HomeMy WebLinkAboutBldg Permit 01-0594
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 01
AND UTILITY CONNECTION PERMIT ~ -1-
IJ\ \-,. ,,-;Jt
r ~Q.\'^-\.\'\:'f 4ft"'-
I, Wllite File I PERMIT NO .N1f/5. I
~. i;;,:w ~;';li=' ___' (!f-"..;r4-
. E
j~G(Officeuse)
(Please.;voe or Drint and sign at bottom)
ADDRESS
r-:s ,?\ 0 \
D.cLr \=: I f! Id
LEGAL DESCRIPTION (office use only)
L CL V\f!..
~E::
LOT \ qBLOCK
ADDITION "Q (r--- ~ ; f--' Idol rv-l
OWNER
(Name)
(Address)
(Phone)
BUILDER
(Name. () 0 _ \+hr+-r!ll
(Contact Name) L (LJ ~A--' \ r2 {) ri ('") r
(Address) J.,O'6I.-,C ICe n'n r,o-t<;w Ci.. '0t-C- 10'[:>
L~o__.\1 Q L~\ II () _ (y\ \.. --;J ,,",""--,I)d-J.J
TYPE OF WORK
~ew Construction
DLower Level Finish
o Misc.
Date Rec' d
PID--95-31J.- n J9~()
(Phone)
(Phone)
Q"0 --qs--c) -- 7<':"01
DDeck
DPorch
DAddition
ORe-Roofing
o Fireplace
DAlteration
IO~ 1"')'7
OUtility Connection
PROJECT COST IV ALUE (exc1udio.land) $
DRe-Sidiog
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 I am the owner or
authorized agent fOIf the above-mentioned property 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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter uP)}n th propeny to perfQrm needed inJ\ctions.
X f't < ) /LLt.. H J.. A C"/7 .~r:oo 5 {oS '7 6 .- ;;;z..Cj - 0 f
i ,- Signature Contractor's License No. Date
I Permit Valuation
J Permit Fee
I Plan Check Fee
I State Surcharge
I~
Cf.(,-~
<111::. ')e I
(D7! .74 I
l/t$,. rot) I
I
}tP().~?J I
I'M ."0 I
I $ 35"".6"DI
GnPe~eeJ $ en, .t9t:J I
'hi~('WJAI n' :me Your Building Permit When Approved
" Y(j, ~-7-~
Bulldi 0 lal Date
$
1 $
$
$
1 $
1 $
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Park Support Fee #
I SAC #
I Water Meter Siz~; 1";
I Pressure Reducer
I Sewer/Water Connection Fee #
I Water Tower Fee #
I Builder's Deposit
, Other S ~ W ~tk.
I TOTAL DUE
I Paid
I Date
'7.? a..ri..- U '1
1(' ~
I ReceiotNo. 4o~A-6
I Bv 9-/~-()1
$ ~AP
$ l 1.9-1.cgel
1 $ 'I I;;S-,OO
1$ 4'l.~1
I $ 1,2tJ(J.a20 I
I $ 7tl1C' .d2l7 I
1 $ Ur-~.oe) I
1 $ ; 3S.S'Q I
I $ 7522 4q I
1 . ,
ertify 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
t by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~-~""'-~ ~/1'Lh\ -~..J~:tk".Q,~W-~,t;.
Planning Director Date Special Conditions, if any
24 hour notice Cor all inspections (952) 447-9d50, Cax (952) 447-4245
~
~~
White . Building
Canary - Engineering
Pink - Planning
Th.. C..nll"r of thO' L.kr <.'ountry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT 7) R i!()/21OV
~- /-0 )
,
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is pFOposed at:
5ao/ r/DNifddJ_Uv
~
Accepted Accepted With Corrections
Denied 70ff1( h .
ReViewed~~
~:~Q~~~))~
Date:
&-7-~/
"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 {'rnlrrof Ihr 1,.krCounlry
White - Building
Canary . Engineering
Pink - Planning .
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLlSr
1'<
NAME OF APPLICANT // II
APPLICATION RECEIVED
J
/
I (dl/
I
Ie I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.,.:
i
, ,
/..-./U
Accepted
~
Accepted With Corrections
Dehied ....... J A
Re~iewed BY~~__~.-?"l Date: &/f 2/C'""1
Comments:
.~. . ~ ~~'t\iO ~. Cm.,JNi-S ~
~ V~.U.{\ <l- Pldt-~ ~:~ ~~~
!IJPPvi\~JA 2v& At~/1 v
N.o \JM-~ ~ ~JrY:)y.p .j);(' W~ ~
~..Pl~ ~.v~cA -. LA ~~r
lr? W~~J(, ~< CV\ IJ;t;; I/~ ~ /1<- W~
0" S 7 f;.... ~ ~8*\ LK' UlI\e. ..
"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."
5~~
7/6
S 4 1./
White - Building
Canary - Engineering
Pink - Planning
Th CpOI., :of lh. Lak. ('ounuy
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLl~T
NAME OF APPLICANT
)) /? /1 ()/?TO!l/
~- 1-0 /
APPLICATION RECEIVED
Th!3~uil9ing, Engineering, and Planning Departments have reviewed the building permit
apjllication for construction activity which is proposed at:
~ a{)j j Q(}VAh'Jld! Liv
1/
Ac(:epted
)(
Accepted With Corrections
Denied
Rewiewed By:
Comments:
IIA4 fl-
Date:
(;y- /3-0 I
See Rever!':e Side for Additional Information!
JY7CA i" .n I ~
::see Attachments: 1) Grading Plan, 2) Erosion Control Measures
:on Frnc:ion 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 4. 2001 :l:jUpM
GENZ RVAN PLUMBING AND HEATING
N0.5214 P W40
DlIte Rel;'d
CITY OF PRIOR LAKE PLUMBING PERMIT
6201
L\t,J # .r~'P~ n L"-J. ~E.
~
i: ~: ~~ I PE}{Mi'!' fii-o. 1-;50 I J
.: 3. YclkNt Applir;::W: " -, '-1
I
I- I ZOk~(o~~e)
(P1case tvne or 'Drint a.nd ,iP;n .at bottom)
ADDRBSS
LEGAL DESCliUPTION (ollie. "'. only)
toT IqBLOCK I ADDITIONTY?'_1?_P~ Z~O
PID ;)5'- /:ly 7), - M q- '0
OWNER
(Narnp\ DR Horton Custom Homes
(phone) 651-454-4663
("'ddr~s) 3459 Washington Dr Ste 204 Eagan. MN 55122
APPLICANT
(Name) ra.Y''' 1;l~..",_ 'D,.._1-..~_~_g r u~':
(Phone) _ "", _I. ,,_ 11 "I.
(Addr~s)14745 So Robert Trail
(Address)
Rosemount
MN
55068
(Zip Code)
(City)
Quantity
I
I
I
2-
I
I
I
~o~
- , -- ".-==----
APPLKAl"! rLEASE COMPLETE BELOW
I Type ofFixtnre I Quantity I
I Bath Tub with or without shower I I Rough-ins
I Dishwasher I I - - I Water Heater
J Floor Drain r< /, I Water Softner_
t Lavatory (Bathroom Sink) I I I StandPIpe (Washing MacbIDe) .
I Laundry Tray (l or 2 compartment sink I I Sewage Ejector
I Shower Srall I I Backflow Assembly
sinks I I Bac1dlow Assembly Test
I Bar Sink I Lawn Sprinkler
I Water Closet (Toilet) II other
(Phone)
651-423-1144
DATE t.o\ L( \ D I
(Contact Person) Mary Olson
APPLICANT SIGNATURE I ~
Type of Fixture
I
I
I
-I
I
I
I
I
I
?-
FEE SCHEDULE
Indusmal. Commcnaal &: MUlt:l.-family 1 % of job cost with a $'39,50 minimum Rl:lSldcntial~ New One: & Two-Family $99,50
Residential, Additions & AJ_ons $39.50
Estimated Cost $
Building Permjt #
PLUMBING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
,
} tJ"
t,' ,
L
BuildiDg Offlclal
I Paid
I Dao/ /~~/
24 hour notiee for .11 i..pection5 (9S~) 447-9850. fax (9S~) 447-4~4S
D...
B PAiD'
_ _ UJ~C -.
1 ReceiptNo. fl:-. . j
IB~/ I
(om~~ UI5~ Daly)
r This Application Becomes Your Building Penuit When Approved'
v
lun, 4, 2001 j:mM
GENZ RVAN PLUMBING AND HEATING
N0.5214 P, 4ii/40
Date Rec'd
CITY ,OF PRIOR LAKE
SEWER AND WATER PERMIT
(Please tvDe onnint: and. sUm '\it hottDml
I ADDRESS
62DID_~-A.rzW L/0,
'~ ~ ~\~. I PERMIT NO, /- CUi J
3. Gold AppIi<>W '-J If....j-
,'\G-
ZONING (0__1
12,(
PIDd5~ 37J.- O(!..~
LEGAL DESClUPTION (office we only)
LOT tq BLOCK I ADDmONDPP'~ 2r0W
OWNER
(Name).--IJ&-..I;1""::,,:,~~- "'UB-rgm. RQm~-
(phone) _'<1',<~~'
(AdMess) 3459 Washington Dr Ste 204
(Add=s)
Eagan, MN 55122
(City) (Zlo Codo)
, APPUCANT
~~cl Gen~-Ryan Plumhing & Heatin~
(Phone) 651-423-1144
(AdMes~ 14745 So Rober~ Trail
(Address)
Rosemount. MN 55068
(City) (Zip Cook)
(D""",,_) &q ',"on &
~PLICANT SIGNATtJRE J.~ _ , ..
0.,_ _ _...__._. __,
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure
Type of sewer pipe. 0 ABC 0 PVC
Estimated length of sewer line feet.
Clean out (if required) located at feet from structure.
DATE
65] -423- 1144
l nll-\c:') I
(Phone)
feet.
o Cast Iron
Residential Sewer and water line cO.w;loction
Sewer connection only
FEE SCHEDULE
$35.50 Industrial, Com'l & Multi-family 1% of job cost with a $39.50 winimum
$1750 Watereonnectiononly $17.50
Estimated Cost $
Building Pennit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$ - .
$
.50
L
(Olli,. Use Oaly)
I This Application Becomes Your Building Permit Wh.n Approved I P.id
I DatI>':. -
. D... . ~//fiJ/
~4 hoar nonce f<>r all in.pectioD' ('S~) 447-9850, ~ (952) 447-4~4S
Buildia,1r O:oldaJ
.1-}
;" r
( ,.
BUILDING P'.:' -.'
L.:.:. 11\,,_.
, Receipt No. ,.
IBY~ I
U
----,----_.,---~_., ----_.~-----"_.__._._..._....
CITY OF PRIOR LAKE
HEATING/AIR CONDlTIONING/FIREPLACE PERMIT
Date Rec'd
5'Z/) \
/) e.er&lrI
L..a.De.- SE
; :~" ~:~ I p. ERMIT NO. (-5 q Ju'
3. Yellow Applicant . I I
I
ZONING{officeu,,) ,
PI
_ (Please tvne or orillt and siRD at bottom)
ADDRESS
LEGAL DESCRIPTION (office use only) ~
LOT /q BLOCK I ADDITION ~~ ..Lv,~cf d. rJ:L
g,':e~RD.'M. Horfon (lLlsbm H,{me~"'--.
(Address)df)l((oO .J.(!".Ohrirl.~ G4Lo.k e.vil1e Mf\)
APPLICANT II ". t M 1_
(Name) IlL1'Cl()e~.h.,J-i/rl. (Phone) Ib5/-45:L-,:f(775'
(Address)..l..<oScJ f<le.nr"lebe('-~. 5:I:e,#j Ea_aon .?"5/..1;2_
(Address) '-' (City) (Zip Code)
(Contact Person) ~f.rr~ Z;rnmprfY'l_Q.n (Phone) (P5/-/-/5/1- .;/77!:J
APPLICANTSIGNATl!.k..J~h{f(!.~__'_U)~ DATE 8/;'/tJl
APPLICANT PLEASE COMPLETE BELOW
0'NEW CONSTRUCTION DREPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL 1>r'1-tln+- ~~A-Umill), 0 FUEL l\Jo.h-un I
FLUESIZEtf-"cla.soz, 'EL RETURN OPENINGS '+ INPUT 10,000 OUTPUT 6u..DOO
TYPE OF SYSTEM HEATING OR POWER PLANT
Pln:0 -J1J-(j;9--(j,
(Phone) 95a - Wit5 -7~7..2..
550~ _
OWarm Air Planls
OGravily
o Mechanical
~ Conditioning
[!Vent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o .other Devices
PLEASE NOtE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi.;.Pamily
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
Residential, Heating & Ale (New Construction)
Residential; Heating Only (New Construction)
Estimated Cost $ Building Permit #
(Office Use Only)
This Application Becomes Your Building Permit When Approved
HEATING PERMIT FEE $
STATE SURCHARGE $ ,50
TOtAL PE1U\1rt FEE $
il, II. PA,ID
. ~D,'tvG~II/y
'E:;F;/~..-,..
v" I
Building Official
Date
I Paid
I Date
Y' ~/O- I
IRec~
I By C;r::
t7
----
l
I
24 hon, notice fo, all inspections (952) 447-9850, fax (952) 447-4245
DEC.11'2001 07:40 651 633 8884
FIRESIDE CORNER
#6031 P.OO2(013
CITY OF PRIOR lAKE
HEATING/Am CONDITIONlNGIFIREPLACE PERMIT
Date Rec'd
I. l"lnk
.,.....
). y..,l...
~;'k"" I Cr!.Nf..u NO'O/-05r;~
(Please f:YrIe or tlrmt nnd IdRn at bol:D:n:D..'
ADDRESS
:)..).0 I 'J)P'1/,U :fr......
LEGAl. DESCRIP'I10N (offi<e use only)
z...",."G (olluu,e) I
LOT
Bl.OCK
ADDmON
PID
OWNER
(Name)
("--7) ,f?
d;n.-
(phone)
(Acl.dros.)
APPLICANT
(Nom.e' AJ"..J.IED l"IRESIOE DBA FIRESIDE COMER
(Phone) 651-63]-7<;61
(Address)
2700 N. FAIRVIEW ~
(Add,.,,)
BRENDA HUS'l'ON
1>QSF.\7T r.:r.., 'f'"
(City)
(PhODe) fS5J.-633 -2561
SCi1ll
(Zip Co4e)
(Con.taCt Pe15on)
APPLICANTSIGNATUREr ~JA'~ iJ-",z;;:::
DATE
/ :J-lir/,) J
APPLICANT PLEASE COMPLETE BELOW
~W CONSTRUCTION 0 REPJ.ACEMENT 0 AI. TF.RATIONS
FURNACE MAKE AND MODEL FUEL
FT.UE SIZE RETlJRN OPENINGS
TYPE OF SYSTEM
OWarm Air PllUllS
OO",.itY
o Mechanical
OAir Condir,ioning
OVen,. SyS!","
FIREPLACE MAKE AND MODEL ~ C, I...
INPUT
HEATING OR POWER PLANT
o Sleom
o Hol Water
D Radi8.llon
o Special Devio..
D Other Devices
OUTPUT
PLEASE NOTE:
Air Conditioner Units
eMllO! Enr:roach into
RequitEd Side Yard
Setbacks
_SL 7,[1)
IndUSTrial. Commcrc:iaf /II. Multi-F~mlly
FEE SCHEDULE
J% of job coSI Residenlial, Oa.s Fireplace
$J9.50 minimum
$~9.50 Residential, Addldons & Aheration"
$64.50 RtsldentWJ, AC Only
$39.5D
Residential. H"ling &. NC (New ConSllllctiQ[l)
Residential, Hooting Only (New COlUtru<lion)
$3~_50
$3~.50
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE S
6/- OStJ+-
,.... PAlO 'N\~BiJ.\i
.slf ~\U)\~~~
Estfmated Cost $ Building pennil #
(Ol'llec Use OnlY)
Tbls Ap~~tM mm~ Your Building Permit When Approved
~ (l/(j-Ul
Bulldl.. om".1 DA'"
I Paid
I Pate
Receipt No.
By
Z4 boor noli.. for nil In.pectlon. (951) 447-9850, fa. (951) 447.4;l45
.I"
PRIOR LAKE
INSPECTION RECORD
f/?./\-
DEPARTMENT oJ Ma.ill\.t;--k
BUILDING AND INSPECTION
SITE ADDRESS 6-;:). (')
NATURE OF WORK IJ~
USE OF BUILDING . rvr:A-
PERMIT NO. ~ DATE ISSUED C:;-7-2t8e:J{
CONTRACTOR _ n~ - \.--t....,----.:-~ PHONE--.%'S'=- ~67
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DATE
1J71j"f 41 IfI/o1tp
, FOUNDATION (Prior to Backfill)~:;' I ~ gj / If//)/ ~ f67 ~/tJ [ l
PLACE NO CONCRETE UNTIL ABdvE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC I I
FRAMING I 4 /,?/.;l-71IDI
INSULATION I '1:-_~ _ 'll.. 01
ELECTRICAL I r .
PLUMBING v..G. V~J ~ ~!'7/61 I 6_ 1/).1/1'10/
HEATING (if required) I / ~ I j;;)/;J.JJ /0/
FIREPLACE I ,6;. 1/2/d?kl
GAS LINE AIR TEST ~.e ~ ~ I~. \ 2..( I 2.{ 0 I I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
,~ (h. /ZIt4/Jr I
Q FINALS
GRADING (Prior to Sodding) _ 1f2R,.
BUILDING T,c...~, -t!.J.1 g- /, If) 2.- 8:r .).Ir p;lf)!./ ~
ELECTRICAL .
PLUMBING
HEATING
DO NOT OCCUpy
I FOOTING ~- ~. nh'1}o'
L
t5;.SPE!:rDR
J
I :?J 7., ~
1fd-t/1o 7/
-, 'I
I ~
I
UNTIL ABOVE
NOTICE
~
;2// '-I~ Z-
;:;Jr i/o z.-
,
BEEN SIGNED
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
PHONE NO.
7(n
S7I)\ 1 S"LO~/)7.0\ S1.i)J fJtfR.r'1~ 0 1-..10
CONTR. n:R. H-ntCtIO~
PERMIT NO. 0.' ~"<1""') S'15, 59(0)5<17
o PLUMBING RI )( E~IFILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GAS LINE AIR TST
o MECH FINAL 0
SCHEDULED
ADDRESS
OWNER
o FOOTING
o FOUNDA liON
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
COMMENTS:
S -WI - l-u....AJ E. t;' (> .J'N..,f-,rJ'y..
,SuY'.., - (,-ou.J&( (.v.P...-P. f,()'x
S?p S - Lcv.Yf' (~.J/l....f-... r,dX
c; 7..u--' - () 1\
S~I
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: J^ -!~ fl Owner/Contr:
CALL 444850 F TH; NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
-,,--_._'"~-~-----_._.-
DATE TIME
CITY OF PRIOR LAKE ..,ha!..
INSPECTION NOTICE SCHEDULED ~ A.Tt
ADDRESS 5201,.3, 5 , 7 066;eR6t-O t...Ai
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
SDP/Trb66
I
/-S9~ .595, 59"
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
(;J ~
i
/tI #hU .~
~ ~/?{fn-~'
J~
. UDD
l'd~''''~
c.1WORK SATISFACTORY, PROCEED V'--' 11;0'2/
F "'1"
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~
;'
fALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
Il'iSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
~1'1'/CL- 1/6t'J
ADDRESS
5,,;!t)(
tkv/.: eLJ~.
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING Rl
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION @) 0 SEWER HOOKUP
o FINAL J!) PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: <<1 vU-rl- ov-c .i&rl'
,
;vtl .- .cG.--. - ~
~~~
6/ -5:'7'/
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
,
o WORK SATISFACTORY, PROCEED
!d CORRECT ACTION AND PROCEED
o CORRECT W?lK, CALL FOR RElNSPECTlON BEFORE COVERING
Inspector: {(?:1{ Owner/Contr:
CALL 447.9860 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
2-(,,~O 'Z. 4wrJ
ADDRESS 520/ DF-.6R;::IFf.L) LtJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
/- 594-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING @ 0 WATER HOOKUP
o INSULATION ~ 0 SEWER HOOKUP
~FlNAL AtiO PLUMBING FINAL
o SITE INSPECTION '~)ll. MECH FINAL
COMMENTS:(/) P/l~ ');~ . ,~ ~
~ ~. eJl...r....'Af71-1. '
@ ~"'r:,:' ~. ~ >if)"" -"1/ 0
~~~~
.
I; e.., n .-tfJJl
'IS!
-
~~~ dv
I~~
I 0 7...-
I
o WORK SATISFACTORY, PROCEED
)ll7 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
i3+,
Inspector:
Owner/Contr:
I
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
APPLIANCE
PERFORMANCE TEST
Attach to gas line adjacent to regulator
Heating Contractor
Name ot Tester
"''' \.._~ "'\..u-
\<.s:..;\_
?- - 1- 0-:>..
Date
Job Address 5"';1. C:>I O..r\..\ ~ (k
Heating Contractor 1\" ',-'" ""=~
Name of Tester v....:.+,--
Date
:).-1-0-:"'\
Percent 0,
(..)
Percent CO
Percent CO,
-0-
Stack Temp
'i".r
1,i-'
Combustion air is adequately supplied per
UMC See, 606 'l~
input ....r, .,..'"