HomeMy WebLinkAboutBldg Permit 05-0322
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
Lj- 13- dS-
I. White File I PERMIT NO
2. Pink City . 05. 03 Z- Z-
3 YeJlow Applicant
(Please type or print and sign at bottom)
ADDRESS
~"? 90 U) ,lll')~ Lc...J...
ZONING (office use)
AI..W.
PU.o
LEGAL DESCRIPTION (office use only)
LOT / {t1?BLOCK
I
ADDITION
~T~J,'~ _rQu'f'~
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if1' CA/ t:- ~ 7' .
PID25.307. O/~. D
~=R /h ~ f)Oh~(J
(Address) , (,O , 14 rl' ~
(Phone) ~!:;> - .l./ 6..1- 7 t. 0 I
/J.40J'<-t/~}I- /h-. ST/~'I
, '"""
BUILDER .g I j ~ i
(Company Name).M, tp~t:(/ (/ L ~ .
(Contact Name) :t < ~ \ 'Q;J.I S~__
(Address) '1 (pO ( L5iS "'1- L. tSr ~4- s-7:
..4;1/ 'C-
(Phone) 'in -43:1 - ? ~CS (
(Phone) ~ I;).... ? tJ -1?'(, kl t(
tAL//~ ,lh- .C:::C' / ~ ~
TYPE OF WORK ~ Construction ~ck M'Porch ORe-Roofing ORe-Siding
OAddition OAlteration ~~ Connection 0 Misc.
CODE: ~ .C. OLB.C.
Type of &;'~~ction: I II ill IV V A B
Occupancy Group: A B E F HIM R S U
D~b~~ I 2 3 4 S
~ower Level Finish I!(Fireplace
PROJECT COST/VALUE $ 4 J()/, sO
(excluding land)
I State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
I hereby certifY that I have ntrnished information on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or authoflzed agent for the
above-mentioned property and that all construction will conform to aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
:cial Ci.,r rJe, e}s per .t for just cause Furthermore, I hereby agree that the city official ora;;n:e ~ e:;.r ;n[; property to perform 3:Jl:ns. ~
V Signature Contractor's License No. Date
Permit Valuation {~/tJ~ tJtJtJ, 00 I Park Support Fee # $ 8SlJ,fJeJ
$ ~'J/g, 5' 0 I SAC _ # $/~5",,,a
$ IS? 'Y::?, 7 r I Water Meter Size 5/lr~ $ 300, tJ 0
$ za s-;. 00 I Pressure Reducer $ 7S,. IJ 0
$ I Sewer /w ater Connection Fee # $ / s () 0 , (J (J
$ IOtJ,l)o I Water Tower Fee # $/~{) 0,<<'0
$10 0,00 I Builder's Deposit $ Is-at:), 40
$ 5 'S, $""0 I Other $
$ J.M,.fJO I TOTALDUE ~.f. Z6',~5 $//1'&2-.78
Permit Fee
Plan Check Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
. This Application Becomes Your Building Pennit When Approved
h~ ~ 1I~s/or
Building Otlicial Date
Paid
Date
"
/!, Cf('Z. 7I
i -f--.x, . ClJ
Receipt No. .f9/R:?
Bv fIL
ThiS IS to certifY that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commenCe. Before occupancy, a Cenificate of Occupancy must be
i~~
Platining Director
fY-, s-;; S'
/ Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
Residential Building Permit Checklist
New Construction for Single or Two.family Dwellings in R.1 or R~2 Districts'
Reviewed by: ~ ~ Date: .1/d-S~S'
Building Permit #
Address: d? 791J
Legal: LJ ft, , B
PID:
p~~
/ Subdivision:
Existing Structure? YES@
CONFORMS TO ZONING
ORDINANCE
Yard Setbacks: NA I FAIL~ COM!:.llEi'
. Front Yard (can be 20' if avq. w/in 150')
. Side Yards
. Sidewall exceeding 50' requires additional side 2"
setback for every l' over 50' in lenqth
. Rear Yard
. Patio Door: provide for minimum 10' deck or sign
statement indicatinq no deck will be built in the future
. From 100 year flood elevation of wetland/NURP
pond
. From OHW (Prior or Spring Lake)
, Floor Area Ratio: NA 1 FAILS (COMP.!:LI;$'
. Yard Encroachments: NAI FAILScfCCfMPLI~
Eaves and Gutters no more than 2 feet in width and no
closer than 5 feet to a lot line (Easements).
Ale and other equipment cannot encroach on interior
side yards,
! Tree Preservatior( NAJ FAILS 1 COMPLIES
. Total caliper in~
. Permit 25% Removal
. Caliper Inches Removed
I. Caliper Inches Preserved
I. Replacement
L:\TE1tIPLA TE\BLDGLIST.DOC
Zoning:
A).W.
~~
Existing Nonconforming Structure? YES@
YES
NO
10' setback +
2"/1' over 50'
25'
10' sidel
25' rear
30'
~
c:?'1' I
I ' I
~ r -/~b~ fAj,
~~
1{~' /~!.tJ" t5",
.... &'~..,,~.
....,,~ z..S'~.
f'J'-o-tJ€
~ "".
Standard
25'
10'1
25' if abutting a street
Proposed
75' or setback average of
adjacent structures, but no
less than 50'
tJ A.,
,30 Maximum
t I/JUv P ui) .
Standard it- Proposed
~ ~ Olo-' It) (\10 ,.,) ~
rJO~b
Standard
Proposed
%:1
I Driveway: NA 1 FAILS ItDrrtPE'!b Standard ,. Proposed
. Maximum width at property line 24' I zo '
. Required setback 5' from side lot line or I
30' from r-o-w on comer lots Iv
I · Maximum slope 10% ~?O/~
. All parking areas to be paved including R-Vor erk-
spaces adjacent to the garage
I · location to match subdivision grading plan ~
, Building Hei~ht: ~MPLleS 1 FAILS. 35' Maximum ~ ,
,- t
Shoreland District:~ FAILS 1 COMPLIES Standard Proposed
Minimum lot area (square feet) 7,500 Rip, 7,999 Non-rip I
I Minimum lot width 50' Rip, 57.3' Non-rip [
I Shoreland alterations I
I Impervious surface 30% Maximum ,
I Bluff in Shorelancl(N'A) FAILS 1 COMPLIES Standard Proposed
. Setback from top of bluff By planning dept.
I · Bluff impact zone 20' From Top of Bluff
. I · Engineering certification submitted/approved By City Engineer
, . Grading in bluff or bluff impact zone No importin~/exporting
.
I Floodplair(: NA) FAILS 1 COMPLIES Standard Proposed
. 100 year flood elevation 908.9' Prior lake
914.4' Spring lake
. Lowest floor elevation 909.9' Prior lake 1
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
higher
. Road access must be no more than 2 feet below 907.9' for Prior lake
Regulatory Flood Protection Elevation 913.4' for Spring lake
I Accessory Structure(N~1 FAILS 1 COMPLIES I Standard Proposed
. Size I 832 sQ.ft. or 25% rear yard
I · Not located in front yard (Materials) I
I · Side yard and rear yard setbacks I 10'
I · Maximum height 15'
I · Materials compatible with principle structure
L:\TEMPLA TE\BLDGLIST.DOC
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White - Bulldin"
(,:~nkarv :- I:n~,"eerin~ )
n - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
jl/,?,. L)ClV/It...,O c..(Ij\jJ'77~ .
C/~ /4-.0.S-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at: /
Z'79() (.liILL).5 ?I1/l/C IV/V
Accepted
Denied
Reviewed By: .Itllf!> Date: 'I-jr..oS-
Comments: See- Reverse Side for Additionallnformationl
.X:
Accepted With Corrections
See Attachment~= 1) (;rsuling Phm, 2) F,ro~ion Control 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.1I
~..-
. ..
White - Building
c.anarv - En~rlng
( t'lnlL- - Plannl~
BUILDING PERMIT APPLICATION OEPARTMENT CHECKLIST
NAME OF APPLICANT
/t/r~bCNrlt-O tU/\jf'77~.
4./4-.0S-
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity W~iCh is proposed at:...- ., /
2 790 II//LVS ?I1IVt;, /V/V
Accepted
Accepted With Corrections
/'
Denied
0K_ _ " ~_,. 1'1. .
Reviewed By: ~ ~
Comments: ,I!~ a...e..f ~~..
~ /~l 7~ ~ O'r-
Date:
~45~S-
No ~
-ftjJ ~,
!_..... d:iti "0,'.1 'W"" ., . 11
.L""-~ ""an. . oller liJ.l(;..;W.I.\:,.l .l.w.it;\...u..a.IU(;CU
Units Cannc't Encroach into Req:-~i1"ed
8itlt:; 'Yaru Sei...u{.uzk.~
"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."
c.. i OF PRIOR LAKE PLUMBING PERJ\I,u~
Dati Ree'd
5 23.05"
i.:: ~~ I PERMIT NO.AC' ...."
, Yellow AppllOlM ".. ..,........
~1!f~Drirltand..q ."""j)
ADDItBSS 8190 l{;i Id~ L fA Yl e Ii W,
ZONING (oIIIcc_)
LEGAL DBSCRu uON (oftl.ClCl use only)
LOT /~ m.ocx OJ ADDmON S; -fer /,' n 3 So 4th
. &~~R MC-/[)Bhald C\oy,~frur;{f; Oh~/;t1C, (phone>'lQ- Y3;)-76'0 I
(~) '&oJ ;t/dJ., sf. VAlti Ap.pJe /jrJiEl, t2.JJ -S,. ~7 ~ 'I
~~~ANT .-E'tlP ,,,-/-all' P/urnb;R~.:rnC,- (Phone) 6-0/'- YS-9-- fJ /~O
(AddmJ)~\Y S-+h~y1JaYlJ !Jr>, ' t/;f)r>db~(I v MJt1 S-~!)9
(Address) J / / (City) (Zip Code)
(C_ Penon) J) (I. If ifJ r SYh;+ h. ,,(Phone) t, i" / - 'K01- r.P /rJ6 _
APPLICANT SIGNATURE ----.&~ ~.~ DATE ~- dO-OJ
Q..-.tity
I
I.
I
'-I
/
It
I
~<
PlD 25.307. OIIP.O
.',.
APPLICANT PLEASE.COl\1PLETEBELOW
Type of Ftxt8re Qautity .. Type of Fixture
'Bath Tub with or withoutsbower Rough-ins
Dishwasher I Wader Heater
I Floor Drain Water Softner
, Lcwatory(Bathroom. Sink) t. Stand Pipe (Washing Machine)
Laundry Tray 0 or i compamnent sink -sewap J3jeetor
Shower Stall a.cJd1ow Assembly
Sinks Baoktlow Assembly Test
Bar Sink Lawn S1)t'inkJer
W ater Cl6ie~{Toilet) Other
FEE S\..nJLDULE
,. Industrial.Commcl'Clial &,)o{u,Iti:'Yamilyf% of job cost with a 539.50 minimum Residential, New One" Two-Family
, J / Retidentlal. Additions &. Alterations
. EstimatedCost $ / /1~OrOO BuildingPermiU Or-OSdd
$.~~~
$ 1 -v .50
$
$99,50
$39,50
PLUMBING PERMIT FEE
STATESURCHAROE
TOTAL PERMIT FEE
(QIIce UM Onl)')
Tbls AppUcatlo..lecoDlesVour BuiJdillg......it Wlten Approved
p~~
.~6: 23. 06
IR"~ '
tBY~':1
/
Bulletllll OftIclll
.,..
'4tiollr noCkc ror aU'iillpM1loDI <"1) 447-""'fU (5)>52) ....'-4:l45
CITY OF PRIOR LAKE
HEAlli'iG/AIR CONDl110NING/~lKEPLACE PERMIT
Date Ree'd
~ ttP! or matand~ at bottom)
ADDRESS
r::J7 cr() (~J /I[)~
l~ ~ PERl\fiTNO.~ A~."
3 Yellow I\ppIic'aI ~~
~;. ''A
A/. lAj,
ZONING (ofBee
*)
LEGAL DESCRlPrION (office use oNy)
LOT BLOCT<
ADomON
PID
OWNERfn r:J:v..n/[)
(Name) . -
Co1U~I-,
(Phone) ?"Z ~ .. 7GO(
. (Address)
APPUCANT . ~
(Name)~~ 0
aft"
_ (Phone)
-1Go - ffi~~
(AddIess) "I
r.I /;:;} 10 1.:7"n InA J 11"e... ~ ( ~) ~
(Add:reae) r -cr- (City)
(Contact Person} . (Phone)
APPLICANTSIGNATUREk~ ~~ DATE
..---
_ APPLICANT PLEASE COMPLETE BELOW
.,....EjNEW. CONSTRUCTION 0 REPLACEMENT . 0 AL !ERA-nONS
FURNACEMAKEANDMODEL~k.4~j'1 C9.1J?P'>>/1Y\ FUEL /JoJ--
FLUE SlZE ~ I} .PV( t... RETURN OPENINGS INPUT ,/I:2C.a::l' . OUTPUT Q.:J /?CO
t , ,...
HEATINC OR POWER PLANT
o Steam
o Hot Water
o Radiation
o S~a1 Devices
o Other Devices
ss"o 0> 1'.
(Zip Code)
G-/~os-'
TYPE OF SY;:, I ~wf
DWarm Air Plants
D9.DMty
A:r..}fecbanical
....eTAir_ Conditioning
~L SyStem.
PLEASE N01'E:
Air Conditioner Units
Cannot Bncroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
FEE SCHEDULE
IndusaiaJ. Commercial &: M\lJti-Family 1 % orjob eost Resideatinl, Gas FiIep1acc
S39.S0 minimum
Residemia1, &ating" Ale (N~ Construction) $99.50 R.osidential, Additions &: Altl:rations
Residential. HAting Only (New CoDStJ'UCtion) S64.50 Residential. AC Only
S39.S0
S39.50
$39.50
(Office UIe 011I)') _
ThIs App6eation Becomes Your Building Pemait Whca Approved '~. ~~~ LG U.. ill \\: 1 Receipt No.
....... 0lIdd .... II ~H! 2005 ]~\s.
L._'
24 hour Dotiee tor an illllpectlons (9S2) 44.t!J8S0. ' ru (951) 447-424S
By_
Estimated Cost S Building Permit #
HBA TING PERMIT FEE $
STATE SURCHAROE $
TOTAL PERMIT FEE S
PAID WITH
BUILDING PERMIT
.50
lOO~
HIV Ild. 110H.LNO::l
9L6909tlS9 IVd 6C:60 <<aM S006/10/90
Page 1 of2
Lynda Allen
_ From: Christa Wegwart [WegwartC@hearthnhome.com)
('
Sent: Friday, May 27,200510:22 AM
To: Lynda Allen
Subject: NEW PERMIT FOR 2790 WILDS LANE NW - 2 FIREPLACES
CITY OF PRIOR LAKE
HEA TING/ AIR CONDITIONING/FIREPLACE
PERMIT
Date Rec'
'Please type or print and sip. at b" . "" ... )
ADDRESS
LPink File I ~ )1-1'2-[
2. Green City PERMIT NO.:/" . --
3. Yellow Applicant
ZONING (office use)
2790 WILDS LANE NW
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name MCDONALD CONSTR
~ .<\ddress)
(Phone)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOME
2561
(Phone)
651-633-
(Address)
2700 NORTH FAIRVIEW AVENUE
(Address)
ROSEVILLE
(City)
55113
(Zip Code)
(Contact Person)
2561
BRENDA HUSTON
(Phone)
651-633-
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
OS/27/2005
APPLICANT PLEASE COMPLETE BELOW
X NEW CONSTRUCTION REPLACEMENT ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT
OUTPUT
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
!~ 'IREPLACE MAKE AND MODEL HEAT N GLO 6000TR-OAK X 2
Industrial, Commercial & Multi-Family
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$39.50
5/27/2005
PRIOR LAKE ,.=r=~N,JD~:SPEcnON
INSPECTION RECORD
SITE ADDRESS --27q() ~."'C.DS lJe tJ...,. .
NATURE OF WORK ~ Q c--,TM L.c... Fit-tItH)
USE OF BUILDING S. t:: 0, - ~
PERMIT NO. 05.032 L . DATE ISSUED &.J,tS/oS
CONTRACTOR f'lCD6~ ~. PHONE~.~"
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~
FOUNDATION (Prior to Backfill) I {V I \r 6- I
PLACE NO CONCRETE UNTIL ABOVE AAS BEEN SIGNED
ROUGH - INS
DATE
FOOTING
we I
I $/- ;? /- oc....,
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (If required)
FIREPLACE
GAS LINE AIR TEST yV1- f ~ rP. ~ y M (r J....~
, .._;Ol:~.~O WORK UNTIL AmE J:lAS BEEN SIGNED
~C~,., rf~}/UJP!50 I
" FINALS
GRADING (Prior to Soddln9) f\) ~1 ~
BUILDING (/ ~~ 11 t Jl-1~~S W c" .\(f,
ELECTRICAL .J
PLUMBING rlS 19;J1~
HEAnNG vvV ~ ~ J;t+-'5'
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical IefVlce cabinet prior to rough-ln Inspections
and maintained until all Inspections have beef" 'approved. On buildings and additions
where no service cabinet Is available, card ....a'l be placed near main entrance.
,.
/
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\Mil'." tlW/
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5\"~~'~
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J
FOR ALL INSPECTIONS (952) 447-9850
f
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~,,';'j,"'J.:.;,;t.'c'~.. ~II' 1111111;11
';"';'>11/ ';\il' '.'~ ~ >.:..i '.j,,,,",,'i/":;"i.i~;I"~":.J ,t":'':''''>L~''-''''';<'11 III II' .....::;.. J;:": ':II~ "1,1'.' 1'",,,'1 ,.~
..w.. -
"~
........
DATE Tille
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
5,U-OJ
PHONE NO.
::2 75o~,'tl5 LI1,
CONTR. ;r7v~J~
PERMIT NO. f!)S- 32Z-
ADDRESS
OWNER
D FOOTING
D FOUNDATION
D FRAMING
D INSULATION
~L
D SITE INSPECTION
D PLUMBING RI
D MECH RI
D WATER HOOKUP
D SEWER HOOKUP
D PLUMBING FINAL
D MECH FINAL
~~LLING
D COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GASLINE AIR TST
D
COMMENTS:
G J"O~ oJ
(,,)6 f;yf- be
1:;0
'W'WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
D 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!
INSNOTI
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS 27JO \J."'~~ LIA.-
/~
PHONE NO.
CONTR.
PERMITNO. 'S" - O~~<
OWNER
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:
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
)l G~':i-AIR TST
I, Fn...J- 5j...J., ~,
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.,
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
Q'"t10
WI.U2s lxA,
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
D..)JEWER HOOKUP
d PLUMBING FINAL
o MECH FINAL
CO!~M~JS:_ _
/, ~ ~;t" rr .-r)
2. Q~~:._ ~
~~~~
't. ~ .c:'Ytu~~
DATE nilE
fj-{ 0..01
~~'--
5'-~
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
'197- 'P,1~
o )YORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRZSE' CALL FOR REINSPECTION BEFORE COVERING
Inspector /: Owner/Contr:
CAL~.985 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~REMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
11/SliOTl
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
,jPFINAL
o SITE INSPECTION
COMMENTS:
ill ~vtt.l (
7f') >or1d
SCHEDULED
) 71(6 WlI) ( ~
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
[] WATER HOOKUP
o SEWER HOOKUP
[] PLUMBING F,,",.
~ECHFINALLV
DATE nME
f5,,).'f ~S-
S--3l.- L
[] EXIGRADIFILLlNG
o COMPLAINT
[] FIREPLACE RI
o FIREPLACE FINAL
[] GASLINE AIR TST
o
~
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q fJ/mut"A /
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'7 ~ WI/? 1fi1;"""
,
~t-~
11-1-(7~
o WORK SATISFACTORY, PROCEED
<t CORRECT ACTION AND PROCEED
o CORRECT W~R~, ~ REINSPECTION BEFORE COVERING
Inspector: --V-JL/../ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTI