HomeMy WebLinkAboutBldg Permit 04-0661
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
O~ PRIO",
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+J'NIVESO"'\'"
White
Pink
Yellow
File
City
Applicam
I PERMIT NO. 04-. 0 (p (p V
(Please type or print and si2t1 at bottom)
ADDRESS -<?/ If1 IAI D
vv U I f1//LOrv 00
LEGAL DESCRIPTION (office use only)
LOT/3'BLOCK
I ADDITION
OWNER
(Name)
(Address)
~ IV'tV
WOOp[ @ WI&tJJ
Date Rec' d
~. 7.04-
ZONING (office use)
;::;(/0
PID2b. 383.00.0
(Phone)
BUILDER ~ .
(companYName)h t:;tJf!-r I~(~ _ _ A J
(Contact Name) b 1f2-~
(Address)~0.~ offrfl. 12;;d8r:L 0Vv(~
TYPE OF WORK /)(,New Construction DDeck DPorch ORe-Roofing
lElAdditlon DAlteration DUtility Connectlon 0 Misc.
CODE: Dt1I.R.C. OLB.C.
Type of6nstruction: I
Occupancy Group: A B E
Division:
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
(Phone) 95"2 j),-;~ -1-3/.. ~
(Phone)
G. fJ . ~ ~.., ~ t/-cJ-
r
ORe-Siding o Lower Level Finish D Fireplace
II
F
1
III IV @!)A ~
~rmfiPSu
PROJECTCOST/VALUE $ ffl f:--
(excludiug land)
? 0 ()4- ,1$/I.57PCf.1fJ
II
Receiptflo. 4'7~
By A
U
Park Support Fee
#
ormation on this application which is to the best of my knowkdge true and correct I also certify that I am the owner or authOrized agent for the
construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
"" F,,,'h"m e. J hmby "eee th" ,he "'Y offin,J m '~3'Zn;J:.n the pwperty to pcrfo,m needed m'pnwm,
I Contractor's Lirense No
,lL/eto, dOD,ad
$ 3D'3,<:;ol
$ ZOLrJ,7'il
$ ZZC,Oo
$
$
$
$
$
SAC
#
Water Meter Size 5/8'~
Pressure Reducer
Sewer/Water Connection Fee
#
/00.00
IOo,De
sS. sO
1./0. ()t/
Water Tower Fee
#
Builder's Deposit
Other
~
This Application Becomes Your Building Pennit When Approved
~
Buildllw.OmCi<li
~flIlL
TOTALDUE ~
j
I Paid "1S,'1. 71
I Date 1-/-i/<1-
~
$ 'i1S().{)O
$ 13So.00
$ SOO,OCJ
$ 70,00
$ Iz...oo,Oo
$ 700.00
$ ISOo, 00
$
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 Ihe City Planner conslllutes a temporary Certificate of Zoning compliance and allows construction to commence. Before llccupancy, a Certificate of Occupancy must be
i~YMP
Planning Director
ID/IB/at( ~ a,,(./ oJ, J4t,...,J;:J
. . Date - Special ~onditions, if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
White . Building
c:ClilQarv . Enqln ,.i:i...,..)
Pink . Planning
Thr C~nlrf of Ih. L.x" ('ounlry
BUILDING PERMIT APPLICATION DEEARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
;VEMI1, /Ne-.
? . q. 04-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
33 rC q I V / LV { V () 00 T/L;-f / L ;V IV
Accepted
x
Accepted With Corrections
Denied
Reviewed By:
/YJ'913
Date:
C-2f-o'l
Comments: -,~PP RpVRr!'\!' Sirle for Additional Informationl
Spp Attachments: n Gradin~ Plan. 2) Erosion Control Measllrp<,
"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
~ - I"noineering
CPink " PlanniiiQ-::.
Thf C..nl.-r or Ih..I..k.. Counlr,..
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/VE l/rl,
/!vG.
/
<..-./, ,~,..
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/
!
I
r-1/ / /', / / I
, L.. /'" '"
Accepted
Accepted With Corrections
/'
Denied
Reviewed By:
Date:
0;( J?;;: ;/
+:.~
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."
t~1
~ite . BuildiiiQ)
Canary . Engineenng
Pink - Planning
-
Th~ ernlrr tlf thr L.kr ('ountr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
JlEM!f, INC--.
,
(P. q. 04-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
33 fO q
W/l.-O w()oD TJ2../t/ L- tiN
Accepted
Accepted With Corrections
/'
Denied
Reviewed By:
&':
e .fUJ-.-{)
~
~
cuP ~~
Date:
f's,lu1o <I
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."
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
7. Z,tJ+-
'Gco" FiI, I PERMIT NO A_
2. Yellow City .0 -r-, 0 G,c./
3, Gold Applicant
(Please ~ or orint and sien at bottom)
ADDRESS
ZONING (office use)
33loq
(1 \, L-L, ,^,""r1
lv-n.\
. LEGAL DESCRIPTION (office use only)
LOTI5 BLOCK
ADDITION ~ 000 S @ ~ WI vi)J
PID ZS; 33J. Olf, 7)
OWNER I I
(Name) NO.M/O
(Address) ~n 5
C'lvr[p
(Phone)
~rlo",
(City)
qS.:l. -qLWo - /3lo?-
553#
\ f\{'
nCD ( P
(Address)
[(-ir\JP
PCQi........'P
(Zip Code)
APPLIC~
(Name) \--inn\ Gyn-A~ \ (\C (Phone) q5~ -:;)3;:<' -I :doo
(Address)\3IS N\nV'r><::" 5+-rre...e:t- ~\ S~oJ<-Dppe 5S:=>"q
(Address) (City) (Zip Code)
(Contact Person) '!()l'\v\\p -fJIc... L011\,o..YY\.:'" (Phone) OfS'd. -:r33-1 :L.OO
APPLICANT SIGNATURE~.--@;/i0?'#~..8~ DATE
APPLICANT PLEASE COMPLETE BELOW
Size of water service [ inches.
Location of any couplings from structure
Type of sewer pipe. D ABC !5<l'PVC
Estimated length of sewer line .5S. feet.
Clean out (ifrequired) located at feet from structure.
feet.
D Cast Iron
FEE SCHEDULE
Residential sewer and water line connection $35.50 Industrial, Com'l & Multi-family 1% of job cost with a $39.50 minimum
Sewer connection only $17.50 Water connection only $17.50
Estimated Cost $
Building Permit #
~ 0 6~ ~~
~ .50 (~ .otr
;,/ iJV(V
.-.->
$
$
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Building Official
Date
IPaid~
I Oa11. 'Z- .04--"
I
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
,.-- -- ...--- ..-"
..........,..... .,............,',........,1_
. .
-.................-
Date Rec'd
CITY OF PR10R~ LAKE PLUMBING PERMIT
l A;;;~;':~%~.,~~\
~E-,,~ Jt%
::: ~~. I PERMIT NO.
).YAII~ AIII'_l
~i- cq 6/
,ow
I ZONING<......., \
LEGAL OESClUPT'ION (Gill.. ... otllYl
LOT BLOCK
ADDmON
PIIl
OWNER
(N,-..,
(FaOM)
(Addle..)
APPIlCAN'I' I /.
(NameL V\ I .-l4 ;') 1.)-1 f\t LC..~ (l'bgnc) 'lis. ~ -47Cf -Ci c::;;
(Add:ds) (rO-S 1'\ IN L-1 l? _ 0 v'\ A-O/( fJ/~ -Se:::s:<7'
(Add:e..) {.. (citY1 . (ZIp Cocs'e) .
(COM4c:tP=>nJ LC"l~ 4::::'( oJ c- (paone) &<",'2..-+'9-0 -p;/,s''7.-
APPtICAN'I'SIGNAT!J~.~..---" DATIl !!J -(2. ..-() l/-
- .
Al'PLICAN~ASE COMPLETE BELOW
Quadlity I type of F111ture I QuaIlIi'J
? _ Bath Ulb WIth or w,thOlll SII_er I /
D~w"h.r I I
f I cor Dram I
i) I Lavatori (Balhroom Sink) I I
{ I Laundq Tray (l or 2 co...... ......; link
I Sllower Stall
I I Sinks
( I aar SInk
-r W Iter dOlet (ToU.t)
Type or l'isIU'e
I
~Up.inli
WaIBr Hoater
I Watw Sonnet
siancl Pipe (WIslling ~ne)
SMge Ejector
Bactflow A5sIIrnbly
baclcnow AUomIilY Teet
La'Wll Sprlrikier
Other
1
j
(
FEE SCHEDULE
lml~slriol. Commercial. MuJti.fimi/y I,. .fJob 0011 wlth I SJ9.50 minlmulIl
R.CIldC/ldal. New 011o. 1'......1'11II11) S99.~O
R...I~"lill. Add~.t A/lonllOIlS S39,~
EstlmaredCOIt $ 2.tJ~ BuUdl~Permit/l
PLU~lNO PERMIT m $
STATE SURCHARGE S
TOTAL PERMIT FEE S
IIUiIllm.OIlldaJ
D."
I Paid
I Dale
.s.o~V
O-~ Q --~
t3' }1)~ -t--( BY
10m.. u.. 0111)
This Apl'llc:ollon B...."'.. Your Balldilll ,.....it Wh... .-.pproml
U boar dOH.. for III ItI " 1'5Z) 441."50, Cu 1"2) 44'''3.s
I'ZIO ~II' C_ A..... $.I:, 'rIlll'La.. MIl 5531z"t7l4
,...,."
TOTAL P.01
.d W~.~:60 ~00c c. '6n~
~"tL9 6Lt' .O~~ 3~!!JHd
F,er'ls6ul>1 : WOd"
06121102 FRI 08:a6 FAX 612447424~
-- .
CITY OF PRIOR LAKE
IilI 001
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Ree'd
~ue: ~ or ortln uzd sSl!:I1llbormm)
ADDRESS d
33(PQ \Iv; Id woO /Fail
~;;;:" ~ I P .t.lU"uT NO'^""'- .^'111
J, Y.~ ~ ~. ~
M.W.
I ZONING (ollle....l I
LEGAL DESCIupnON (0_ .... ..Iy)
LOT BLOCK
.ADDmON
PID
I ^.Je.. . (phone) q 5Z ~ q ~(p -I Q/;.3
Off i t-~ ?t/d~f.-.. C;nAe.. EQQn PrairiL
'oJ
~;~~ANT l-i, QXy H to. .. q I U (phone) q82 - q ~( - <J 2.. /I
(Addre:,,) /1;0'1 Cj /); 0 f( ev I t:aiJ EC1 PIl Prai ri Q. 1'1/oJ
n ,(A.ddrw) icilJ'):; (zip C....,
(CootactPcr,on) ~)e1qe, nQ I.~.~ (Phone) Q5;;L-QJ,I-tiJ....//
APPLICANT SlGNATlJR~ ~.-",l ... N \~XJ DATE ~n'-i
l;PLIC~;PLEASE COMPLEtE BELOW .
~EW CONSTRUCTION 0 R.EPI.ACEMENT 0 ALTERATIONS
FURNII.CEMAKE AND MODEL U.NlOlL Gr 51 47 Q.- - OqO fUEL n1rf\/ra)
F1..UESIZE 'l' -PV~ REnlRNOPENTNGS II INPUT ~ 000 OUTPUTt'-Q ()(X)
,
HEA TlNG OR POWEll. PLANT
OStcam
o HotWIICI'
o R.>dl.don
o Spe.ia1 Devices
o Other Devices
OWNER
(Name)
NtMII
'1 'j l.P. CO
(Addros)
,
TYPEOl'.)l.)>".-d
OW"",AirPIIIlII
oa"'It)'
o Mcc:hDnta-1
'[lAir Canditianing
OVOllC SY!lelll
PLEASE NOTE:
Air Condirionet Units
Canoot Encro.ch Into
Required Side Yard
Setbacl<:!
FIREPLACE MAKE AND MOOEI.
Inlluntf.L Cornm=i.1 &. Molti.f'arnlly
FElt SCREDULE
I % of jOb case: Residential, GIS Fire.plac:c:
539.50 minimum
599.50 Rc;id"",lal. Addition, &. Allocation,
S600 RClidl:lllial, AC Only
$39.'0
Rc:siclcmiol. Hcotinl A:. A1C (N... C4nSllllCl:l ,n)
R..idcnlW. Hatina Only (New ConstNctlo'l)
539.'0
$39.50
Eotimoted CostS Buildin& PCfIIIlt "
HEATINO PERMIT FEE S
STATE SURCHARGE $
TOTAL PERMIT lEE $
...~
0... 0" ~"" U,....
"'U/I.!J.'NG 11...-;,
.so .. P&:IMrr
~~~ ~
This AppllC3t10n BeCOIll.. Your 81I11dtngl'ermlt When Approved .~, ~,~ Ii! Q ~J ~ ~11W~OCClpt No.
o.Odl.. om...., Do... JL ~G 1 7 2004 ~Iay
2d ~o.r nod.. for .111.'1l.cll.... (9SZ) U '.9850. ,.. (9S%) 447.4245
By
,',.<
~b;=b)bb:nl
O1b;:O) ,b';;:O<:;';
,H~~ ~~~,~:wn~, b;:O:" b0101;:O-)T-~nH
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGlFlREPLACE PERMIT
Date Rec'd
(ple~ ~ or uric.r ilJld SlPll at bOmJrn)
ADDRESS _
3 ;)0 9 0, (d wcoJ T f'CU I
~ ~ :::~. I PERMIT NO.1 i_, It I
1 Yello.... ^~hCMl ..., ~ (Q
I ZONING (afficcwe) I
LEGAL DESCRIPTION (affice U3C only)
LOT
BLOCK
ADDiTION
PID
OWNER
(Name)
(Addr""s)
N~IV1.Ci
Lr}<2
(phone)
~:;~~;,<;:~.:.~\) '{ ~ I:'~ f6 0 , [J (~ ~::)U P P I i
(Address) / 3"!;05 /,5"~ I7vCf/ Uf
\. (Address)
(Contact Person) De,^-
(phone) 763 - t,7'Y - 51 iP6 3
!J/ymf?uflr, ss'!l1/
(City) (Zip Code)
APPLICANT SIGNATURE
fVt <i:. r- (phone)
~. ~~/H.CJ.1,
DATE
/olr /0 '/
-
APPLICANT PLEASE COMPLETE BELOW
-;::: t f> I ~ ~EW CONSTRUCTION 0 REPLACE~ 0 ALTERATIONS
_0. ~ .:..c ~kEAND MODEL E [) II 'i o? 5 ( .;< j fUEL 10 C<... i- 9 '<-'3
FLUE SIZE s;- I, RETURN OPENINGS INPUT OUTPUT ~
TYPE OF SYSTEM HEATING OR POWER PLANT
OWarm Air Plants
OGravity
o Mcchonical
DAiI' Conditioning
OVent System
o Steam
o Hot Wat<r
o Radiation
o Special Devices
o Other Dcviccs
PLEASE NOTE:
Air Conditioner Units
Canno, Encroach intO
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial. Commercial & Multi-Fa.mily
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
S99.50 Rl;Sidential, Additions &. Alterations
164.50 Residential. AC Only
$39.50
Residential, Heating & Ale (New Construction)
RMsidential. Hearing Only (New Construction)
$39.50
$39.50
Estimated Co., $ J..QOD. () b Building PCtmit #
REA TING PERMIT FEE $
STATE SURCHARGE $ .50
TOTAL PERMIT FEE $
J:.:t. .. :~:'''': 'I
"i" "'l." i'''''""
"-, . 1'~- ~.... ....ll "~"'"
did'.,. ,.,," 1f'1.l.J
......;,~1"~ ....,
""\::!~"':'b
. r-t:rlMrr
(Office: Use Only)
.~.
Bui]din~ On:iciaL
\R'il (rrt~ 0 \TI ~
\ 't are
Da.. D nrr n II 7004
24 nour notic, for all inspection' (952) 447"9 ~~, tl1x (952) 4474245
~ l:ceiPt No.
.-J
This Application Becomes Your Building Permit When Approved
IBy
T"" r-;:<,
T""~~I"lC' (:''J'':/rr'''TT'"la C"V":TT,',,",
100(\('('("'-01 v.....1 Tl'.nn ""ICf)/f)T
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS ~3Coq lJl'I-O\\)~OO "flU.. ItJ.W.
NATURE OF WORK tJ~~ Go",~/o~
USE OF BUILDING S.~t>,
PERMIT NO. ()1',O(,(; ( .DATE ISSUED ~a&/
CONTRACTOR ~~ft..)C.. (~ PHONE$Z~''''. /31iS
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT '
'FOOTING ~\ we... _ INSPECTOif/3 I ') _ 7;/
, FOUNDATION (Prior to Backfill) I<> c.. I V h I 7. 721
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST ~...:'~1.. t: ~..42 7""0
COVER NO WORK UNTlt' ABOVE HAS BEEN SIGNED
~TJ{e- /l'hL7l/ttnJ mN6'1 I
, FINALS . /.'
GRADING (Prior to Sgdding) ;V jS
BUILDING ,.t::,t:..../w.h, $-\-0(, I1Y'1 (//)
ELECTRICAL' " .
PLUMBING /7/;1
HEATING rI~
DO NOT 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.
pI; fib
/1
,
l2J
!/tr~ ffJ
fh
FOR ALL INSPECTIONS (952) 447.9850
If) -j
to -0
~ - ( j,.,() tf
: J-- 7 ,
~f/~
, I. ;? () (p
11/2.'7/01
I I
.
,,2 j; [/~-
QItrhfitatt . or' <IDrrupautl!
CITY OF PRIOR LAKE
~tparfmtuf of ~uH~iug JIusptdilIU
111 Final Permitted
D Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 110 of the 0 Residential! 0 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 04-0661
Use Classification
Bldg. Permit No.
Occupancy Type
R3
VN
PUD
Legal Description
Type ConstrUction_ Zoning Distri,..'
L13, BI, THE WOODS AT THE WILDS
Owner of Building
Contractor's Name & Address NEMA, I~~---7565
ROBERT D. HUTCHINS \ \i
Building Official \
3369 WILDWOOD TFAIL N.W.
Site Address
OFFICE RIDGE CIRCLE, EDEN PRAIRIE
.lANE KANSIER
55344
City Planner
Date:
Date:
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
330 q 11///(..,,0 N o-v 0 7lU-_
OWNER
CONTR.
PHONE NO.
PERMIT NO.
4- _ fora I
o FOOTING
o FOUNDATION
o FRAMING
~SULATION
INAL
SITE INSPECTION
o PLUMBING Rt
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
(' jJJj~ Plt.E
~
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ,~8 OWner/Conlr:
CALL ~7.9J1I1oR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY/
INSNOT'
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~)G'j
OWNER
PHONE NO.
o FOOTING
[J FOUNDATION
o FRAMING
o INSULATION
,;EH:tNAL
[] SITE INSPECTION
COMMENTS:
DATE TIMt:
SCHEDULED J-"~
WI;j I.,/CyAi T:r", 1'1
CONTR.
IV:,,,,,,
PERMIT NO.
JJt(-C{,/
o PLUMBING RI
o MECH RI
[] WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
[] MECH FINAL
l'I::i:"EXIGRADIFILLING
Vo COMPLAINT
[J FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
[]
bi'l:.d1-_- (?(
c'lib K-,f- cJ!(
v(..\!ORK SATISFACTORY. PROCEED
o 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.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
....."
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
1-,1.~
ADDRESS -:3") (,.1, w..\& ~
PHONE NO.
OWNER CONTR.
PERMIT NO.
q-~f
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
a'FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
D WATER HOOKUP
D SEWER HOOKUP
O,f'LUMBING FINAL
JlI MECH FINAL
o EXIGRADIFILLlNG
D COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
J. fite. T~ 9~;r.uf. .
"). t:'~.........D l:.~ 11A~~"0'Y\. ~ 't~1-_l/<l7-~~
~. ~\'~~ (<)~ fLAlAA. /..15\- ,',^ -Irod .y.aJ
-------
r1~
'1-ru.
I
10
1:1 .
a ,,/- O(p
\
N..,~ ~~/
o WORK SATISFACTORY. PROCEED
o CORREC T~O D PROCEED
X CORR TWO,! fA L FOR REINSPECTION BEFORE COVERING
Inspect . V OWner/Contr.
C .447.9850 FOR TJ NEXT INSPECTION 24 HOURS IN ADVANCE.
.~ARE FOR YOUR PERSONAL HEALTH & SAFETY/
"""""
DA.TE TIME
,JIJds-
/'
L?:?6f t-V'IJ/tUC(jd 1;/
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
D FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
.,..If"1'tUMBING FINAL
o MECH FINAL
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
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o ~S:TlSFACTORY, ;;;CEE~~ "'" / . .~.
.....-1JCORRECT ACTION AND PROCEED ~ C.
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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/ ~~ Owner/Contr:
Inspector:
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CALL 0&47.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH 4 SAFETY/