HomeMy WebLinkAboutBldg Permit 05-0914
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
3 Yellow Applicant
Cj.~..1Yf
I PERMIT NO. 05,0 q 14-'
(Please type or print and sicn at b" ..,.....)
ADDRESS
~q~f W:/Js
Lo-~
ZONING (office use)
-PiLl)
LEGAL DESCRIPTION (office use only)
LOT kJy,LOCK (ADDITION
OWNER
(Name)
~ +eA,l; ~S-
"""
.fJI1 dJ (()~ f/J-~t'.
tJ hol /4SJ4 ~ J tJ J -e,<;;;-J .
~f!kJfi.- PID 3/)1-' 081
(Phone) c;s,. - 't:r$ ~ 6a/
(Address)
BUILDER /1 J I /)
{Company Name)f12t/:./" /b./b' ( .r,'" ~ 1-- ,
(Contact Name) 2t'.c:t:7 /d y Ik.>f d~
{Address)'7beC 14S-7-~ .s-r-t;vq7 .j}.~-L vJ--.
er-
(Phone) Qs';2~ ~J~.. 960/
(Phone) 9s:J-,$fl..- IObG
/U-- ~/;1l,F
TYPE OF. .WORK ~ Construction ~c~~rch ORe-Roofing
OAddition o Alteration IlD\:tility Connection
CODE: '.C. DI.B.c. 0 Misc.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-Siding ~er Level Finish ~irePlace
PROJECT COST IV ALUE
(excluding land)
$ '?S3 ? 7? . ro
- - ./ ~ -
I hereby certify that I have furnished information on this application which is to the best of my knowledge tme and correct. I also certify that I am the owner or authonzed agent for the
above-me lioned rop~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 ca re this er it for Just cause Furthermore, I hereby agree that the Ctty official or a designee may enter upon the property to perform needed inspectIOns.
X W--, IS e -ftY 37b B-~-- os--
~.r----' Contractor's License No. Date
I Permit Valuation .35:g, OO{). -- I Park Support Fee # $ f?50~-
Permit Fee $ ;::;}~~/~60 I SAC # $ 1l/50,-
$ 1lL2J" Lt..R' I Water Meter Size 5/8"; I"; $ . 3otJ.-
$'" I '? ~.J s- a I Pressure Reducer $ -70.-
$" I Sewer/WaterConnectionFee # $ 15"'()tJ~
$ /I21!J . "0 I Water Tower Fee # $ I () ()O. --
$ I tJD .00 I I Builder's Deposit $ I. &;00 ~ ..,,-
$ 35.6'0 I Other $ ,
$ '{t),-' I TOTALDUE ~ 4.'UJ.o5"
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$11.3&Q. q~
M B -, Yom BuB'm.;,T [;- A""""
W6~te
.
Paid
Date
//.Jt,9. ff
. 9. pI. ~ r'
Receipt N}l.
By /L.
f
ff9(,'f
ThiS is to certify thatlhe 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 conSl1tutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning 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
Residential Building Permit Checklist
New Construction for Single or Two-family Dwellings in R-1 or R72 Districts',
Reviewed by: ~
Building Permit #
Address: d 9fo I
Legal: L F 7 ' B I
tLiffi
Date: . f (r ~(t; S
PIC:
tJ~~
Zoning:
Subdivision:
Existing Structure? YES ~
Existing Nonconforming Structure? YES!@
CONFORMS TO ZONING
ORDINANCE
YES
Yard Setbacks: NAI FAILS(C6M'PLlE~
. Front Yard (can be 20' if avg. w/in 150')
. Side Yards
Standard
25'
10'1
25' if abutting a street
. Sidewall exceeding 50' requires additional side 2"
setback for every l' over 50' in length
I. Rear Yard
. Patio Door: provide for minimum 10' deck or sign
statement indicating no deck will be built in the future
. From 100 year flood elevation of wetland/NURP
pond
. From OHW (Prior or Spring Lake)
10' setback +
2"/1' over 50'
25'
10' sidel
25' rear
30'
75' or setback average of
adjacent structures, but no
less than 50'
--
, Floor Area Ratio: NA 1 FAILs::rCOI'VfPLI~
.30 Maximum
1 Yard Encroachments: NA 1 FAIL~OMPLlEsY
Eaves and Gutters no more than 2 feet in width and no
closer than 5 feet to a lot line (Easements).
AlG and other equipment cannot encroach on interior
side yards.
Standard
Tree Preservation:~4.1 FAILS 1 COMPLIES
. Total caliper incnes
I. Pennit 25% Removal
I. Caliper Inches Removed
I. Caliper Inches Preserved
I. Replacement
Standard
%:1
L:\TEMPLA TE\BLDGLIST.DOC
NO
Proposed
d?1
cJ-' -'-S
,
I]dvJ' ~I ,.. /D ~
/~ / /5- ~J~
dc::" w~.'
JJ/1
Pfl -
Nit
~UIJ
Proposed
rJ6~
tJo ,de
I
Proposed'
I Driveway: NA / FAILS ~MP1J,~ Standard Proposed
. Maximum width at property line 24' 20'
. Required setback 5' from side lot line or
3D' from r-o-w on comer lots
. Maximum slope 10% //7%
. All parking areas to be paved including R-Vor ~
spaces adjacent to the garage
,. Location to match subdivision grading plan ~
, Building Height: ~PLlE~AILS 35' Maximum 27 ' ,
Shoreland District: (fJ~ FAILS / COMPLIES Standard Proposed
Minimum lot area (square feet) 7,500 Rip, 7,999 Non-rip ...,,,.... .
I Minimum lot width 50' Rip, 57.3' Non-rip
Shoreland alterations
Impervious surface 30% Maximum
- I
I Bluff in Shoreland:~~/ FAILS / COMPLIES Standard Proposed r
. Setback from top-of bluff By planning dept.
. Bluff impact zone 20' From Top of Bluff
I. Engineering certification submitted/approved By City Enqineer
, . Gradinq in bluff or bluff impact zone No importing/exporting
I Floodplain{I4A'hFAILS / COMPLIES Standard Proposed
. 1 00 year flood elevation 908.9' Prior Lake
914.4' Spring Lake
. Lowest floor elevation 909.9' Prior Lake /
915.4' Spring Lake
. Proposed lowest floor elevation Must be l' above flood
elevation for new and existing
structures. If existing
structure was constructed
9/19/90,.11/22/97 then
additional foot is not required.
. Elevations 15 feet from structure Must be flood elevation or
. hiqher
. Road access must be no more than 2 feet below 907.9' for Prior Lake
ReQulatorv Flood Protection Elevation 913.4' for SprinQ Lake
-'" I Accessory Structure:(NAJFAILS / COMPLIES
I Standard Proposed !
. Size 832 sQ.ft. or 25% rear yard
. Not located in front yard (Materials) I
I · Side yard and rear yard setbacks 10'
I · Maximum height 15'
I · Materials compatible with principle structure
L:\TEMPLA TE\BLDGLlST.DOC
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White - Building
CanarY - ineerlng
<'" t"lnk ~ Plannln
BUILDIN~RMIT APPLlC.ATION De.f,ARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
Aft /l/'__
'y ( / /) <--
.-'" ..c;, / ,:-./.~
-,> /)...< 1(' ':1.4/ /(' /y...,.f)
. .' j /' .. ...,'" (~ -t
.-:/t-'U..f/;.-t .
,,,~' .' J' --,... V ""----
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed a,:
,t r:-; / .t? / ./7/"/7 / .--~ <. C'; ..I
7 &~ ~.-(..../:..ek: (..1::;::;:: 'J ..-:--J _ Q...--;. -"'---"
Accepted
Accepted With Corrections
/
Denied
0~ ~ Date: '1/1(,,;;;5
tU~ tueft ~ ~ ~
J '
~.. .../._" ~ /0 r,.f!~~0::__. >. t9t1<<-~
(~J ~ ~~."'~~ ,
l
Reviewed By:
Comments:
'~"',&" ; k
~
-"""
,.",.'I'f
~~.11'
_4J7' nOilrlitionp.1" and 0'. her 1Iechanica1"
Units Car/Rot Encron'~li into Required
~:de y~_ ~~tbacks
....-
;.till'''
~~,.,4
"...'~
"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."
1
<-.wbitP - ~
..' canary - Engrneerlng
Pink - Planning
NAME OF APPLICANT
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
R I c5(~/~5
17)1~~~~
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
0<_9(P/ ~ ~
X
Accepted
Accepted With Corrections
:::::ed By: WJ~
~S:UJQ ~~
Date: q Ie, k-r
/ / -
~~~
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."
~
~ -&ul~
~rv - EnglneerlnQ:::)
Pink - Planning
.BUllDING PERMIT APPUCATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~ c9~/()5 _,
- I 1 /i '
;/}1~ (~&-1( ~.rCJZ (Z!g~
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed a,:
c9y'(P/ ~~ ~~
Accepted
Denied
x
Accepted With Corrections
Reviewed By:
~
Date:
7-7~S-
. .
Comments: See Reverse Side for Additionallnformationl
!'.'
See Attachri1ent~: 1) Grading Plan, 2) Erosion Contt:ol Measures
..,
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. II
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
(Please type or print and sign at bottom)
ADDRESS
2961 WILDS LANE NORTHWEST
1. Pink File PERMIT NO~ ~~~
2. Green City
3 . Yellow Applicant
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name MCDONALD CONSTRUCTION
(Phone)
(Address)
APPLICANT
(Name)HEARTH AN]) BC1M:B TECHNOLOGIES DBA FIRESIDE HEARTH & HOME (Phone)
2561
651-633-
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(phone)
651-633-2561
APPLICANT SIGNATURE
BRfNf)A HUSTON
DATE
10/18/ 05
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE
RETURN OPENINGS
TYPE OF SYSTEM
DWarm Air Plants
o Gravity
o Mechanical
DAir Conditioning
DVent. System
INPUT
HEATING OR POWER PLANT
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-Family
HEAT N GLO 6000TR-OAK X 2
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 & AlC (New Construction)
Residential, Heating Only (New Construction)
$39.50
$39.50
Estimated Cost $
REA TING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
PAID WITH
p'DING PERMIT
(Office Use Only)
This Application Becomes Your Building Permit When Approved
Buildin2 Official
Date
24 hour notice for all inspections (952) 447- ii~9521.u7-424S____
. &...,~
f@4'::c,;
,. , I
1
II
~'l"""""l
Jq~ I l/;; / c1~ La h g
C.L 1 'i 01' "P,lUOR LAKE PLVMBING PERM,.1
Dat. Rtc'd
I(),II. oS"
i;" i... f PKRMJT NU. 5. 9/? I
. ZONlNO(lllk.) .
J.IOAL Duo... . ..ON (oftJco \lie oe\)')
un87BLOCXO) ADDmON -S'fer h}, q -S(Jv,+~
. "/
:"l11kJj (;(1 h,,,froc.- f; n h J n r. ? . (PhODe) 9t;J, Y 0>6) - '7 h(})
~~bO) LY~tJ sf We,d- / A;,dP Ifd/Py r-JVI., '- \--0 Oi Y. .
=~b:JLP ,c;iJtl!!Jj#1~ ,.Tor . (~...) ..6.r~9'- ft.sf.1J
Vwi*-) W...su-+Aer~T l}. Y/o4ti6Ufll( ~ '\\'-S7;:)Lf' .
(AddM8s) I . / I (City) (Zip Code)
(C" Pefal) .JJ;..p S'nqill.~ ~ (Phone) .h .s-I"- Y~9 '- rt' /\PJ
_ AIft.lCAldSIGNATUaB _ ~ ~,-yt:1Z-- !).ATE I () ~ /7~()V-
~
l
I
f
'-/
I '
V(\J
I
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pU)
. APPUCANT PLEASE COMPLETE BELOW
't'r of." Qua., \ 'J"y," of Fl.""
tSatb 'I \a0 WliIl or Witbout .bow.r ~.m.
o._wa.. I "'W'iiiir !tH_
,loor iWD . w.__
1A ..-- -... / -..- (WulUn Maobmt
..~~.rlb..'~eoJ..-..... ......._. .. I
,r;;t;; ,.. ~ Aii....:g
il_. . \ WdIiW Ariiu,a "'eel
...... &..Wi......
, ...... aONt (lfOIIet) tiMr.
nE s.........DVLE
ltIdldIriaI. Comm~1 ct. Mdi-ftmily 1.., of' job cost with a 139.50 Iftlftlftwm Jt.esidtfttlal. New ODe II: T~o-PlMil)' ,tUO
~. AddldonJ" A~.' ..50
'BdlmatN Colt s.J~, SCJO, 00 Bu1tcUna;t". O~~-:().qjJ
PLUMBING PPMlT fEE $ rJ'Y'- W1TH
STAft SUltCHAkOB S
TOTALlUMlTnC s 9UILDING PERMIT
tolIlIt u.0IIIJ~ - n\
1'bII A,...... 'BMo... VO\lr Build.. ...... "'.... Ap". ... - D ~ ~ 0 \~ [, \ ReceIPt NO.
......~l DIIIlI. \ \\ ~T .9. 0 190~ Goo .~
S4 b..r....... tOr .............. (Ha) oW .... 4M2) ...,... \,
~,d
\
- .
,\,-
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
l!'1_eaae ~ or 'PI'int and ale. at bottom\
ADDRESS
~ ~ ~... PERMIT NO. s: ~
dXJ~ /
t. ),'/J)~
i.p.uF
. ZONING (oIIice
use)
LEGAL DESCRIPTION (oHlce use only)
LOT BLOCK
AoomON
PID
~= ~D"-b\(1/~)
~.t.-)s.J- ..
(Phone)
.yJ[;) - 7G(:J!
(Address)
~:;~~ANTC~/~ ~_ ();t1
(Addre65;VI-9 It) f.!.Oh, ^ ) Ar ) e '
(Address)
(Phone)
..;/ 6h - ~~.::I :l.
'~6ty)
~~
(Zip Code)
(Contact Person) . . _ (phone)
APPUCANTSIGNATIJRE r-:..,'-v~ ~.~ DATE IC .... d'" 0 S
, --
APPLICANT PLEASE COMPLETE BELOW
ANEW CONSTRUCTION 0 ~PLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL7ij9Nf> 7iI...Y0~O FUEL Am!-
FLUESIZE r~1( PUc.. RETURNOPENINGS INPUT ~()"1..('T)r\~ OUTPUT .zr~, ~C)
TYPE OF SYSTEM HEATING OR POWER PLANT
DWann Air Plants
~
....{JM~banica1
~ Conditioning
~nt. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other D~c:c:s
l>LEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yani
Setb~ks
FIREPLACE MAKE AND MODEL
-.-.- ------ ,--, ~--
FEE SCHEDULE
I % of job cost Residential. Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions &: Altero.tiOIl$
564.50 R.csidc;ntiaJ. AC Only
$39.50
$39.50
539.50
Industrial, Commercial &: Multi-Family
Residential. Heating I!t. AlC (New Construction)
R.c5idcutiaI. HAting Only (New COIIlItl'Uction)
(Office Vile Oaly)
Bstimated Cost S _ Building Permit #
HEA rING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE S
PAID W\TH
..,'LO'NG PERMIT
Bulldlll2 Official
Da~
~'I~a@ ~~ U \~ i1: Iii." Receipt No.
J) II,
Jl OOT 2 0 2005 I~ By
This Application Becomes Your Building Pennit When Approved
24 hour DOrice for an inspections (952) ~:aso. ~(952) 447..U~S~_ ... . .
.--'
too lP1
MIV \.1.'1! !OM.LNO::>
9L6909ttS9 IVd tC:6t IMd S006/tt/Ot
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ~_. tcJ ihIs LN
NATURE OF WORK ~
USE OF BUILDING ~ J=./) .f
PERMIT NO. 0$- OQ/4-: DAT ISSUED 1 /(~ / ()~ ,
CONTRACTOR P~E~ U' I () ("
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
/"'l INSPECTOR I QATE
I FOOTING~~d~~~l~~l\M.etVC I rd',6 I 'j;?"?!d1:P
~ . j~' I'...
, FOUNDATION (Prior to Backfill) I /M I '9/./- ? ftj
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS A
t.. n
~::~:~ WATER I SEPTIC _ j'l t-f ~
INSULATION ff~ / I tlAJ ;00.
.) I i~
ELECTRICAL
PLUMBING J /I A L? fO.' ., ~Vt)
HEATING (if required) 1/ VIF rrl/l' II' /q~
FIREPLACE I 2J rff II/,,-//,
GAS LINE AIR TEST Fr ~ Ff l)~ ' ,
COV9H NO WORK UNTIL ABOVE HAS BEEN SIGNED
Lo.th /1-t~ I L~ tP"P I
/ FINALS
GRADING (Prior to Sodding) N ~ "
BUU:.DING /\~ lA~ l, - IVy
ELEqrRICAL R
PLUMBING I /~4J, t/~
HEATING ' I I/\,t( /
DO NOT OCCUPY UNTIL ABOVE HAS
NOTICE
q"~
. l} 1,.../ 1/lJ~
I I
5.}J,.olt
5 I 50 I 6V
/"
-- rz-k'~
;' ,
\- (ti)~
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.
FOR ALL INSPECTIONS (952) 447-9850
':;"';,
Q1~tfifitaf~ lIf Q1)ttupantll
CITY OF PRIOR LAKE
@.tparfmeuf nf ~uil~iug J(uspetfinu
final Permitted D Conditional C.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:
Use Classification _ Sltl~(,.e F,H/'i/L-V _ Bldg.PennitNo. OS. 69/~
,
1'<3 Type Construction VAl _ Zoning District PU [)
L- 87 I t3 / , 5~'-/ We:, :50t./77-f
- .
Site Address Z 9 (p / It 11...0 S t.JrllJ c.,
Contractor's Name & Address /'i('..OOfl/Ai-LJ . 7(,0/ 1457")-1 .5T.. ,...11. I"lPPL-e VAt..I-6y'55/;.
. if
y
Occupancy Type
, .
"
Legal Description
Owner of Building _
Date:
_ City Planner
Building Officil}l .. '0
/) '? c () If' jj/ ik! Date:
- / 11/ POST IN CONSPICUOUS PLACE
,.
,I
DATE TIME
CITY OF PRIOR LAKE 1/*
INSPECTION NOTICE SCHEDULED
ADDRESS ~'1(,{ W (trt~ LV'\, )
OWNER CONTR.
PHONE NO. PERMIT NO. ~-91<f
o FOOTING o PLUMBING RI o EXIGRADIFILLING
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 GASLINE AIR TST
o SITE INSPECTION ~MECH FINAL 0
COM.MENTS: ~_ _I)
\. ~~ .-r~
-
(~~?
o WORK SATISFACTORY, PROCEED
~OR~T r;ION AND PROCEED
o COR ~ foR CALL FOR REINSPECTION BEFORE COVERING
Inspeete lJ) ~ / Owner/Contr:
~o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
V../
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~9? I W/~/) Lf?
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~L
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~-C)L
C~/1o ~ () I(
DATE nilE
s-u~
/Yl"POtl41/
f;S'71,
~ILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
!Jt WORK SATISFACTORY, PROCEED
, 0 'coRRECT ACTION AND PROCEED
o CORRECT WORK, CAL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr.
.P
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
IJISIfOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
).f((, I
LVi/ds
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
"FINAL
-fj SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
ffi
h"t.ef I
5t1cl c::l
q,,,uck
.>
1"' /'C'C 'e;
ClL)Pnll/e.1 /
\
-
r: /"..c f4(7 dV1. +-/1
~
Dot. TE TIME
I-to-a;.
~
s- CI,../
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
G -I-db
o WORK 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.
_n
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &I SAFETY!