HomeMy WebLinkAboutBldg Permit 01-0580
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
5' z.. r-tJ I
Please e or rint and si at bottom
ADDRESS
If}
cc
LEGAL DESCRIPTION (office use only)
LOT , BLOCK
b.sz...a. r
ADDITION
Date Rec' d
I While
~ Pink
3. Yellow
File
City
Applicant
[PERMITNO. 0/.0580
~
IrQ
J
ZONING (office use)
~/s.o
st-
~70 - of7 -
PID25-
OWNER
(Name)
(Phone)
(Address)
BUlLDEJj k
(NameL
kl-c-:> r +-1>1\
(Address)
TYPE OF WORK
ew Construction
OLower Level Finish
o Fireplace
o Misc.
(Phone) --9 '6 C) - / 5501
L
OPorch
ORe-Roofing
ORe-Siding
OAddition
OAlteration
OUtility Connection
PROJECT COST/VALUE (excluding land) $
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or
authorized agent for the above-mentioned property and that all construction will conform to all existing state and local1aws and will proceed in accordance with
submitted plans. am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the petty to performpeeded iosp .oos. $
x
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
t{O . a>
our Building Permit When Approved
&'-52&0/
Date
~X5f)
Contractor's License No.
5-dt/-O/
Date
Park Support Fee
SAC
#
#
Water Meter
Si 5! "; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
9 /0 o. t /
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
iSSU/'3t:-J!\ _~__ _ ~(rA[tp{ ~1f\Ag-.(~~
{./l"'~gDircctor Date "~C~:Conditions,irany
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
~~
White - Building
Canary - Engineering
Pink - Planning
Thf ('rnln of Ihr t..kr Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. e - J=LoR-IO rJ
f)-~~-Ol
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
17/ 0 to
WI W 6R- ~JJ;SS (12Af L
Accepted
Accepted With Corrections Y
Denied ~..., p
Reviewed~I':.\...o"V-76 Date: ~-<?-da?'
"'m~nts~/1 J/ r ' fJ
~~(hk
"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."
Thr (-rnlrT of lhr I..kf ("ounlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
D. C. tiC I~IC {\j
...~ - ~ (I - C I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
17 Ie ~.... (I,ll, i / F ! <_ j, F/:~=:~Tkj\ I L
Aocepted ~
Accepted With Corrections
Date:
&-,/&!tJ(
,
3. -1
Wv-lMV' Q,D 'W f)
1M ~ L531- se/ 4' GYb..
~~ ?- t{ F, (;y~ t,) lfJ.~ Asl
0~~1~~~J
"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 - Engineering
Pink - Planning
Thr CrnlrrClflhr I.lktCountry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
1-.
NAME OF APPLICANT
APPLICATION RECEIVED.
D. 12-. /=LDR--m rJ
~-'29-01
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.
.
/71 0 (.;
vv ILA)F;I<-t~JJ;SS (lZA1 L
Accepted
x
Accepted With Corrections
Denied
RevieWed By:
A/f}-t3
Date: fa -? - D I
Comments: See Reverse Side for Additional Information!
See Attachments: 1) Gradmg Plan, 2) Erosion Control Measures
3) Erosion Control Plan
"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,25, 2UU1 4:31PM
GENZ RYAN PLUMBING AND HEATING
liI-o-, ~66 8
,), . .
P, 5/7
Date Rec'd
CITY ,OF PRIOR LAKE
SEWER AND WATER PEnfiT
( !
'i JUN 2 5 2001
L,
(Please l.yJ>e ot~IJ11;;;;tb6lli>ml .
I ADDRESS I' .; U)/'{ ()Lrnf's..~ Tft,(...-- )e.-
i ~~; I PERMIT NO. I - 58'0
3, QDhl AppIi..u:
ZONING (9Ili<<".)
LEGAL DESCRIPTION (olli<c u.s. Ol:liy)
Lor r BLOCK:
ADOmON
PIDd.5 ~ .
OWNEll.
(Name) n~ v....rt...... f'"...~n..... u......._,
(l?hone) ';5'-45/, (tH3
Eagan, MN 55122
(city) (Zip ~)
(Address) 3459 Washington Dr 5u 204
(Addle")
APPLICANT
(Name) Genz-Ryan Plumbing & Heat:lng
(phone) 651-423-1144
(Addr""s) 14745 50 Robert: Trail
i ; (Addr...)
'UCANT SIGNATURE
Rosemount. MN 55068
(City) (Zip Code)
(Phone)
DATE
:"r"
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.
FEE SCHEDULE
Residential sewer and water line connection $35.50 Industria!, Com'l &: Multi-fiunily 1% of job cost with a $39.50 minimum
Sewer connection only $17.50 W.uerconnectionon1y $17.50
Estimated Cost $
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
s.
$
.50 r
PAID v'e'iT! . ,..
aUIl.D'NG PEC:"y' .
~._ tUlfl'
(alii.. Un Only)
This Appliestion Bec:om.., Y OIU' BllildiDg Permit When Approved
I:;~
,.
\
~
Bulldl"" OlIidoJ
Pate
IP~
Date '[-3 -01
14 bour notice for .11 in.poeti... (951) 447-98'50, tou: I'S) 447.4245
CITY OF PRIOR LAKE
HEATING/AIR CONDlTIONING/FIREPLACE PERMIT
Date Rec'd
~. ~~~" ~:~ I PERMIT NO. 1- 51/0 I
J. Yellow Applicant. 0 ,
rnes
~
fr.
ZONING (office use)
rsD
LEGAL DESCRIPTION (office use only)
LOT \ BLOCK 5 ADDITION
PID
-3--;t) -0'/
OWNER '" ---:J
(Name) !.). K.
(Phone)
(Address)
Ste. #'
/oibL
APPLICANT
J)r.
(Phone) t!5/-,;)5 01- &775
Lo..gCJVl 66/ d J...
(~) (ZIp Code)
(Phone) X 020 I
L-DATE
(Contact Person) ~
APPLICANT PLEASE COMPLETE BELOW
IXINEW CONSTRUCTION o REPLACEMENT o AL TERA TIONS
FURNACE MAKE AND MODEL '"Br'jo..r>-t 9.,,1 % FUEL "-Jo.t. GqS
FLUE SIZE o? K polL RETURN OPENINGS INPUT IOO/Of) 0 OUTPUT 80. G>lHJ
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarl1! Air Plants o Sleam PLEASE NOTE:
OGravity o Hot Water Air Conditioner Units
o Mechanical o Radiation Cannot Encroach into
&Air Conditioning o Special Devices Required Side Yard
OVent. System o Uther Devices Setbacks
FIREPLACE MAKEAND MODEL
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64.50 Residential, AC Only
$39.50
Residential, Heating & Ale (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $ 1000. 0-0
Building Permit #
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
PAID\i1i"
,BUILDING F:~
(omce llse Only)
This Application Becomes Your Building Permit When Approved
Paid
Recei t No.
Building Official
Date
Date /_ J-3
24 hour notice for all inspectious (952) 447-9850, fax (952) 447-4245
10:45 651 633 8884
FIRESIDE CORNER
CITY OF PlUOR LAM:
HEA TING/AIR CONDlTIONINGIFIREPJ...ACE PERMIT
#0796 P.DD1/OOS
LnnJ::.I'ot."'I:.'U
I c:D'~;;;S~prinliUld.'IWla.ll>o""l!'l
/-]IOCc (A l;'dOAAoP':S 7A&p.. So'f
\~ E~,,,,,, I PERMlTNO. 7-SflD
ZONlNG (ofli<" v,,)
~ 5/)
LEGAL DESCRIPTION (Dlllee use only)
LOT BLOCK 5 ADDmON
PuV7-
OWNER
(Name)
~-DfZi~
[Phone)
(Add.ress)
APPUCANT
(Nwne) ALLIED rr.FESIDE DBA FIRESIDE CORNER
(Pbone) 651-633-2561
(Contacl Person)
APPLICANt SIGNATURE
RO~E:.VT'T.TF. MH
(City)
651.-633 -2561
(Phone)
,:;~'11.
(Zip Co4e)
(Address) 27 00
N. FAI~VIE~ AVXNUE
(Ad,jrc,,)
BRENDA !ltlSTON
DATE
.),
.APPLICANT PLEASE COMPLETE BELOW
,w CONSTRUCTION 0 REPLACEMENT 0 AI.TERA TIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPB OF SYSTEM HEATING OR POWER PLANT
FIREPLACE MAKE AND MODEL
o Sr~.m,
o H.ot. WlIter
o Itsdlotfon
o Spedol Dev;ee.
D Olhcr Devil:...
,s(.. '"Iso
PLEASE NOTE,
Air Cunditioner lJnils
CaluIl)t Enaoal:il into
Required Side Yard
Setbacks
OWallh Air PI",,!>
OGnI"ity
o Mcchllllical
OAir Conditioning
OVen!.. Syst.em
Gc....
Industri.l. Commercial & Multi.Family
FEE SCHEDULE
1% of job cost R,o,;4.nll.l. G.. Pi"",!..e
$39.'0 minimum
$!/9.50 Re,identi.'!, Ad4it;pn, /It; Alrerulons
$64.50 Rosld."tial, AC Only
$39.50
Re.idontlB!. He,tlng & NC (New Constructionl
Residential., He',ling Only (New Const.",Clion)
539.'0
$39.50
E.timated Cast $
Buildfn.g Permit #
(om.. !l.. Only)
This AppJj~tltion Beco"''' Your Baildlnll Permit Wilen Approved P.id
-'
&1 /:>
'./t~O'JI,:,
ji1!,~~\ /'
{~,
(.
Reeelpt No, ",
liEA 11NG PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE S
.50
BlIjMln~ om<i.1
Date
S r ;)./-
n.r.
l4 ~ou, 0.01:1.. fo' .lIl..poed.n. (99) 4.47-9BSQ. Ill. [9!ll447"'~4:5
Jun.25. 2001 4:31PM GENZ RVAN PLUMBING AND HEATING Nu.6668 p. 4/7
. . Date Rec'd
.. .. !
CITY OF PRIOR LAKE PLUMBING PERMIT('
\: ~ 2 5 2001
- L.,..
\ (
I. Dille rue
2.Gctfd CiI;y
).nl..... ",ppltosm
~E.
I PERMIT NO. -1.- -c; -'j&-I
I
m_~or:add:~~Ug~
f ADt-lI ~ . . '.'- . ~)(: -tXfrl~~" IY/ J
LEGAL DESCRIPTION (office use oDly)
LOT (BLOCK ADDmON
/5/
PIDdS -3?o- 0
()
OWNER
(Nwne) DR Horton CUB eo", Homes
(phone) 651-454-4663
(A~~ 3459 Washington Dr 5te 204 Eagan, MN 55122
APPUCANT
(Name) ~a....'lI'_~Y""" i'lHlP1-....f:,",B. A. U....af".......g
(phone) ';,1_1..', 111..1..
(Ad.dress) 14745 So Roberto Trail
(Address)
Rosemount
MN
55068
(Zip Code)
(City)
;,".
(phone)
651-423-1144
(Contact Person) Mar
.:,/',.-
APPUCAN'!' SIGNATURE
DATE
EASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of F'b:ture
-z...- Bath Tub with or without sh.".rer 3 Rough-ins
Dishwasher ./ Warer Hearer
Floor Drain - r Warer Soflner
tf. Lavatory (BatlJroom Sink) I Stand Pipe (Washmg Machine)
I Lam1dry Tray (l or 2 compartment sink Sewage Ejector
I Shower Stall Backflow Assembly
r Sinks Backflow A$sembly Test
Bar Sink Lawn Spri.o.k.ler
, .0 Water Closet (Toilet) Other
FEE SCHEDULE
lndustnal, CommercIal & Mulll-family 1% of job cost wjlb a $39.50 millimum Resldontial, New One & Two-F.unlly $9950
R..idontial, Additions & A1bntioos $39.50
EOlon"led Cost $
Buildlng Permit #
.so
lJlJ/~A,ID ~/,,,,,..
~^'G p I 'tIt
'E:I)''v:tr
PLUMBlNG PERMIT FEE $
STAlE SURCHARGE $
TOTAL PERMIT FEE $
(om.. Use Ouly)
Thi. Application Becom.. Your BuUding Permit When Approved
Paid
Receipt No.
1
,\
S.UdiDg Omclal
Date
Date-;_ :3 - 0 !
By
C--/
~4 hour ootice for aUlo"pedloo. (952) 447-9850, fax (952) 447~~
-"~-.__.,._----".._--_.._..._._--,---_._..-
.t
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS -L2J(') CQ 'AI; Id~rnec::;.~ ~
NATURE OF WORK ..1Jew
USE OF BUILDING SED
PERMIT NO. ~S~ DATE ISSUED Cb-s -;;;<oo(
CONTRACTOR .l.2..K Her- PHONE 98S-- 7AQ7
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
I FOOTING f.;q. .
FOUNDATION (Prior to Backfill) I))
PLACE NO CONCRETE UNTIL ABOVE HAS BEE
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION .
ELECTRICAL
PLUMBING ;(k~'
HEATING if required)
FIREPLACE
GAS LINE AIR TEST I'V'-' F~'
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Soddin )
BUILDING ""',C-.D ,-tJ..( S' I ~ .~.
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN
NOTICE
This card must be posted near an electric.al s~rvice 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
If; () I
SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
QLertiftcutt nt. ODccupancy
CITY OF PRIOR LAKE
Department of ~uilbing Jn~pettion
pifFinal Permitted 0 Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform 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:
Use Classification SINGLE FAMILY
Occupancy Type R3 Type Construction VN Fire Zone
Ll, B5, DEERFIELD FIRST ADDITION
Legal Description
Owner of Building
Contractor's Name &. Address D. R. HORTON J
ROBERT D. HUTCHINS
Building Official
IJ[?O/ol-
,.
Site Address
Bldg. Permit No.
N/A
01-0580
R1SD
Zoning District
17106 WILDERNESS TRAIL
20860 KENBRIDGE CT., SUITE 100, LAKEVILLE
DON RYE
City Planner
Dare:
Dare:
POST IN A CONSPICUOUS PLACE
,.L
~ .'.
HOUSE HEATING TEST RECORD JOB # Iu,
ADDRESL1..J..WJ(,.J[.:)/ ld6'f Yl(:,~~-Cd APT. _FLOOR ~CITYPr'D( ~U;\JRB
OCCUPANT OWNER
HEAT LOSS DATE HTG. INST. gjol
SOLD BY INSTALLED BY r- re' rJr'cj" ....c:> -,
Electrical Work By Gas Line By l '- l \
TYPE OF HEAT GA_FA)(:-HW _STEAM_SPACE HTR. _UNIT HTR. _OTHER
R '.. GAS. DESIGN CONVERSION
MAKE r ~___ MAKE OF BURNER
Model ~~ Model
Se,;ol 0 . Mo.. BTU Rot;ng
INPUT __. MAKE OF FURNACE
Model
\ CONTffLS
THERMOSTAT.hOVlf,~~eft ~g
Volve(..:Jl.\I~ ( o.yr
Limit
Vent S;zo 3' \ P \) '-
KIND OF LINER
Draft Hood
Fi Iters Size
Chimney Location
Chimney Construction
SIZ~ NONE
RegulaTor '\C I W-:o \
L i mi t Setting
Fon Setting
Pilot Type
Pilot Make
Pilot Model
Pilot Timing
L. W. Cut Off
Pressure 3 .S
Input CFH
Stack Temp. IOd<::i
_Humber
Inside
y
Outs i de
t\ ~-C-
Smoke Bomb _ Wiring
Droft Test T 09
Door Pressure lighting Inst.
Pe,cen' CO2 ~I_ Dote Testod JtJ -;}'::/,O\
Po'cont O2 ~. Compony Te.,;ngAAlllaj,t MechaniCj'l, ~6591Kf'nnebec
_ P~rcent CO ---0-- Name of Tester f'4rC.A.. a, II'-.... ...l A....J \ Ll-
Dr., Eagan, MN 55122
Form 235
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED ~~,!a( I/.' d<.J
uJ~ 7k,
ADDRESS / 7 / () 4>
OWNER
CONTR.
PHONE NO.
PERMIT NO.
d ( -SS>'O
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
~ 0 MECHRI
III WATER HOOKUP
)If SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTSG) ~ ,~".L<~
@)
\
i ~
-r
b WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
( ~ CORRECT WO , CALL FOR REINSPECTION BEFORE COVERING
-y.......
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
&/to(O'l"
/110h Wlt,o@!!.N'65S ~.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDA nON
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
S 00 / r;u:,r:.;
I
COMMENTS:
DAlE
TIME
~
01 - 0580
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ C:.-'I- 1"';1--.-1
jlWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RElNSPECTlON BEFORE COVERING
Inspector: ~. Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
JI'iSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
lH~...Q1 ,;(::-~O
ADDRESS n IO(P 0;-tLerv\e.$-& 17.
SCHEDULED
OWNER CONTR.
PHONE NO. PERMIT NO.
o FOOTING 0 PLUMBING Rl
o FOUNDATIO~ 0 MECHRI
o FRAMING . \ 0 WATER HOOKUP
o INSULATlO I" 0 SEWER HOOKUP
j1 FINAL /FS\ 0 PLUMBING FINAL
o SITE INSPECTION ~toMECH FINAL
COMMENTS
o EX/GRAD/FILLING
o COMPLAINT
~O FIREPLACE RI
. 18ilR1FIREPLACE FINAL
o GASLINE AIR TST
o
~
~~~a-k-~
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
:S:::ECT ~ALL FOR REINS:::::::::FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNon
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~L
o SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
Jlf"!;V~ LING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
01(
5rT
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RElNSPECTION BEFORE COVERING
InSpectOr:/~er/COn\r:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
conE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETYI
INSNOT'J
/O-30-Of
iUA~(J~~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULEQ
ADDRESS
1'71(J~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING Rl
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION .t:f\\ 0 SEWER HOOKUP
o FINAL (\t5J ~LUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
DA. TE TIME
~_30
J -sg~
o EltIGRAD/FlLLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~MMENT~~ ~ ~~J'
f. ) 'ftl a.. . {... - uJ , H~
~
~~r
o WORK SATISFACTORY, PROCEED
)qJCORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RElNSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSlWTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!