HomeMy WebLinkAboutBldg Permit 04-1229
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT /2-9-01/
(Please type or print and si2Jl at bottom)
ADDRESS
~)~ ()_' J'L,)~
LEGAL DESCRIPTION (office use only)
LOT I C{BLOCK I ADDITION ~ C:--f- ~ . \ · '"'-c...
i -. ~
~=R,frJ".{jP')/lr~J6J C(~~~/"
(Address)~{...u, I LtS..:::::r~ r;) ~J.e'~j--,
J.r. '-""'L "!:. -
1_ White File
2 Pink City
3 Yellow Applicant
I PERMIT NO. 04', I Z Z r
I
ZONING (office use)
PUD
11 ( A/
. - \- -
_~n~ i/--A-
PIDz.5.307. 611. 0
(Phone) ~~-~~ '?/..O L
~d/~kdJ- h-,
~c~~~~Name)/hl?iJo,..,~l/ (!OF''-'" (Phone) .7<:.-p....-4?';)....~?bO (
(Contact Name) ~ (' c4s..r"' .,.. e.tl/ly {.for)..--.-. (Phone) o<~...~ tt:; ""' I ~ ~
(Address)?(~O( I LI..::>/..-. ~ J-C,v:r t ~ ft7.-_ .T\:- ~ -;01 "'~GLI'f4
- '" c;;r- ..$'~/~c.( .
TYPE OF WORK J2fNew Construction ~ ~ ORe-Roofing ORe-Siding ~Level Finish ~place
DAddition OAlteration ~ty Connection 0 Misc.
CODE: ~.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV
H I
2 3
V
M
4
A
R
5
PROJECT COST IV ALUE
(excluding land)
~pql
, .
B
S U
I hereby certify that I have htrnished mformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
red pro erty 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
'Jke i permit for Just cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed mspections.
~ --- i<c:....~ )f-. .<-0,(
Signature - 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
~350.JOO{J.DO
$ ~ ~8'q. >0
$ If.t,i3.18
$ 17?,,08
$
$
$
$
$
/00 . 0 0
laC). t:1 t)
:5 '5". ,,>"0
.t!O,()Q
. This Application Becomes Your Building Permit When Approved
~,~ /Z/t;,/oi
I Park Support Fee
I SAC
I Water Meter Size 518'6
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE ~
- .j/
Paid lOt (,9v./o/
Date ?z..;uJ p ~
/
$ ?S"O. 00
$ 1~S-(1. 00
$ 500,0'0
$ 70 .0 0
$ \"200. Do
$ 700.00
$ ~aa. 00
$
iZ.t7.b~ $/~ t;;9~.IB
I" #
. R~eei ' . ff&IJ
By ~
./
#
#
#
#
ThIS IS to certify that the request in the above applicalton and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when si ned by the City Planner Cllnst~ a temporaty Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
1. e :;V-{)./lJ M0~
Hanning 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
-.
The C"rnlrr of Ihr l..kt Counl.-,'
White - Building
(\..anarv. - ~nqineerm~
Pink' - Pla"nning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
--i. /r) <.}....-1.. ..... /. rii
/ ') /(J. Ii \. v>( " (,..i..LL(,. t ./
f
f
/i ........ . _ '_ ........ . /
/ 171. : T ,) I . '7. . ,........J... .
{ / u' 't.u~' ",' (..( _ L L.t. L.. '-../
I:'"", 1-:.'1'./;.....
c:. . '-/. (. ...,...--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
-,I' -" ., ,
.....-:-f __.'1 '"_ ~-) /i. ,/ . '.. /. .. .....
./ 1,_-\ L. t. ,. , 1/1"./ / .. -T.'" J
(;-- /.--'/ - \"".....;;:'): ,1L,'C"(.~.'~--/{c" / ,~t.....---
L Lei
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
IYJf-6
Date:
j) -It - &L/
Comments: See Reverse Sidt( for Additional Informationl
See Attachments: 1) Gradin~ 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
Canary - Enaineering
<. Pin~~~nnin:D:>
The ("enler of Ihe Like Counlr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
"--1-" i,' /"~, .....,.- ;'" / I' .'-.0- --+--' - .
I'I/L.. f \.1" luLCC{./ ({ hJ-(A{ (A~,{( '"-"I (
. Ie:.. .(~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,'/-,"- ..~-,
/JL--
I' /
. ."\L---...
c.1'i__r~
/
./ ( L t,~
Accepted
Accepted With Corrections
".,--
"'"
Denied
~ -:J~~ Date: It!lb(;c{
, ,
Comments: A.c., ~ ~ ~ ~
.~. ~ !;{~ ~~, tJ~ ~
(1~ ~ .:..:i:. ~ ~~
.~
Reviewed By:
"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
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
L Pink File PERMIT NO~z:JJ~ .,
2. Green City
3 . Yellow Applicant
ZONING (office use)
2752 WILDS LANE NW
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name MCDONALD CaNST
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOME
(Phone)
651-633-2561
(Address)
2700 NORTH F AIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone)
651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
1/24/05
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
DWarm Air Plants
o Gravity
D Mechanical
DAir Conditioning
DVent. System
INPUT
HEATING OR POWER PLANT
OUTPUT
o Steam
o Hot Water
D Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
Industrial, Commercial & Multi-Family
HEAT N GLO 6000TR-OAK
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
Residential, Additions & Alterations
Residential, AC Only
$39.50
$39.50
$39.50
FIREPLACE MAKE AND MODEL
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50
~o ~f\t.A\1"
6U\\..O\~G
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Paid
Receipt No.
Buildinl!: Official
Date
Dat~IAN 2 7 2005
By
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
HEA1 J.liG/AIR CONDITIONING,r.l.l.'\EPLACE PERMIT
Date Rec'd
(PIeaae ttpe or prim and silr;D all . .......)
ADDRE~7 rc( d &JI)~
iAJr.)P
i:::' ~~ I PERMITNq& '7'1(.1
J YdlGw AIPIicaal - ~
ZONING (ol5cc
\I5e)
AI. uJ .
LEGAL DESClUr lION (o!:flce use only)
LOT BLOCK
ADDlTION
PID
&'Z:R /7'/,. ()~ II 1 (1 If)
~It~-J.
(phone) 1"3~ -7bC (
(Address)
~~F~A)~~/t.D
(1;1"
(Phone) 4C-i) - ~:;>
(Address)
;.o/~ 1("\
Gn In ^ \ 4/Jr:.
(Address)
..-
/-1 ~~
(Oty)
S~~-4
(Zip Code)
(Contact Person)
~ Zd;;- wrl(}
(phone)
APPllCANT SIGNATURE
/- /9 -0 s;'
DATE
APPLICANT PLEASE COMPLETE BELOW
....E!NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS. L
FURNACEMAKEANDMODEL~~I-~(' Cq.irlD/c:">n FUEL ~
FLUE SIZE ~ f r ~V('. RETURN OPENrn"GS c.. INPUT fa:!) ~ OUlPUT 96) .o~
I ,
1YPE OF SYSTEM HEATING OR POWER PLANT
~ Air Plants 0 Steam
~ity 0 Hot Water
~ec:hanical 0 RadiBIion
~. Conditioning 0 Special Devices
~rrt. Sys=n 0 Orher Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
Industrial, Com..."...:al &: Multi-Family 1% of job cost Rcsideutial, Gas Fireplace
539.50 minimum
Residential, H.~ &. AlC (New CoDStrllction) 599.50 Residential. Additions &. Altl:rations
Rc;sjdemial. Heating Only (New ConstNc'lion) $64.50 Residential, AC Only
$39.50
$39.50
$39.50
Estimated Cost $ Building Permit #
HEATING PERMIT FEE $
STATE SURCHARGE $ _50
TOTAL PERMIT FEE S
(OBice Use OIl1y)
This Appli .,:. ,',. D Becomes Your Building Permit Wbeo Approved
:Paid
Receipt No.
B1lIIdlDI! Ofttcial
D.te
D~~N 2 7 2005
By
24 boar Ilotite for aU IDspeetioDI (952) 441-~850, fax (952) 447-4245
TOO~
HIV a3110HLNO:)
9L~909tTS9 XVd tt:OT aa" SOO~/6T/TO
Date Rec'd
CITY OF PRIOR LAKE PL1:MBING PERMIT
1 Blue File
2. Gold City
3. Yellow Applicant
I PERMIT NfI"'o.d1
(!llease !YIle or print and sign at b~ww._)
ADDRESS Al
A1-:s(j. ~1Ij' Jd.s Lo. '11 e / C tv
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT /q BLOCK 0 J ADDITION Sfe (' /; ~ q ~ ~-'~k
PID
~=e~R I1G{)tJ,JJ G~+rl-{~ +;0 h / :bC-: .:,
(AdAlress) hlO I l'Kfj, s:+ IUpA / Aprdp ~! ley / !2n '-C;- ~/ OJ Y
APPLICANT p. c...L lJ/. J' I. - V 9 ()/JYO
{Name)C1JIf? ~7a'(' L-/..J.rrtbl"'j,.~ (Phone) f,r/- /:,r -~, \r
(Address) "~~Y &'A+A er/afld ty{\j'l/e l!A,od6lJrv. Mn .s-..s/c;;)9
, (Address) / (aty)/ ' (Zip Code)
(C<Jntact personLf) 1A.Jl; d t" 5;... :+1, ~ I -. (phone) (; .S'''F Ys<! - of / ~ ()
APPLICANT SIGNATURE dI~~" rxl~ DATE / -;) 6,--t1~
Quantity
I
J
"}
'i
}
..:y
J
~:~
(Phone) 9sJ... XJ~-7h() I
APPLICANT PLEASE COMPLETE BELOW
Type of Fixture Quantity
Bath Tub with or without shower
Dishwasher
Floor Drain
Lavatory (Bathroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
Sinks
Bar Sink
Water Closet (Toilet)
Type of Fixture
I
Rough-ins
; Water Heater
Water Softner
Stand Pipe (Washing Machine)
Sewage Ejector
Backflow Assembly
Backflow Assembly Test
Lawn Sprinkler
Other
I
Estimated Cost $ / ) -.sl) 0 ( () ~
/
11&11. ~/L)
Residential, New One DJA.~~M9.S0
R"idon'W, Additi... :;~~.,o
Building Permit # oY -./ ~ d 9 v.,..
-aJA.I,t...
~F ,~
$
FEE SCHEDULE
Industrial, Commercial & Multi-family 1% of job cost with a $39,50 minimum
PLUMBING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Omellt
Date
Paid I Receipt No.
t Dat~\ .FEB 8 20051 ~y':
I " ,
24 hour notice for all inspections (952) 447-9850; fax (952) 447-4245
05/03/2005 17:30
9528815975
BOB JECHE
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
PAGE 05
Date Rec'd
~~ ~~i~' I PERM!i;~:; ~
- ZONING (office use)
(Please tYPe or Ilrint and ~im at bottom)
- ADDRESS
~'1S~ ~
wo/
LEGAL DESCRIPTION (office use only)
LOT' l\BLOCK 't ADDITION l} t c::lt' t i ~1
r
50
OWNER I~", ! 1
(Name) I 1 ( . ') C: ~ {\ 1 ~...
(Addre:ss)
('. ~ D Y\ \ r.
(Address)
(City)
APPLIC~ i ~~~" .'. II 1)/1 + ,\ u'
(Name) 1\; v...r i.I1 ~ l",,~, (!,~
(Address) .~ II L t :r'f') b, \ ~) rJ} a (~ ~
~. . (Addr~ss) .
....... I ...._~-- r
(Contact Person) I' \ :) J~"/~. i
APPLICANT SIGNATURE , ~ )~ I.. ..:. .J_".J;~ c
(Phone)
. . 1
! t
r i CUttl (I ,OJ.1
(Qity)
(Phone)
DATE
PID
(Phone)
(lip Code)
/\;/~/
l;l7- '-1;; /
...,
(Zip Code)
,f .. r.t ... /) 5
(
APPLICANT PLEASE COMPLETE BELOW
Size of water service I inches.
Location of any couplings from structure feet.
Type of sewer pipe. 0 ABC GjPVC 0 Cast Iron
Estimated length of sewer line feet.
Clean out (if required) located at feet trom structure.
"
Residential sewer and water line connection
Sewer connection only
FEE SCHEDULE
$35.50 Industrial. Com'} & Multi-family J% of job cost with a$39.50 minimum
$17.50 Water connection only $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
ST A TE SURCHARGE
TOT AL PERMIT FEE
$
$
$
comet ll~e Only)
8i.J. PAID
.'/IJO/ftl ""rr,..,
"iG p€
IYA,frr
Tllis Application Becomes Your BuiWlng Permit When Approved .\~ill'tf~ D
;:~I,DUA
_ ))It~ . ,i 11 Y t 3 200~
1 I I ~
24 hour notice for 1111 inspections (9~2) 44"~~50. fax (952) 447-4245
Bul.Idiog Ollieial
t
~\ Receipt No.
,i B ~
i!i Y
IlJJ
_J 0
'~I"
a'l .__n___..____._..______.__.
. -
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS Z 7~ 2.. IAl i U.s t.A.NIi ~. &.J ·
NATURE OF WORK ~ ~N'T~I~
USE OF BUILDING S. ~ C.
PERMIT NO. _104- ;/ Z z--q DATE ISSUED 0'"
CONTRACTOR 1~ ,... PHONE 2-/0.'
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~O~~~: l.<k-\\ ;A. s~~....Q. INSPE7b I I i t;"/:5~
FOUNDATION (Prior to Backfill) I ij,S I I i 5" i~ '1
. ~LACE NO CONCRETE UNTIL ABOVE HAS BEEN ~IGNED
(I...rr-- ROUGH - INS
--.
SEWER I WATER I SEPTIC ~, ,./.....-!>.
FRAMING v ,iVY'"
INSULATION j&/j.-
ELECTRICAL
PLUMBING
HeATING (if required)
FIAEPLACE
GA'S LINE AIR TESTA?, '9~""P
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
... I. , ..
~"'611J1lA" I~ ;l1F .,z//Io, I
FINALS e~ ;::~
tJ.if C;, ? z.. ~ .r-' 1 I
,f/~ J J leg J05
I 1/
II!> rfp<?? lZ -
OCCUPY UNTIL ABOVE/HAS BEEN SIGNED
NOTICE
GRADING (P-:,ior to Sodding) /
BUILDING Arl ~ ~ -~- () ?
ELECTRICAt '
PLUMBING
HEATING
DO NOT
" .' ~~, ."..M'l..., ." .".,_.!, ",_, _....','~.....I
DEP~RTMENT OF
BUILDING AND INSPECTION
t--~-o5
..thrV;s
/"
&f
,.
~~-
10/ 11 -
IVY'"
?-- J,.L-\.-Q S-
f- - H- os-
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.
~"~"--"_...-........._--....'~"~" ,_...--,.,- -~.,.~.........,.,----~--,~._._,.~"~.,~---~---~._...~~..__.,,~.
J:'OqALt INSO-='CT'O~'~ IO~?' tt.17_0~r.::,.,
QIrrfifirafr of @rrupanrl!
CITY OF PRIOR LAKE
~tparfmtnf llf ~uil~ing JI nspttfilln
~/Final Permitted D 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 04-1229
Use Classification Bldg. Permit No.
Occupancy Type _
R3
VN
_ Zoning District
PUD
Legal Description _
Type Construction_
L19, BJ, STERLING SOUTH
Owner of Building
Site Address
27S? WILDS LANE N.W.
Date:
I: r- /. ~ing Official
1\ 1.n ({.
\ I
COr.. TR..,
In
Iii /
1/ I
I) t
7601 145TH ST. \.:., APPLE VALLEY 55124
JANE Y..ANSIER
City Planner
MCDONALD
Contractor's Name & Address
ROBERT D. HUTCHINS
Date:
'" .., ....~......i.'" '~_,,"<lL. I..' I ~,'"
"-:'d' ", ':..... ,j" ."--'":....,,,,.... :~.~,';.Cl ,.,:. ,;;1 .'.~ I~...'.'~, ,__.. \_....._ ~'~L~f!!f~j'1!!~1~~
'_.,~~.i-:.:.;.~.h~ L~
~,
. JfIP,'
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS 275Z WIUJ t.N
OWNER CONTR.
PHONE NO. PERMIT NO. 4-./2-Z,'/
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o Mi FINAL 0
COMMENTS: 5j
I
1!lo7JI ~ t 11
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~CR ALL FOR 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!
ININOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS '2 752...
OWNER
PHONE NO.
o FOOTING
lJ FOUNDA liON
o FRAMING
o INSULA liON
,;g:FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
~
LJ Ms:.: l......A-
CONTR.
PERMIT NO.
-Y - ! 22.'7
o PLUMBING RI
lJ MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o ..eLUMBING FINAL
7MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
(, r:'~ ~~~eJL~ -. ~
-
'2-- ~JL ct- -) ~
~.
U .0-0
':."-0
T I ~
o - / - l?~
o WORK SATISFACTORY, PROCEED
o CORRECT ACT AND PROCEED
J( CORR~ RK, REINSPECTION BEFORE COVERING
Inspector 41: Owner/Contr:
CAL'\..I - 850 FOw4'HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUlREJ,vrs ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/ INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
"2752.. w,'lis L.." (.
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
DATE TIME
'~2l~
tile o,>A,.1I
0'/,1221
rd:.~ILLlNG
I.btOMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
Cvlb B@-t)/(
W'- - () IL-
1'.1 et"AV\ ~,' It- I ^ ~D~K.J @J t, .'Xt)
f/ 0 ~J-'"
o WORK SATISFACTORY, PROCEED
>(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.
_on
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 27..5;;;'
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
SCHEDULED '/~dGl
W:t&~ LV\.
CONTR.
PERMIT NO.
4- l12q
.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
,Ji!f PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS: (J J
l~..l U~~
2, WI ~ ) If4;pj /
Lf.!JJ - 98 r3
o WORK SATISFACTORY, PROCEED
.x90RREC A :nON AND PROCEED
o CORR CT RK, CALL FOR REINSPECTION BEFORE COVERING
Inspecto : Owner/Contr:
CA 447~~FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
C~UlREMENTS ARE FOR YOUR PERSONAL HEALTH'( SAFETY!
_orl