
~~ O'^ SDvf4t ~t'ut_ ~ ~tI!It-- c,nv/ (:;r;,1'"Q~ C/I'l
G.J.- "?!, In LIS +- I FYY1V(,'! G~rM \"Ie, I- fr &11 {.9a..1l-\
Prnov/-v ~
, t (
See Attachments: l.).j;rading 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." '"
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
I. Green File PERMIT NO. L/._~r/lL
2. Yellow City lAJ
3. Gold Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
JC/07~ ~S L \C. 0 e.
LEGAL DESCRlt'TlON (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name) tJ..;WV ()w c) OD Ho^", ~
(Phone)
(Address)
(Address)
(City)
(Zip Code)
APPLICANb
(Name) . il-~S Hu ,;)<..(.
(Address) ) f.. Jig ro I' L"'Z# Lv J1.v
(Address)
(Contact Person) ~
APPLICANT SIGNATURE r ~ ~
U
(Phone)
~S-J.~ ,(!iq..'1 ~,~" ~
S ..(t)l( '"
(Zip Code)
L IL () L .
(City)
(Phone)
DATE
~ 1.:11 } b~
APPLICANT PLEASE COMPLETE BELOW
Size of water service I inches.
Location of any couplings from structure .- feet.
Type of sewer pipe. 0 ABC C8 PVC 0 Cast Iron
Estimated length of sewer line S 6' feet.
Clean out (if required) located at feet from structure.
Estimated Cost $
FEE SCHEDULE
$35.50 Industrial, Com'l & Multi-family 1 % of job cost with a $39.50 minimum
$17.50 Water connection only $17.50
...0
"00 - Building Permit #
Residential sewer and water line connection
Sewer connection only
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
Building Official
Paid bt tyO ~eoeipt No___
Date tf'- J/-f) Li By G--
I ?J
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Date
(Office Use Only)
This Application Becomes Your Building Permit When Approved
MATTHEW DANIELS,INC.
423 3017
P.04
lJate Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
LEGAL DESC.R.u:- L LON (office lJ$e only)
LOT 10 BLOCK I ADDITION *~ ~
OWNER .'. ~...I \
(Na.me) W' ~ ~ (phone) _f.JSP. . 'itlS'". 8!I:!I!i
1/,,:' ~~ fLu.. ~.. I/Jm {J!l./; Ii 7;) ,y..[;j .Qfi'l?
APPLICAN!.,.j _. . ~
(Name) -~1 OJ;) Au J.d,d.. ~8. tJ." (phone) bSJ. ..j.:J...:1). ~
(Address)..JSJJ..~ (JA~i.)() 4) - .~,h. qVll1'Y III ,r "-tJ;) s:!i06f1
(Address) V (Ciry) (Zip Code)
(Contact Penon) i:H J ; ,I , .c. '- 4,. -J-; ,~'k-" ') (phone) ~J. ./~. ~
APPLICANT SIGNATURE JJ,.IP.J '-ti.r~uJ;6U).'~r'"' DATE rfbt:.. IS-, .{).{)o4
'-'-T u
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower 4-
Dishwasher I
Floor Dra.ip I Ai..
Lavatory (Bathroom Sink) J
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
! Water Closet (Toilet)
(please type or prine and si~ ac bottom)
ADDRESS
14a7q
~~
(Address)
1dQu
Quantity
.tL
J
:L
.~
I
I
I
lki...
I H"'-.
I
...=i
FEE SCHEDULE
Industrial, Commercia! & Multi-family 1% of job cost with a. $39,50 minimum
Estimated Cost $
Building Permit #
PLUMBIN'G PERMIT FEE $
I STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only)
This Application Becomes Your BuDding Permit When Approved
Building Ome!.1
D.~
l. alu. 'il. I PED1\IIT NO~- .
:. Golcl City ~
). Y cllo'" ^ppl i.....
ZONING (office yse)
pm
Type of Fixture
Rough-ins
Water Heater
Wattr Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
Residential, New One & Two-Family $99.50
Residential. Additions & Alteralions $39.50
q.,~ ,~S
2~ hour notice Co,. all inspections (952) 447"~P.!~ax (9S2} 441424S.__"...
t.-:= ,
TOTAL P.04
NO. 832
p, 7
JJnlc Ucc'lI
fJ'Ifj,!!/: tvee ur urlm Ind alJm at bU\lOfl\)
A~QRESS
,'-\ t.)I '\ \~ ~~ ~ lC', \It. (,' r(.,~
~: ~:JI ~!~ I PERMIT NO.U, - d IWi:!"'"
J. V.llaw "1,pJ"'a.1 -, ~V:i)
---..
ZONING (llffice USt)
LnOAL DJJSCRIP'fION Comee use only)
LOT\ ~ BLOCK \ ^DDlTI~ ~ \ ~~..l N o,.~~
~~:c~R \r~ ~ ,,~\A "'j~~ ~~~
,(A~ldfess) '\ '-\ ~ ~ \ .(;.. ~ ~ "\ {\. -J'\- ~ o v.. ...'" ~ \} \ \\1
,
PlD
(Phollt~) <l\ S~... ~ ~\ ~ -~ "\\.\ ~
s s ")() ~(J
AFP(.,ICANl' '^ \ .-.,--.
(~arlle) \<\<:L-\:~'~' ~ -\- '" ("
(Al,id !'C3S) \ ~ c\ ~ \J \J '<. \ l. (J ~ f\. V \...
(A(ldreu)
(Cl./lllilCC Person) f\ (,\ V\ L.\J S f....\-\ I( \... \ \.
AN'LlCANT SIGNATURE Jf\~.1 ~ \}...
(Pbone) ~ S :~, \-\ '-\ -/.. ~ \ ~, \,{
~..., ()- \.LI\ ~ ~\~ ~~~) S., d.
(CiIY) (Zip Cud!!)
(Phone) 9 ~''),~ \;\\.\ {. ~ \ f).~
DATn
AI)!'LICANT PLEASE COMIJLETE BELOW
~mw CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS ~
FU~~^CE MAKE ^ND MOL)EL ~ v~ ~ l.'r\ ~ 'f \ ~~ ~ ~ ~ FUEI...f\Ili\
rqJ~ SIZI1 f \I L IU!TURN OPENINO-S \ .~ INPUT ~O, (jQ~ OUTPUT iL:L~ Q ~
TYPE OP SYSTEM HEATING OR POWER rI.,AN"r
. ~Warlll Air PlnllL~
OGrnvlly
o Mechllllicul
~^jr ComliliLJllillg
~Vcnt Syslem
o 81elll11
o Hot WOler
o Radialion
o Special Devices
o Olher Device~
PLI~ASE NOTE:
Air CondItioner Unlls
Canllot Encroach ill to
Roquired Side Yard
S~tbnckB
11n~EIILAc.:B MAKE AND MODEL.
Elllimaced Cost $
Flm SemmULE
I % of job cost ResilJcllLilll. Gas fireplace
$39,jO minImum
$99,50 IlesidclIlinl, Additions & ^"CTlllioJls
oSMoSO ltcsidclllilll, AC Only
\ 'd,: <J ('\\'\~ Buildillg Permi! ff
$.19,50
InUllSII illl. l:umrnerclnl & Multi-IllIlIlily
Re~luc'ltilll, "euting & NC (New Constructlon)
Re~jcJ~J\llnl, HeAling Quly (New COllslnlclion)
SJ9.50
.$'39.50
1)ulllllllll Otntlnl
$
$
$
~~~
~i~ II \J - \ ~ ~ Receipt No.
- .", \ faC1 '! 8 IUU4 \:I\y a
24 hour lIolle\! rOl' nlllnsl'tlclio,u (?52) ~47- \0, fnJl (952J_ 4i~ !/
B'/"-------:::/
l-IEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
.50
.tJ~'~'..,~~b,..."
"'~ "'i. .'-'.'
"t.Y~~\ . . .:~~I
.. .
'l).
, "..;""
'" . - ~
IOltie. lI!r Ollly)
1'hl~ ^JlIlllC:lltlon DtccJlues Your DuUdlllg Penult When Apl,,'ove!l
11/08/04 08:58 FAX 7635530887 GUYERS BUILDERS SUPPLY
CITY OF PRIOR LAKE
HEATING! AIR CONDITIONINGIFIREPLACE PERMlT
~002
Date Rec'd
i~.. ~l~. I PERMIT NOIJ_ ~~ tlr
l. Volle.. ^pph_ "7' 7~
. (please tyJ)e or print ami !il';l1 at bOlIOm)
ADDRESS
IV () 7 9
//4. Ct.. .S
Lake. C, ~/f'
ZONING (officcuse)
LEGAL DESCRlPTION (offICe use only)
LOT
BLOCK
ADDITION
PID
,
I OWNER t J (
(Name) LV J I'/. 0 WOO()
(phone)
(Address)
APPLICANT /I t'. - {
(Name) ( ') v" .,0." S I~ 0 t (d~l s E J<. P re"::J'j (Phone) 7 t. ?-
I -
I ?/~O 5 IS-P1fl-vcllue. Plvmnuth
(Address) I (City)
(Contact Person) f0 D V'\.. " ~ (phone)
APPLICANT SIGNATURE ~ r~ /J4d/J DATE .Lt/g
/;- .
APPLICANT PLEASE COMPLETE BELOW
~EW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
fURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
~EOFSYS~M HBATmGORPOWERP~
(Address)
(p 9cJ - '/ (p " ."":)
~~<f I
(Zip Code)
OWarm Air Plants
OOravity
o Mechanical
. OAk Conditioning
OVent. System
o Steam
o Hot Was.er
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Coaditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
L e t1. (to "J..
Gbv''fO~S-
ua..f (1q c,
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
$39.50
$39.50
Residential, Heating & AlC (NeVI Construction)
Residentia.l, I-Ieating Only (New ConstrUction)
Estimated Cost $ / OOO(!JO)
Building Pennit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PE&.~ FEE
$
$
$
~.,' "
If .~
. .
,
.50
.~. '..... ,..Jf";
,/''If'~;,,.
~ ~~.,. ~~
".
(Office U~C Only)
This Application Becomes Your Building Permit When Approved
Paid-
Receipt No.
Building Official
Dalc
Dare
I'JO\l 0 9 iQQ4
By
r
24 hour notice for all inspections (95Z) <<7-9850, fax (952) 447-4245
'_____,........_~.___._..._..._M:.... ,._-' -"'.~" ....',__., .
PRIOR LAKE DEPARTMENT OF
Bl:JI1.DING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS It''' 79 ~ i.Aq- ClA!4J,G
NATURE OF WORK N61AJ .~_e,*~
USE OF BUILDING .s:~~. _
PERMIT NO. of/. Oqor;;- DATE ISSUED 2/. ~
CONTRACTOR 1lUj.J.~..MJ ~ PHONE~4'S- m,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
(7/J
FOUNDATION (Prior to Backfill) lJ//(. I ,;/If~ ~ I /~ ~ ;; I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
.--.
-~ 7'~~
m4
#a
::
DATE
t FOOTING
\v(~
19-C6
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
.
GAS LINE AIR TEST <~ W
"
C~VER NO",WORK UNTIL ABOVE HAS BEEN SIG~qD
,"'rllr/.rrlit~L6tu6lt61J ~ lJe,. PD I lZ/'/ibcf
I I FINALS ~ ~~
I GRADING (Prior to Sodding) /113 &.;).7. 0 r" J /
BUILDING .,..~ 1'0 8.l"'6~ ~ (f Jl> II. 12..1' / t5>'1
ELECTRICAL J I
....
PLUMBING JIlIY'"
HEATING (~'-; ·
,
DO NOT OCCUpy UNTIL ABOVE HAS
D~ t~ 1.oU:l~ NOTICE
This card must be posted near an electrical s~rvice cabinet prior to rough-in inspections
and maintained until all inspections haye. been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
.
//~//o/
//;/,,~y
///?/co/
~~ /~CJ2
I /?t4-
I /fU-
I
I .
I /!/~/~
I' ////fJ/Oo/
I '
[-It.-IX
1-2&,-oS-
BEEN SIGNED
FOR ALL INSPECTIONS (952) 447-9850
- .-
~
~.___."':_._;~___.__~___~".._..____~L_ .....
...".,,-.--..
_. ~____,__.~ ..Ji~~. ...
_:__.!!2if,
'....
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS } 40 7 cr
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~NAL
o SITE INSPECTION
COMMENTS:
DATE
SCHEDULED "I*-
J./o..e.. ~ l k- <:::j'r
TIME
CONTR.
PERMIT NO.
r-!~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~~~LfE AIR TST
Q\o~
II) '-1
""fOL IL L("
. -
>t WORK SATISFACTORY. PROCEED
o CORRECT CTlON AND PROCEED
o CORRE T . CALL FOR REINSPECTION BEFORE COVERING
Inspector: ) Owner/Contr:
CAl L L7JS50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
v
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
,~ l,L 'J 'EX)
PHONE NO.
/ LIt; 77 Hqfd L~ (41'1
w ;,Jl"JoJ) ~ts
ol/-7~
;J5...~ILlING
o cdlll...LAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
D
CONTR.
ADDRESS
OWNER
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
D PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
(;l.At'h g~- ~ _
h"4~ ~ &~
~ WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
InSpector:~~
OwnerlContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSl'IOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
(J'Z~~
ADDRESS I '-to 1. ~
tltCA9
Lk {,h-
COMMENTS:
" ~.:II\.~ ~tO'--\. (\mJ1J)
~. ~~ ~~O
'1. '"""'--td g~r{~
t.\ . 'Z>r-t.uto ~ (~:i...
~. 0.sulk SI't:1~ -
(" ~U t;t" \1~ ~ '\~F' ~J:'O~
~6~~ t.{'n-Cf9lo
1 t CSo-t ~1~ fIJ" ~~(~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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
o PLUMBING FINAL
o MECH FINAL
M~
~ ~6~' 0
a4- &f 01
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
1
2,4 o_~ ftof.I,'~
~
+0 8-[-Cf:)
~t
o WORK SATISFACTORY, PROCEED
o CORRE ACT AND PROCEED
o COR CT K CALL FOR REINSPECTION BEFORE COVERING
Inspect!, - Owner/Contr:
CAll J6~o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CO~QUlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/-/1--oT
ADDRESS
&071 ~S ~b cL
OWNER
CONTR.
PHONE NO.
PERMIT NO.
4,-10S"
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
S"PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~
@)
-
ku$ fnr- ifyap (;,
1~ tull 4t1'td- 5cqj
Lv+- (J~ ~Js OYl
5p"'lI\iJ.w rJ/7A.l~
r -r1lV/d1tc rtJ(Jf" UA..(}S
v /l5.f.o,v;
Ate./...,- .
~/ Lode-
~0.
h;r
v
o ))'ORK SATISFACTORY, PROCEED
}If CORRECT ACTION AND PROCEED
o CORRECT WORK~ FOR REINSPECTION BEFORE COVERING
Inspector: M Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
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