HomeMy WebLinkAboutBldg Permit 01-0904
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
'3 I 5 1) "S hc..~ ~ C. Ove ""1>0; r'\ +-
LEGAL DESCRIPTION (office use only)
Date Rec' d
1 White File I PERMIT NO.
2. Pink City
3. Yellow Applicant
LOTZ.:3BLOCK , ADDITIONN"+"""oo~ Oc...\L.s 'E..~c-.\.e~ z.~~ A~t PID,;?,C)-.';>?/-Oc?l-3-a
OWNER
(Name) \ <. ~h.Q s. bo r 0 ,--elL
.... ~
(Address)
\~,,^-.e.. ~
BUILDER
(Name) U.~",~Shoro~~ ~""-e.S. LLG
" ~
(Address)"i'7sD ~ 9 0 ~ s-\-o s.
(Phone)
(Phone) b5" 1- y"f(O - I?' ~ I
rc...)l. tsl- 7'-t;'-7..'I7S
c...ottc.-~ Grove, M...u sso/b
TYPE OF WORK gNew Construction
OLower Level Finish
o Misc.
ODeck
o Fireplace
OPorch
OAddition
ORe- Roofing
ORe-Siding
PROJECT COST /V ALUE (excluding land) $ 2 (, Y I 0 z 9
OUtility Connection
I Park Support Fee
I SAC i~
I Water Meter Si~ I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
TOTALDUE ~ 9#ZZ#b)
I Paid 0//7/. <:7
I Date t$-~...Q.j
#
#
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 for 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
~te~~ec~e~ons. ~oo :)%'530 ~ /.3 /0 ,
Signature Contractor's License No. 'Date
OAlteration
#
#
$~
$ 1,13:),-89
$ . I 12s:CJ?f
$ ~.~
$ 1,20::;.ctY
$ 7M.o-GJ
$ /f'<:;OaU
$' I
$9./71. 5/
.
. #)5/ j"
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and proceed as requested. This document
when sig d y the Ci Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
$
$
$
$
$
$
$
$
2k8 ,190 c:
Il'\ -sc.( _~?
l f) c:? ~..H.I
,
( ~1I .00
I ~O . C) (3
"00.00
35. ~O
L/o.~
.~~.
Planning Director
~,~'b let
~ ~~tc"'Wf~~
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
White - Building
Canary - Engineering
Pink - Planning
ThE' ('pnier of Ihe Lak, Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
r
NAME OF APPLICANT ~ b
APPLICATION RECEIVED 5? - fo-o
~~
,
The Building, Engineering, and Planning Departments have reviewed the building permit
application 3;:;~ctSAi:1Jl~:::: P-r
u
Accepted
Accepted With Corrections
)(
Denied //)/n _ j
Reviewed B~f1 ~ "7t Date: 8- 1... ~ I
~::/di ~~:w .kJ! cn:k
"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."
Th. ('.nler of Ih. J.oke ('ounlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT l\
I
,- ., j
, J"
I
/
il ..i' / (;~.'/\
..1 t..- , "--"
]r",_J'.;.;.J....
APPLICATION RECEIVED
- .,?-Q 1/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~.. I '.',
, I [~R '/' .;'./... t/ /)",-.7). I:;
" ...J-_ ,'-:;- . "I' J i .~.
I
f
Accepted ~
Accepted With Corrections
Denied ~. A
Reviewed By: ~. &J.,~ ~
~
Date:
&/i3hr
Comments:
JAA.~J~ ,~L/: p- ~J~ ~
~ ...... . ~~) vZl<9tJ
(\6(' ~~ "
liThe 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."
~iL -l~%
Canary - Engineering
Pink - Planning
The eeRier of Ihe take Counlry
:.:J---
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT !{.r/1'!~~()4~ "/~
APPLICATION RECEIVED J 'S -- ~-ot
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: '"\
~~ l5'f SAucL- C/} A-7~-" fJ t-
U
Accepted
ex:
,
Accepted With Corrections
Denied
Reviewed By:
AI II- S
Date:
9- /'1-() I
Comments: See Reverse Side for Additionallnformcruon!
~
~ee Attacnments: 1) Grading Plan, 2) Erosion Control Measures
3) Ero.~lQn 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."
09/19/2001 08:21 6514372112
FI\X 812UH2U
SWANSONS
Cl'l'Y nt' I'IUOR LAKE
PAGE 01
..,......
DI'e Rec'd
CITY OF PIUOI<< LAKE PLUMBING PERMIT
I I.... '110
J 10oo1. eft.
J v..... A",n_
: PERMJTNO'OI"qO'-/ I
1'....!Jp& or umr I~;, UiII!... bollOlI1)
ADOR.SSS
3158
~Shacj{J' C LJl}t~..J} ~
lONlNO '''''III)
f1 I. <f;J
I, """"-"
LBGAL DESCRi ITION C.llke UIe ollly)
LOT~SBLOd, I ADDlTION ~.Jo,.Ltl,('-'loud C'\IJ:.:S E:..S((U("~' :;..01. PJD~-<</71-0;r?J-()
,
j. ,
OWN~R . \,l I
(Na~) ~.t,()~~ bC.lTCLl.q....h -1,\ (JY(\(1 ,'i. _ (Ph(.lftt!) JoS I - 48"0 - I 'if 0
(Addlcar) g"I'Se) era 'Ii" .,~;L~C:~l..:1.9 I, C/,>lllKtC CIYC1LtC. rnv 5;')C)ll"
APPtJC~ '~. r' .
(Name) ~1..0~~Oll LU"7112Lfll1 ~~ "'k.c.) I I (k..&- (Phone) (Co~~\J Lf37-qd/~
(A~drellJ) -35QQ Vcr rn.LR.~i,:( an) ~t;;I. I \0,8+ I ~~ ~ . rYlU S S6j ~
, (Address) (Cily) (Zap Code)
(Con~ct PO'JOrl) III nw. t{- ('hI'" i8'len~'U..)^ ) (Phone) (~SI ) '1.37. Q6H.5l
.L,,~.,;<.,~.> \-.YV:1 ." /' .1- /I~J I/"IJ
APPLICANTSl<! -lATUIlJ! :c,;,<c...7~,~- ,,(,Ct //~'~'l.....J.._ DAlE ~V' "Y.../,-'
Qu.ntUy
J
t
d-
'-t
I
~
I -
\. ~
, APPLICANT fLEAS!!: COMPLETE IIIl:LOW
I ._-
I ' Type ofFI.s"are Q\I~ntlty
~:' th Tub with or without sho...u
-(Ii Ihwashc:r
'~' lor Drain
""'[ : rl\or)' (Bllt"roorn Sink)
"'t; ~ndl}' Tra)' (lor 2 compartment Si/lk
sll )wer St.lI
-s- ,i Jt.t
- '1i'; : Sin\(
.:._~! ~ter Clo.tt (Toilet)
I
Typ. 'II FI.s'..re
ROUII~lns
Waler Hater
Water Softl1l,r
Sr&nd Pipe (W.,hil\l M."hinc)
Sew lie Ejector
Bac;kflow A..embly
Sackl1Qw A...mhly T.11
L.wn Sprinkler
Othcr
.,,'
"
FiE SCIRDUL E
Indll.uiil. Comma,,' II" r""ulIHamily /~ Llf J\)b CII51 with II $J"O minlnl\.1m
I '
R.Ji,sclldal, Ne'~ One a. TWQ-Femlly 599,'0
R.sillc"I,.I. AddiliDf\J .. Allcrealon. 1]11..50
Enlmwl,d Cost ,. _____
SundlnC Pllf'Jnh II
PLUMBrNn PERMJT FEE
STAT);! SUR,cHAkOe
TOTAL PERMIT FE):
S
.$
s
,SQ
C, I 11-..
t .. t. .' ---,
.....II.J,,,,_ "Ii!
... H\\.:i P~'-''''
Cr ./JJ""
II II, I
(omu lJ... 0111,,)
: ThlJ Appllcatlon~. ecll..... YQur Huildln, P.rtftU Wben Approved
Patel
Recltipc No.
.....1111 OIl, ~,J
I,
~~~dO,..o I
,
U h."r notic. (Dr .11 "up.dio". ('I5Z) 4-'1-'150, fn ("1) ..7"'1<<5
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CITY OF PRIOR LAKE Me
16200 Elgie Creek Av. S,E. Pennil No. 1- q aLl
Prior Like, MN 55372
f'1
~
HEATtNG APPlICAnON I PERMIT
Oate_ \D- \9 -0 \ PID'.c~5- ,37/-(J;).=?-D
Sit. Address , "'3 \ ~ 8 s hulL. ~ r bI\Jtl ~-\- ~
lota~ Btock I _ AdditionC;1~J..)rr)4-(()-dA 19~
Owner'. Name K. \. ^-Q 5. bO(" C'\lAQ '" ~ m p .r::....
-.J \J
Addre&! ~Q....Q (l b r t'\ \i1l.
....
Heating Conl.actor . ?'\'fId" r \-\-~n-\.i,^n., ~ Air
J
Address,~ t+a...rdrna.Y'l Av~. A),: ~ ~1-_ fhuJ S-SOI s:
Telephon.', (a S I-Ll S,- ~-, '& \
-rr~e..
Furnace Make & Model ,'"t\J...l<.\ D(")
.-i
~
~
N
IT\
.-i II
+>
u
o
o
z
w
z
o
I
lL
Model Size \ 00 . 0 t:::l("') '1 \U
Conn. Load
Fuel ~. co..s.Flue Size 3"
;J .
Supply Openings a.noroK (:J..
. .
Return Op.nings 0J0 f) r 0 )( en
TYPE OF SYSTEM
Warm AIr Plants
Gravily _
Mechanical
Air eo "'dltloni"'9 "3-\n1A
Vent. System \I 12.;(\. mD....-
HEATING OR POWER PLANT
Sleam ,
Hot Waler
Radiallon
Special Devices
, .
Input
Edr.
C'm..
Output _
Olhe r Devices
z
o
(fJ
Q
Z
a:
a:::
w
Q
Z
....
III
a:
TYPE OF WORK
Alterations
New Conslruclien
;(
Replacement
Repair
Est. Comp. DaIa _
Est Cost S
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAl PERMIT FEES $
0\,- oqO{o
B/ Permh 1# .
/.50'
/
PAID 'NITH
EU/LDING PERMIT
E
o
a:::
LL
R&c&ipt 1# ,
TYPE OF STRUCTURE
I. rl~"
1(Jren
], Ydlow
Fill
01,
ConIndDr
Single Family
Commeltial
)<.
Mulli.Famlly
Two.Family
Industrial
Public .
Other
Fee Schedule ~
fnduslrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Onlv
Residential, Gas Fnplaoe
Residential, Additions & AReratlons
Resldential, AC Only
1% of Job oosl ($39.50 minimum)
$99.50
$64.50
$39.50
$39.50
$39.50
Remember 10 add the Slale Sultharge on the bottom 01 this application.
The price of your heating permit includes on. rough.in and one final inspection.
Addilional inspections wiN be blled al $35.00 each.
House Heating Test Record musl be submilted with "'"i~~i~ "'P,~om .,.,,~t,I'i. befor.lllJild.
ing certificate of occupancy will be issued.
HEAT CALCULATIONS ~Fnl 'IRJ=(1 with number of supply and retUfn openll\Q9 lilted per
room wilh CFM's per ope ning. New slructunt$ or additlona send II00r plan with supply
an<l relum localions shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAilED TO THE CITY Of PRIOR LAKE, 16200 EI\GlE
CREEK AVE. S.E. PRIOR LAKE. MN 55372.
City Hall business hours are 8 a.m. . 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-JN AND FINAL) . CALL CITY HALL
447-4230
I hereby apply 'or a mechanical systems permit and I 8eknowledge thallhe
information aboVtt is complete and accurate; thallhe work win be in conformance
wi1h lhe ordinances and codes of the cltv and with the slate buUdinwmachanical
cedes; Ihat this 'orm does not become a permn unlilsigned by lhe BUILDING
OFFICIAL; Ihat the work will be in accordance with lhe approved plan In the
case of all work which requires review and approval of plans.
ILI/It f3iYrd/A
AP~e Signature
BuirdiilfJ Offical's Slgnalure
10-(9-01
Dafe
(C).-~~ --of
Date
P.01
NOV-27-2001 11:18
~rl/:~~..~~""(" . el.l rOFPRlORLAKE .
5~= 1lEA1J1'iG/AIR COND.ulONlNG/~~PLACE PED1J.~
."Jlrlrl:.o"~
Date Rec-d
I, Pink
z. a.-
). y.u.;.w
':..1 PERMIT NO. /;-1 ti/
/
ZO~G (aCIiIz_J
e,sD
~we tV('e or nrint aDG silQl at bolJDm) _ ,
ADDRESS ; ~'-
,~I69 0hod~ ~-tir'rtj
LBGAL DESCR.u:- uON (offi<< use oaly)
LOT.:PaLOCK 1 ADOmON '7l1J7;f/J (1 Va! Or1.k f%:J- ~ tJcl--
'~~'
D - q \. ){tt:-ef (' <;, <: ~!~~. {~Ol
- I
=~~/n(p_ ~~.
(Ad4ress) 9J3J ~W \. w-r.e.,t
(AddJas)
(Contact Person) fill t Jle.l}p ~ Pde;c!5DJU
APPLICANTSIGNAlURE It.'J~~
~ ~ '
APPLICANT PLEASE COMPLETE BELOW
ONEW CONSTRUCTION 0 REPLACEMENT 0 AL TERAnON~ ( I
FURNACE MAKE AND MODEL . , FUEL ~yJ.. Ga. <)
FLUE SIZE g II REtuRN OPENINGS IN}lUT .dJ_/"lY) OUTPUT ~y)
TYPE OF SYSTEM HEATING OR POWER PLANT
" OWann A.ir Plants 0 Steam
OOMlvity 0 Hot Water
o Mechanic:al . 0 Radiation
OAir Conditioning 0 Spccial Devices -
aVcm. System 0 Other Devices
FIREPLACE MAiCE AND MODEL ~ ecd { (.,/0 .J.(fl....j'J--t"e - ~
pw;6 -~ /1-{);J-3()
(phone) -0/-4rto-/YJ1
(Addn:ss)
, (phone) ~ - r93t-//
C \:1;7 nn L flLL (byL. .56i3;L
l r-<Cit'!) (ZipCade)
(phone) 7&t'? -&..31-1
/1- rl_t::,/ul
DATE
PLEASE NqTE:
Air Conditio~ Units
CanDot EDcrO~h into
Required Sid~ Yard
SetblU:ks : '
Industrial, Comm~ial &. Multi-Family
Rl.\sidential. Heating lit. Ale (New ConS1:Iuc:rion)
Residential, Heating Only (New ConstrUction)
FEE S""n.t.DULE
I % of job c:ost Residential. Gas Fireplace
$)9.50 minimlolm
$99.50 Residential, Additions & Altetlllions
$64.50 Residential, AC only
$39.50
539.50
539.50
Estimated Cost S 1,600
Building Permit ##
HEATnJGPE~FEE
STA TE SURCHARGE
TOTAL PERMIT FEE
$ ,'0LJ. ~
$
$ tJD.oo
r--p,
SUn D~!.D r.
, 8.... I~I
'/'G
,
.50
(orner: u,~ Only)
Tbis Application :Becomes Your S..ilding Perodt When Approved
Paid
Receipt No.
8uilding omriaJ
Date
Dare) J-)- 1-1
By
~
II
24 hour notice (or an inspections (95:%) 447-9850, fo (95Z) 441-4145
TOTRL P.01
~ ___,..__~....,_,n"_"".--'-
P R 10 R LA KE DEPARTMENT OF
_ BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS '3 It::;F3 <2..\IV'L~ (1QllJ4.> C?O\~
NATURE OF WORK ~) '............--.0-
USE OF BUILDING S Fj)
PERMIT NO. ('J( oqO~ DAT1ISSU!=D 8- 1- 2~(
CONTRACTOR ~,\'^,~\oor~ ~ PHONE (457- 4er3-/8s1
NOTE: THIS IS NOT Ii. PERMIT~OR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
\~D
\ ,lJ.....\ ....,;: INSPECTOR DATE
FOOTING V~<{& 1 'g,~().UU, 11,1 $\ 01
l FOUNDATION (Prior to Backfill) I ~ ~ \. 0 Z It" I ~(}fU ~ 4 sf 01
PLACE NO CONCRETE UNTIL ABOVE ~ BEEN'SilGtJEt)"
ROUGH - INS
SEWER I WATER I SEPTIC g ~
FRAMING , %~~
INSULATION ~\l~
ELECTRICAL \
PLUMBING {.~~~lf.,~Q( tA.&u ~ ~~ to )~i,2.'
HEATING (if required) Ll.. It 1 ~~(..l.. (,t}!i: or
FIREPLACE ~~\O(
GAS LINE AIR TEST .' '6 ~~ \ II 5'fOl
COVER NO WORK UNTIL ABOVE HAS BEEN S'IG~NED
1 I
FINALS
r~ 1ftf> tY
. ~ ~ ~ 1 ,I (. .0).... tJ V --1--;: 6
b\)t1 1\ {- C..L
~~CLW1 1 , (Co ,OJ..
OCCUpy UNTIL ABOVE HAS BEEN I SI"GNED
NOTICE
Q)lolol
.. ,
II (~ ~,
t\ . t?\ Q\
, J
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
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
,.
-.
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/-/6' (J%..--- tf: IIlJ
ADDRESS
3158 S/f,q.oV c,oV'6
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
k 0 INSULATION
FINAL
~ SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
^ ~LUMBING FINAL
flr?'I' MECH FINAL
1--9~q
I
o EX/GRAD/FILLING
Cl COMPLAINT
o FIREPLACE RI
L"IlIFIREPLACE FINAL
fl ~ 0 GASLlNE AIR TST
o
COMMENOt:: ~ ~~ ~
~l ~ Ol ,02.... . '; . ..
~(4 Cl fr~V\J ~ tJ'i e2\-1 ~
-+ :{etA
~ .
~ a_J iV't~ Q€A"""' ~e.:O~tMfM\ -
j 'I
, - -
fsscJ~ l.p~r 0-~O
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORt>. CALL FOR REINSPECTION BEFORE COVERING
Inspector: <:J) -\ ~ Owner/Contr:
CALL 447-9850 FOR T~E NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/2 2;tJ .tJ1
l.. : 30
ADDRESS
/~Z-02.
3/58 Gf/~DV t!AJvG
,
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
Il 0 SEWER HOOKUP
n>5. PLUMBING FINAL
o MECH FINAL
VI^_DM.o t.tA.J:-er
COMMENTS:
l-qt;4-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~C;:;EINSPECTION BEFORE COVERING
Inspector: ~)\ Owner/Contr:
CALL ~-9850-FOR THE LEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
7-~z-
S/srs ~hc,~v ~f/~ Pf-
~Js~I'~',
OJ ..-0 Q04-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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
COMMENTS:
DATE TIME
-,F-e~/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
k'H.-.)E.ll L..oA. (!,. ~ '\ r') res 1<. fA.~ ~
"of "('1 ~ () ~ Sa() tj:t ~ '( tJ..~ "110 I)
? IJ.J~
~~t~~ ~l(of~'1' ~
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
HE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
A.DDRESS
~ISA
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE TIME
SCHEDULED ~-~ ~;t
sk~ (ArJ,o. 12-,,-
CONTk.
PERMIT NO. 0 I - q 04-
.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
s+ro\("
COMMENTS:
ISsue (.~,O.
C-~ ~ e-
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~K, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ~ Owner/Contr:
CAll 447-9850 FIR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!
INSNOTl