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Home My WebLink AboutBldg Permit 05-1045 Date Rec' d CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Main File I. White File 2. Pink City 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS I1Lf4b ~ ~.v.- s;E LEGAL DESCRIPTION (office use only) " LOT I BLOCK I ADDIDON ~ /fj.1JA., OWNER (Name) (Address) . (Phone) PERMIT NO. OS./M-5 ZONING (office use) R,z... PID 25. 4U. tJOI. () (Phone) Q!5a-'1gs::j <l13 (Phone~E)? -AAlu-4f~ TYPE OF WORK ~ew Construction ~Deck o Porch ORe-Roofing ORe-Siding ~ower Level Finish ~Fireplace OAddition OAlteration OUtility Connection o Misc. I. l2-. . c,. PROJECT COST IV ALUE (excluding land) S /811, urJ.( 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 a1l construction will conform to a1l 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 ~ten~to'1{tiQ~ ~7 4'-(~r()G Signature Contractor's License No. Date Permit Valuation Permit Fee I Plan Check Fee I State Surcharge I Penalty I Plumbing Permit Fee I Mechanical Permit Fee I Sewer & Water Permit Fee I Gas Fireplace Permit Fee ./1/70,1 8()fJ. 06 $ /17$. so $ '57.71? $ 85.0D $ $ $ $ $ I Park Support Fee I SAC _____ I Water Meter (Size 5/~1"; Pressure Reducer !OO.oo 10 D. "., 35". $"0 '10. 0 0 City SAC and WAC I Water Tower Fee I Builder's Deposit I Other I TOTAL DUE Paid ~K l' f. -? r Date /()~/~~ This Application Becomes Your Building Permit When Approved ~ ~ /1J/~/dS Building Official Date # . $ $ /L{So,oo $ .;1'50. 00 $ 50.. 00 $ 1500. Q 0 $/tJO(). (JO $ /5'D D. QO $ $ft,54/. Z~ Rec~ No. $rJ 1 j.(, By" ,. tf # # # 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 ~hy~."m,muy~:u:-..n~;;,o;;;; .-_..c_~o=p_m~'~ Planning Director Date Special Conditio66, if any 24 hour notice for all inspections (952) 447-9850, tax (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 R~2 Districts' Reviewed by: ~ ~ Date: l~/S-~5 Building Permit # PID: Zoning: Address: /'lr&J(,~ /7'1'1T, rl'S"Do,"S-oz., ~ ~ ~e' Legal: L I ~ 2.~~';I B I Subdivision: ~. I~'t:b Existing Structure? YES@ Existing Nonconforming Structure? YES@ CONFORMS TO ZONING ORDINANCE YES . Yard Setbacks: NA 1 FAILs(CQM15[i~ . Front Yard (can be 20' if avg. wfin -1 SO') . Side Yards Standard 2S' 10'/ 2S' if abutting a street . Sidewall exceeding SO' 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) 10' setback + 2"/1' over 50' 2S' 10' sidel 2S' rear 30' 7S' or setback average of adjacent structures, but no less than 50' I Floor Area Ratio: NA 1 FAILS tt~MPLlES) .30 Maximum . Yard Encroachments: NA 1 FAILS(C"OMP[,!.!:5)) Eaves and Gutters no more than 2 feet in width and no closer than 5 feet to a lot line (Easements). AlC and other equipment cannot encroach on interior side yards. Standard .- Tree Preservation:~ FAILS 1 COMPLIES . Total caliper inches . Permit 2S% Removal I. Caliper Inches Removed . Caliper Inches Preserved . Replacement Standard 12:1 L:\TENIPLA TE\BLDGLIST.DOC NO Proposed ZlD.~/' 2"1 I f3~ ~~!. v 3" 8fun.-. '3U,.~ tr'l}C4 2. ~ ' . ~A NA " IJAc I 6-L Proposed ~~. NO"NIlJ Proposed I Driveway: NA / FAIL~ c1;PUE~ · Maximum width at propertV-'ne · Required setback I. Maximum slope · All parking areas to be paved including R-V or spaces adjacent to the garage · location to match subdivision grading plan , Building Heighr.'CO~PLlE~ FAILS "---" -- Shoreland District((N)tt FAILS / COMPLIES Minimum lot area (square feet) I Minimum lot width I Shore land alterations I Impervious surface I Bluff in Shoreland(~))/ FAILS / COMPLIES · Setback from top-of bluff I. Bluff impact zone · Engineering certification submitted/approved · Grading in bluff or bluff impact zone I Floodplain :tfCtl.) FAILS / COMPLIES · 100 yea}flood elevation · lowest floor elevation · Proposed lo~est floor elevation · Elevations 15 feet from structure · Road access must be no more than 2 feet below Regulatory Flood Protection Elevation - Accesson{ Structure:~Alb FAILS / COMPLIES · Size ,- · Not located in front yard (Materials) I. Side yard and rear yard setbacks · Maximum height · Materials compatible with principle structure L:\TEJYlPLA TE\BLDGLIST.DOC Oc "."". ....~....-- I" ii,.. 4f.,..&'~'II.. _ J l ......... Standard 24' 5' from side lot line or 30' from r-o-w on comer lots 10% 35' Maximum Standard 7,500 Rip, 7,999 Non-rip 50' Rip, 57.3' Non-rip . 30% Maximum Standard By planningdept. 20' From Top of Bluff By City Engineer No importing/exporting Standard' ' 908.9' Prior lake 914.4' Spring lake 909.9' Prior lake / 915.4' Sprinq lake 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. Must be flood elevation or I higher 907.9' for Prior lake 913.4' for Spring lake I Standard t I 832 sq.ft. or 25% rear yard 10' 15' ,. Proposed , I'I~ 19' I cr4r.., . ~ S-' I <;:'.0; '7,2,. 7. UJI' ~ t:A- ~ 2.2-' ~ Proposed t - j I Proposed Proposed Pr.9posed ,'\i .,; i 11UI. ---.... ... -------- . White - Building Canary - Engineering Pink . Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED L,,'. I: / /( l,_ T{ // The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 1/ ,::'f' 9 C:- j) E E I(~ /; / [,'-L [,.J i..J Ie:...... . Accepted X' Accepted With Corrections Denied Reviewed By: m9fS . - Date: /tJ'-/3-CJS Comments: See Reverse Side for Additional Information! IYlc,/~ F',./( ..... "f See Attachments: 1) Gradin~ Plan; 2) Erosion Control M~~~llre~ . "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 CanaO' - Enaineerlng <pink -..!!anrllng> BUILDING PERMIT APPLICATION DI;fARTMENT C.l:lECKUSI NAME OF APPLICANT APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: ! i '-f-'-- (r / ",I / /... / C L c" I. 1<- . Accepted Accepted With Corrections /' Denied 5eviewed By: Comments: rSa~ 4J a.Le 1-~ Date: IIJ /() ~/ a.s- 'JJ k-~-lI ~ . , "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 .JlbitP . ~ Canary . Ehg~~g Pink . Planning BUILDING PERMIT APP.I.lCATION Def.ARTft4ENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED D. re. Ha rl.:(1) t--I The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: /7~9(p f)eG~/GLL) .ott:-. Accepted Denied Accepted With Corrections ~ (~ , .. ~~ ~~~ ~. Date: ./~/s-I05"" , L~:~ , Reviewed By: Comments: , , 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 10/31/2005 MON 9:53 FAX 952 767 1900 GENZ-RYAN ~ 001/008 r Date Rec'd CITY OF PRIOR LAKE SEWER AND WATER PERMIT (!llease type or orint and sUm at :w.........) ADDRESS l'7LJQ(o i =.. ~ I !'Jj;J.(j,\fiTNO.,C' IA~ ). GoIcI Al'Pli_ ,:11'. , ~ LEGAL DESCRIPTION (office use only) LOT (BLOCK J ADDITION [)ff % +~ e) d I)Vl V C- l).eeVh e/ef ZONING (office use) I~tb Pill ~=R D'R \-tr)\f'TOY' (Address) /~()~ or} ~CV1\,)lfIC\C1C eJ. stc.lw (Address) " (phone) q5~-' q~5 -/flll LfJJLiVi'f{f" 550LjLJ . .". (Cio/~ (Zip Code) I APPLICANT fL [") II (Name) 01(Vlr.- IVIII a (11 (Address) two W. I ~ftA/}J I.~ i / (Address)' ~ (Contact Person) 1\.1 ~ . ~L1CANT SIGNATURE' .",1~P1A,d..JlJ , . '- (phone) 1102 - 7 LI/l- (VOl) Bu JW1 S' if/I !f/ N\N rL?Y3 7_ (City) . (Zip Code) . (phone) Of};)Y70 7-{ LW DATE I ()i 3// O~) ."'-- APPLICANT PLEASE COMPLETE BELOW Size of water service inches. Location of any couplings from structure feet. Type of sewer pipe. 0 ABC 0 pvc 0 Cast Iron Estimated length of sewer line feet. Clean out (if required) located at feet from structure. l('J!;E S~.lU!iDULE Residential sewer and water line cOMection $35..50 Industrial, Com'l & Multi-family 1% of job cost with a $39..50 minimum Sewer cOMection only $17.50 Water connection only $17.50 Estimated Cost $ Building Permit # SEWER AND WATER PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE $ $ $ .50 (Offiee Use Only) I This Application Becomes Your Building Permit When Approved I Paid Date Receipt No. - Building Official Date I By 24 hour notice for alllnspeetions (952) 447-9850, fax (952) 447-4245 FAX 952 767 1900 GENZ-RYAN ~ 002/008 Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT .~. (Please type olllrint and sian at bw.......) I AVD;V::SS ) t I L) (j to lier h ~l[{ l)1rj ~rL i~: ~~ I PERMIT N04P. 1AU.JC J. Yellow AIlPlIl:IIIl .., . , "TlitJ8 . ZONING (office use) · LEGAL DESCRIPTION (office use only) LOT (BLOCK I ADDmON f)r r-rli ( J d I ~fb PID ,,-. g;':ef DR ttD\4-()(j (phone) 95:~ - q y~- 7 f(}') (Address) (fO ~LoD t< CVi b ~'1 ~~f (0*. ~ -ft. If;() L-Clk:tV/ !! f___ :=X504 L/ APPUCANT (1_ 'f) q ~ (Name) Clt111.' ~tJ 0-V1 . (phone) "'JL:-IlJi1 -- {aDQ (Address) 2UJO ~^J. I-h,~ u k~ ~/Atl.Vlc,V I' (If, M N 55337 '(Address) ) (City) (Zip Code) (Contact Penon) KJ m . } (phone)Q61-707-- fa 1) APPLlCANTSIGNATURIll~ ,:B!.,/fA.J/ P.P' DATE /fit:3(/{)") APPLICANT PLEASE COMPLETE BELOW Type of Fixture I Quantity Bath Tub with or without shower I :3 I Dishwasher I f I Floor Drain I I I Lavatory (Bathroom Sink) I I j Laundry Tray (l or 2 compartment sink I Shower Stall I Sinks I I Bar Sink I ::L I Water Closet (Toilet) I Quantity J J i ::3 I Type of Fixture ot Rough-ins I Water Heater I Water Softner I Stand Pipe (Washing Machine) I Sewage Ejector I Backflow Assembly I Backflow Assembly Test I Lawn Sprinkler I Other I I FEE SCHEDULE Industrial, Commercial & Multi-family I % of job cost with a $39.50 minimum Residential, New One & Two-Family $99.50 Residential, Additions & Alterations $39.50 Estimated Cost $ Building Permit # PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMIT FEE $ .50 (Office Use Only) , This Application Becomes Your Building Permit When Approved Paid Receipt No. ,~ Date By Building Official Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/J11KEPLACE PERMIT Date Rec'd 1. Pink 2. Green 3. Yellow ~~~. I PERMIT NO. ~ IALL1 Apphcant V. UT"Q I (Please tyve or print and sign at bottom) ADDRESS 17496 DEERFIELD DRIVE ZONING (office use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name DR HORTON (Phone) (Address) APPLICANT (Name)HEARTH AND HOME TECHNOLOGIES DBA FIRESIDE HEARTH & HOME (Phone) 2561 651-633- (Address) 2700 NORTH F AIRVIEW AVENUE (Address) ROSEVILLE (City) 55113 (Zip Code) (Contact Person) BRENDA HUSTON (Phone) 651-633-2561 APPLICANT SIGNATURE BRENDA HUSTON DATE 1/4/06 APPLICANT PLEASE COMPLETE BELOW xD NEW CONSTRUCTION D REPLACEMENT D ALTERATIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS TYPE OF SYSTEM INPUT HEATINGORPO~RPLANT OUTPUT DWarrn Air Plants DGravity D Mechanical DAir Conditioning DVent. System D Steam D Hot Water D Radiation D Special Devices D Other Devices PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks Industrial, Commercial & Multi-Family HEAT N GLO SL-750TR FEE SCHEDULE I % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 Residential, Additions & Alterations $64.50 Residential, AC Only $39.50 FIREPLACE MAKE AND MODEL Residential, Heating & AlC (New Construction) Residential, Heating Only (New Construction) $39.50 $39.50 Estimated Cost $ HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE Building Permit # $ $ $ PAID WITH BUILDING PERMIT .50 (Offiee Use Only) This Application Becomes Your Building Permit When Approved: Buildinl! Offieial Date r. I r I ~ J ~aid . LCC !, I ~ U DLOGO \ tNo. 24 hour notice for all inspections (952) ~.w.::,98.!59.Jax{~)447-4245 '. ........ .~~.?t9.. '. :.: . '/1).t~'~~~d . .l: . " " . . HEATING PERMIT FEE STATE SURCHARGE . ". TOTAL.r.l!..nMIT FEE Bu~ldirig ~e~it # . $i0~~~fb wrfH ." ~:'" ~.'.. .' ."ILDtNG PeRMiT': . . '. ~ ," . :'.'; :.... (~mce lIse Only). . . . ..TliisAppUcation ~eC~iDts:,v.~ur Building Permit When Approved' .' Building omclal. Date i.1 \ ::laid '. i' DaMN 1:; LUUb 'I . : L.L , R=4nk ,By. . ." . L- I "/-'~' .1 (I J .V' . .\',' .' " 24 'hour notice for all inspecti~ns (952) 447 i~~ fa.x~~21.447-4245 CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIt. Date Rec'd 1. Pink 2, Green 3, Yellow File City Applicant PERMIT NOO5.J..046 (Please type or print and sip at bottom) ADDRESS 17496 DEERFIELD DRIVE ZONING (office use) LEGAL DESCRu .l.lON (office use only) LOT BLOCK ADDITION PID OWNER (Name DR HORTON (Phone) (Address) APPLICANT (Name)HEARTH AND HOME TECHNOLQ,QIES DBA FIRESIDE HEARTH & HOME (Phone) 2561 651-633- (Address) 2700 NORTH F AIRVIEW AVENUE (Address) ROSEVILLE (City) 55113 (Zip Code) (Contact Person) BRENDA HUSTON (Phone) 651-633-2561 APPLICANT SIGNATURE BRENDA HUSTON DATE 1/4/06 APPLICANT PLEASE COMPLETE BELOW xD NEW CONSTRUCTION D REPLACEMENT D AL TERA TIONS FURNACE MAKE AND MODEL FUEL FLUE SIZE RETURN OPENINGS INPUT OUTPUT TYPE OF SYSTEM DWarm Air Plants DGravity D Mechanical DAir Conditioning DVent. System HEATINGORPO~RPLANT D Steam D Hot Water D Radiation D Special Devices D Other Devices PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks FIREPLACE MAKE AND MODEL Industrial, Commercial & Multi-Family HEAT N GLO SL-750TR FEE SCHEDULE I % 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 # $ $ $ .50 (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Duildine Official Date 24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245 PRIOR LAKE INSPECTION RECORD SITEADDRESS /7L/~~ J)t:cl2 f:)rtc l)4itlb- $.c. . NATURE OF WORK ~E,W c.t1J1"LA4.~/O~ (10/ L. L. f:i/.JtiHDJ) USE OF BUILDING ~,:; A. . . . PERMIT NO. (JS'/o~S . DATE ISSUED /JJ/rj;.I2 . CONTRACTOR ~. "'IlTaAJ~C.. PHONE · Z.d.-'t7Il NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT DEPARTMENT OF Main File BUILDlblG AND INSPECTION INSPECTOR DATE, I FOOTING I. ~., // A~j , FOUNDATION (Prior to Backfill)~,.,t:'Ju.I~/ ~'//Q.:1"tr'1 #1 1..z)/~5f t , , PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS " SEWER I WATER I SEPTIC r#:'- )/!ft ;;-S- FRAMING ~ /~#~ INSULATION . J:IVt- / /-..25/qb ELECTRICAL / /,2D/CJ{, :~~~::~f~~;~~ II s1~ '%t //;:i/-t d/t FIREPLACE /~r //,,2~~6 GAS LINE AIR TEST !1ttlh f f; I), /Iij- I It i'/6~ COVER NO WORK UNTIL ABpVE HAS BEEN SIGNED 1..A1?I~ /~III'IIAJ/I.I(JO l;feW! N1'@~' I FINALS 11/ f} ...:, GRADING (Prior to Sodding) . I BUILDIfi,G ~Af LO, (/Hf;l 7#M, 14 ELECTRrCAL' . , PLUMBING HEATING DO NOT OCCUpy UNTIL ABOVE HAS NOTICE ~ 5..,2-.f. () ~ A ~ . /11# ~ / b/?/d' . . /?/7& :J/J/46 I J/~ 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 - O1rrfifirafr of @rtupanry CITY OF PRIOR LAKE ~eparfmtnf nf ~uilbing Jlnspttfinn p(Final Permitted D Conditional C.O. Expires. This Certificate issued pursuant to the requirements of Section 110 of the D Residential / D Inremational 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 ,5'/11/ G l c:: F H /"'l/ '- Y Bldg. Permit No. C 5. 104- 5" Occupancy Type _ Ie 2: Type Construction 1'1\1 Zoning District F.. z.. Legal Description _ L /, t3 I , t.J e. E., IGF/ E L U / 2 7'/01 . SiteAddress /7ftir? OEEe;:-/6L-V tJ/~.. Owner of Building Contractor's Name & Address jj J.(. 1-1 t /.C1Z.AJ . ~/ - - 20 8&(; /CC/V CIc:.,1 U c:e e:r, L../1 ICE-V/ (.- U:;" City Planner Date: '-1 ~ A~lding Official Date: DATE TillE SCHEDULED ~~~ A~~tJtV/ J:t- CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS /?~7" OWNER CONTR. PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o INSULATION A"'FfNAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL COMMENTS: tY'1 / //,H'if / ae s- - /t'sVS- o EXIGRADIFILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o ~' /' -- . ------ ~ ./ ----::;::::::-- /' ~ ( /:/d.S1' ~'/p "- ~ ---- ~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 & SAFETYI INSNOTI DATE TIME CITY OF PRIOR LAKE "A. / INSPECTION NOTICE SCHEDULED ~1/~{, ADDRESS /7~?b Ae,-J2/d d- COMM~JS: / ./o/V~.~ /~hO'-"'~~r (17/r "--" F - OWNER PHONE NO. D FOOTING D FOUNDATION D FRAMING D INSULATION D FINAL D SITE INSPECTION ~ ~ 1 e~_F/h/i-h CONTR. PERMIT NO. S--.A7~ D PLUMBING RI D MECH RI D WATER HOOKUP D SEWER HOOKUP ".....B'15i.UMBING FINAL D MECH FINAL D EXIGRADIFILLING D COMPLAINT D FIREPLACE RI D FIREPLACE FINAL D GASLINE AIR TST D ~ / //~/ / J /~ 0 /- ./'- -- '" ./ 1/4r.hL~/ha, 'v" 7, // - ~# ~. / /...... C/L// ~ D _~TISFACTORY, PROCEED ~ORRECT ACTION AND PROCEED D CORRECT WORK, CALL FO REINSPECTION BEFORE COVERING Inspector: CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.. Owner/Contr: CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETY! _n CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS /.? if.f.b' OWNER PHONE NO. o FOOTING o FOUNDA 1ION o FRAMING o INSULATION ~ o SITE INSPECTION SCHEDULED ~~ ~~A/ cf 4 CONTR. PERMIT NO. o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP [] P~BING FINAL 9"""ECH FINAL nilE S-7'0<(,- o EXIGRADIFILLlNG o COMPLAINT o FIREPLACE Rl ~EPLACE FINAL o GASLINE AIR TST o COMM.ENTS~ __ 0pM;ej/ hk/ - ~ - ~ ~ ~dZh- A ~hq/ / c7<<- ~I!/~d- cr,rt;/- /lV/"- , ~ ,If /' .. # ~ / /7 //1' {!;/ ~d ~,., r S~fi1 I- ~.k~/fzC~ Q;i.c~ CX1Ah,,{ ~ir~~ _~, Pb-. /dr- {!)..ad 4- 4,l -/.::; /Ji:,/~ - .I' / ~ ~~~ co. v~~'f{ //~ft, . / - ./ , j"/7/a: o WORK SATISFACTORY, PROCEED ~ECT 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 if SAFETY! CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS /7'I'i~ Jkp{;'e1J PI' OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION CONTR. PERMIT NO. o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL COMMENTS: Lt,fh 81'~~ f-" ~ G,..." ~ .- ~ t;. DATE TillE ,f'~()" 0.1. flt,f';"'~ (Y;-lo'Ir ~ILLlNG DCCidPLAiNT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o btt WORK SATISFACTORY, PROCEED I' ~ORRECT 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 & SAFETYI INSNOTI . ..- APPLIANCE PERFORMANCE TEST, Attach to gas line adjacent to regulator Heating Contractor .A..JL"s.J t1J.. Name of Tester J-f L..Q,J Date 3/1" I" ~ Name of Tester Date Percent 02 Percent CO Percent C02 Stack Temp 3 \.7% ~% ~dF Combustion air is adequately supplied per UMC Sec. 606 \f ~ <S input ~. fJtJ/'j f1tb