HomeMy WebLinkAboutBldg Permit 04-0531
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Main File
(Please type or print and sign at bottom)
ADDRESS
390 ~ IftAJ'/ Jt'nr' V
, I'
LEGAL DESCRIPTION (office use only)
LOT~ BLOCK / ADDITION 5~ F ;:rrJ
OWNER
(Name)
(Address)
BUILDER
(Name) lJ I' N 1./11" A/ /V
(Contact Name) (..,' fA /' l'
(Address) /R9 ~ /~ 2.~
If/~/,f'
..J
f! (J /7t (Jf
I. White File
2. Pink City
3. Yellow Applicant
Date Rec' d
c:br3-Lj
I PERMIT NO. 04-~OS31
tpl
A!w
~fA..r/J
(Phone)
ZONING (office use)
~1
PIDl.r- 39,f- 006 - 0
(Phone)
(Phone)
~Sl - "'Io~" ~y Ot)
(,/;l-JJf-7/'/:l
5.5/;1;J...
Or
Ca JO-N
/1l A/
TYPE OF WORK
~e~~onstruction
o Misc.
OLower Level Finish
PROJECT COST IV ALUE (excluding land) $
o Deck
o Porch
ORe-Roofing
OAlteration
ORe-Siding
OUtility Connection
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
=teru/1=p~7:Z::::- I~)~ J- ~-O Y
. / l..,glgnature Contractor's License No. Date
V
I Permit Valuation
I 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
$
$
$
$
$
$
$
$
J~5. 000
/3 Rg,50
~qq, eJ-f
/J 'J., So
/0".-
ItJO,-
85 Sa
tit), ---
& APPlicati~n Be~S y:~ :~ding Permit When Approved
~ ~ ..s//9,/()~
Building Official Date
o Fireplace
OAddition
#
#
#
#
$
$ /3SD.-
$ Zs-o.oa
$ l./'S;,.OO
$ / d-.OtJ, -
$ '1~,-
$ 1/j'{)O. DO
$
$
-
Rec,e~ No.
By L.
()
1. ~ ?;O~ 76
- I
~97L
I Park Support Fee
I SAC
I Water Meter {Size"5/~I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
.
~ (p bOo 7 Y /
r; . lLl .(J L/
I
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 k..."v...ry Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~
Planning Director
~
S;/;i:f joy
ate Special Conditionl,' if any
24 hour notice for all inspections (952) 447-9850, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~ ad'
Main File
WhitL - Buildin~
(Ci!nary - Engineering)
Pink - t"li:lnI'tiAg--'"
Thr ("tn'rr of thr t.kr Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPL.JCANT
APPLICATION RECEIVED
,. ,j -.>> c:l.~,~1
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
~.:......~..
C'..:-,J
{ ~,
.' ".
t,>./, ,}
"L/),.t;,
(c / cl...
I
Accepted
,y
Accepted With Corrections
r ......
Denied
Reviewed By:
IJ1M
Date:
S-Zo '-OV
Comments: -.See Reverse Side for Additional Information!
n741 h h'tl.
~ee Att~chment~. 1) (1r~c1ing Plan, 2) Erosion (;ontrol Measures
"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."
The Center of the Like Counlry
Main File
~e - Buildi~
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/J )~1VJtfiU \j(~
S- B-Cd
The Building, Engineering, and Planning Departments have reviewed the building permit
application for const]iq ;ij~ W~SA:!:: !?tr!p/ ICcL
')\,2Wj ()f ~~
Accepted Accepted With Corrections ~
Denied
.....
aI'~
~,~;- ~~
~ t:JJJ ~~ .
T ~. .") 8.~_~
Date:
s1r94t1
~~~
~J,
Reviewed By:
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."
""
Main File
White - Building
Canary - EnQineering
(""'PiiiL - PlannlnS:::>
Tht ('tnlpr of the L.kr ('ountr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
.'
0' '../
.:1/'"
./
// /J
-L-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
i ,/ /
("':'"'..." , ,.-"- ~
/
) ;
( /' I c:f.-,
Accepted
Accepted With Corrections /'
Denied
,..
~
Date: 61r9;d y
I '
-1 '.-..,A'"
\_ .~. ,,~. ~ -r-~
j(J.~~JI~~ dl J~" J ,
, ~
Reviewed By: ~
~~ a-U
fi-;~ ~
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."
10/24/01 WED 11:22 FAX 6124474245
CITY OF PRIOR LAKE
~OOl
DatI Rec'd
t-l J i OF PRIOR LAKE PLUMBING PERMIT
(pIt'''!: type or llrint aod s~ ;u L..........)
- ADDRESS \:) \ _._..... \:\ \ -\ ~ C'\ ~
3Of()l. ~o.s:,~~1 ~'~R-~'
~. ~~ ~:~ I PERMIT NOnu".tI!":Z t
I. '.1...... 11""_ ~ ?..:Jl.
ZONING (~, IIK')
LEGAL DESClUmON (office use oN)')
LOT
BLOCK
ADDITION
Quantity
c?-.
I
,
.5
'-..
I
I
Type or I'htlin
I
Rough-ins
Water Heater
Water Softner
Stuld Pipe (Washing Machine)
Sewage Bjector .
Bacldlow Asscrn bly
Bacldlow Assembly Test
Lawn Sprinkler
I Other .
f
4
FEE SCHEDULE
Industrial, Commercii., &; MlJlti-famit)' 10/. of job cost with iI $39.50 minimum Residential. Nc:w One:.t. Two-Family S99.S0
~e:Jidenti.l. Additions &: Al~tions $39.50
estimated CU$t S
Building Penn;t #
,
RfUD WITH
BUILDING PERMr,"'i
PLUMBING l'~T FEE S
ST ATE SURCHARGE S
TOT AL PERMIT FEE ' $ ~
(omce UIC Only) ..:- d
Th.b A ppUcation Becom.. Your Buildinc P.rnrit Wh.. Approved . '1Ji.i(); a; n \1J ~ I n \ Ileceipr No.
.. . _"0" -\ fiPaallN U :, ZUU4" .\. By r
8ulld1nt Official Dllt \!I.\ -'I I f'
d 88 IE 1009 8vON/60 6 ::;is~;io j"'t' :~O~ t'~1ailr) "'I~ ,ge~~'N~~tl f DN I 8~ mN:l1! WaHl
.50'
.:,.
,.,..-.....
Cftll:f.1I 0 ''',r.
n:.w.o", 0 ~"?\J~.I(r
GO\.l) . c:r T '1
C!~y OF P~IOR ~.KE
SHiER ~oND WATER ?SR."!I1'
NOag.S31
mLWNT: W~e.\ \~~
ADDR:::SS: 3c}D~~~ \<.\~~~,
, :c,~,,-:.:"" '- - ~2!'~~~:-=~u~:~~--
NOTE: Sewer 2nd Wa~er
contractors must
be reg istered
with the City.
PHONE =6SJ-'-I9-~J .<0'
DATE:
:7_CG.
-:~'O'A'I"'" .;.:,
... -.. --- - .
1.
Esti~a~ed length
of water ser~ice
:!LL IN THE BL~~~S
30
feet'.
4.
Type 0: sewer pipe,
A5S
I inc~(es). 11 ~
. froln st.::-'..lc";ure 'Vf Vt
PVC._~. Cast Iron
1. in@. .3CJ
feet.
2 .
size of water ser'lice
:3 .
Lccaticn of any co~plin~s
6.
Clean
cut:.
(if
re<;:uired) I
loc~~ad
fee~ ~ fa
<It ~Eeet
f=o~
50
~s~L~a~ed length
of
set,,'e r
s t :':.lC -:'..1:- e .
====================~==;~"=:.===~:============~=======~-========;:
Tr.~s a~plicaticn b€cornes ~O~= perm~t ~hen approve~.
SO,!
Di\T:E:
=======;;=====~=====~~=-=================~==-==~;===-=======~=====
* :=~ :0= e~the= sewe= or w~te~ i~CiVicua~~-~..1 ~o plus
S .50 s'.l=c:J.ar;e. - I.DlNGPERMIT'
...:l ... ~ ).. b
* Sewe= a~~ ~"~te= pe~~ts ~ssuec _O~ new cons~r~ctlon rn~st e
~oc~-4e~ o~~~~;~ '~~~;~ c~-~ ~~ ~he ti-a o~ 'SSu~"CO
~; I;;~~~ ~ ~ ~~-~~~ca~;"\-;e~;'~~ ~~ci~' ~at~;- p~~i~s -~~~
iss:.:.e=.
O,;"C~ ?,',:O ,I JUN fJ~ 2004 i!J. ~~<O"'':' n!D
~;:C':::?':' ~ By-=-.... . R~C 'DS',:'
s
s
s
35.00
.50
35.50
Sewer and wate::- line connection pe=mit.
Surcharge
TOTAL
'F~!s:
. ~ "'.,- \. l": . . ... . ... . ..
,',.. ,..... ,".-,- ,._,~.".,
. .. .....
.. . . . -
\ ,'" ,'. I."
~ d 88~E~0098v 'ON/50: 5 IS/0 I: 5 vO,~ '~ (G3M)
L9EO-~~v-l~9 ONIIV3H ~ ONlaW01d 13ZN3M WOBd
07/19/04 09:55 FAX 6518949955
WENZEL HEATING & AC
IaJ 004
CITY OF PRIOR LAKE Date Rec'd
BEATING/AIR CONDITIONING/J.4J.1(E-pI:.-AeE'.PE~l1l"'~' ."... u._ ~ ...... ...
~~/'/
~iEy)
. (phone)
DATE _-j/~
APPLICANT PLEASE COMPLETE BELOW
.)i!!FJEW CONSTRUCTION U Rf~i.ACEMl=.N 1 0 AI.. TERA TIONS
FURJ.'lACE MAKE AND MODEL biN!'>'! 6 $"1 &~ -" c::;- . fUEL ~/-
flUE SIZE ,;;)-~" RETURN OPENINGS ~ INPUT ~ CJ':i) OUTPUT ~ i 2:0
TYPE OF SYSTEM MEA TING OR POWER PLANT
~ann Air Planl$ 0 Steam
o Gn.vity 0 Hot Wllter
~Meehartieal 0 lW1iation
~ir Conditioning 0 Special Devices
JaVc:nt. System 0 Other Devices
(Please l'Ip.C: or Dnm and sic. at botzlOm'
ADDRESS
~-~/.. I
-~~ ~?~~
. ., I
LEGAL DESCR.u- l.LON (office use oaly)
.&Jr fj
LOT BLOCK
ADDITION
OWNER " l"", I~,,'\/V,.
(Name) ~, ((...1ft f\
~
(Addr~s)
. APPLICANT Ct:?/ ~ / /
(Name) ?I~I'I ~ ~H"~
. /
(Address) 4I~1 /)I'd 4/bt// ~#J
- (Address) / ..
(ContaCt Person) ~/'J ~
APPLICANTSIGNATU~J -::2?d ~
/
F:tREPLACE MAKE AND MODEL
t =. ;.~ PERMIT NO. /JU. ~.' II
J. VoIlow ApplIaN fL:T. ,,~ f
ZONlNG (ot!lceuse) ..
PID
(phone) ~51~~
.'
(phone) h<:::I-1P4~
~~rLZ-
(Zip Code)
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FEE SCHEDULE
Industrial. Commercia! &. Multi-Family 1 'Yo of job eost Residential. Gas Fireplace
$39.50 minimum .
Ro!Sidenti:1I. Heating &. AlC (New ConstNCtion) $99.50 Rcsidc:ntial. Additions & Alteruions
Residential. Heating Only (New CODstrUction) $64.50 Rcsidc:ntial,.AC Only
$39.50
539.50
S39.50
Estimated Cost $ Building Pennit #
HEATING PERMIT FEE S
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Office Use Only) '.
Tbis Application Becom~s Your Building PtrmitWhen Approved
Building 0111ci.s1
Dace
~~AiPJ VullH
6UiW;NG PeRMi1
.50
-
~~l Receipt No.
'\, DJtJL 2 2 2004 ., By
..- L L-_..:....___~-o;..==~-=~I:--'! =~-.;:.::=-:;.=~:=..:.-..."":-~.~ ~.'
14 hour Dotice for 1111 inspections (!J51) 40: 7-98:50, (:ax (951) 441-424S
By
.A
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONING/FIREPLACE PERMIT
Date Rec'd
i.,
(Please tvPe or orint and si~ at bottom)
ADDRESS
;:~:n ~::y. I PERMITNOJ1~~'
3, Yellow Applicant 'If ' ~ J .
ZONING (office use)
3904 RASPBERRY RIDGE RD
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name WENSMANN HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FIRESIDE HEARTH & HOME
2700 NORTH F AIRVIEW AVENUE
(Address)
(Phone)
ROSEVILLE
(City)
651-633-2561
(Address)
55113
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone)
651-633-2561
APPLICANT SIGNATURE
BRENDA HUSTON
DATE
2/15/05
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
D Steam
o Hot Water
o Radiation
D Special Devices
o Other Devices
OUTPUT
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
(!.1IREPLACE MAKE AND MODEL
Industrial, Commercial & Multi-family
HEAT N GLO SL-750TRD
FEE SCHEDULE
1 % of job cost Residential, Gas Fireplace I!Jj k Aa...... $39.50
$39.50 minimum v/)~~
Residential, Heating & AlC (New Construction) $99.50 Residential, Additions & Alteratio $39.50
Residential, Heating Only (New Construction) $64.50 Residential, AC Only ~ $39.50
Estimated Cost $ Building Permit # ~"liIf)-
HEATING PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
.50
(Office Use Only)
This Application Becomes Your Building Permit When Approved
V.-, - lJ).aiUS' '0 ilL \\-'(/ \~ C n'!\' Receipt No.
li L~' 0 L:' \ \.. \ i
[ L .
1\ \\,\ ~B 2 4 Z005 ~1 By
uU
Buildine Oflicial
Date
24 hour notice for all inspections (952) 44~IT3~50, fax~?~4-=,?~~~~?=-=~=,
l.-:
PR 10 R LA K.E DEPARTMENT OF Main File
. BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 31(')'1- II Vld<j.C.
NATURE OF WORK ~ 7-'''
USE OF BUILDING ~ A
PERMIT NO. 0&1- 053/ DATE ISSUED .
CONTRACTOR ~AJ . PHONCdiI..'4- ~/~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
, FOOTING "1.;i ~ I~. ~-~
J FOUNDATION (Prior to Backfi'lI) .. . I ~ ?- t r'"
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
r SEWER I WATER I SEPTIC Y-ul1t,'k ~/? , _</
FRAMING L L j11li ,zjf/o.5~ ~.
INSULATION L. Lt 11I1 ';;'/18/0{. J-i' /0 /?~
ELECTRICAL
PLUMBING (}c/;-- Aft (}'II b !If 7rj/34.t?/5 F..~
HEATING (if required) ~ ~ /H1 /,h8/fs:-' ~.
FIREPLACE U:- ) ~
1 GAS LINE AIR TEST
DATE
. ,
/tJ /..2/ /dy
. ,
?/~~PJ' ,
~,L, /#'/ #dif'
/t>h//t>y ,
~J?A~- .
.
. COYER NO WORK UNTIL ~OVE HAS BEEN SIGNED
(AI1IG,eItUi""bSr~i)u~ PI} hJl/~
v FINALS t. .
GRADING (Prior to Sodding) / bi J~ 1 .1 .Ol/
BUILDIN~J.e-o +0 f!>""" ~ ~ \'-\ r
ELECTRICAL ' '/ CY
PLUMBING Wc- ,tL:'P r-< <-
HEATING
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.
J
FOR ALL INSPECTIONS (952) 447-9850
~lerfifitatellf <0ttuJiantl!_
CITY -OF PRIOR LAKE
~tparfmtnf llf ~uil~ing Jlnspttfilln
y(Final Permitted 0 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 04-0531
Use Classification . Bldg. Permit No.
R3
VN
R1
Legal Description
Type Construction
L6, BI, JEFFERS SOUTH
Zoning District
Occupancy Type
3904 RASPBERRY RIDGE ROAD NW
Owner of Building
Site Address
Contractor's Name & Address WENSMANN HOMES. 1895 PLAZA DRIVE. EAGAN. MINNESOTA 55122
ROBERT D. HUTCHINS
&JfB ilding Official
. .,--1/1(",
/ ,~
. City Planner
DON RYE
Date:
Date:
~.' a . ~ ;. '''J!~~ "
iii, '1IiiiiIiililiII,
c' Iol>.o- ,....'1,...; , H " Hr'- ..,\;. . ;",' <'~' . ,'- .....' }
.'.;~. ",' .-...,~ '~L":>t. " 'I I
.. .-...
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
/4./J -'I~
ADDRESS
39tJ4-- ~Ptf~ ~06G
,
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 rECH FINAL
S:I'I
f
COMMENTS:
-
-
~ .53/
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE R1
o FIREPLACE FINAL
o GASLINE AIR TST
o
~;
/ //
\. ( /( O~
~- -
~
----
tJ'/..~\
f-7 L.L )
/
~
o WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: \f"\ P
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH & SAFETYI
DATE TillE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED '7/ 'Zy ~
ADDRESS 5'1(')(( ~'(J ~ ~/.tc.
,
/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
)r GASLINE AIR TST
o
COMMENTS:
-U;J. d-- ~
2. -hI;\J ~~,J~~f
~~ Q J-()
,p 7?' -L::::P-,<-
o WORK SATISFACTORY, PROCEED
o CORRE AC ON AND PROCEED
~OR CT CALL FOR REINSPECTION BEFORE COVERING
Inspe or: J " Owner/Contr:
~~~OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
/N$NOTI
DATE TIllE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
7- ,~~
ADDRESS 3fo~&f~l/ f< ,J,r /',/
OWNER CONTR. W~#'I ~""'6
PHONE NO. PERMIT NO. nLf S3/
o FOOTING
C FOUNDATION
o FRAMING
o INSULATION
~NAL
wf:J SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
Ji.~LLlNG
o CO PLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
hr,," - Cf) I(
Cv(b &,.,t - () IL
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~~... Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cI: SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
'511)1.{ ~ ~
OWNER
DATE
p~
nUE
CONTR.
PERMIT NO. tJ -c:~
PHONE NO.
o FOOTING
D FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
D~R HOOKUP
~ PLUMBING FINAL
o MECH FINAL
COMMENTS: .
D~t: i/7 ~A ~
~, ~Jj '~ O~
3. D~ t1.kl~('"
,
,.
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/'
/
LORK SATISFACTORY, PROCEED
~ ~~RRECT ACTION AND PROCEED
D CORRE~RK1ALL FOR RElNSPECTION BEFORE COVERING
Inspector: I I ~ Owner/Contr:
CAL ~ ",,-Jash FOR ~E NEXT INSPECTION 24 HOURS IN ADVANCE.
v U--;
CODE ~lfIR:EA.'l:.J' 1 0) ARE FOR YOUR PERSONAL HEALTH &I SAFETYI
/N$NOrl