HomeMy WebLinkAboutBldg Permit 06-0204
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
~.-8-Q(o
~
\Vhire
Pink
Yellow
File
City
Applicant
I PERMIT NO.O~ .D 204-
(Please type or print and si~n at bottom)
ADDRESS
2tR~7
MtCdS
kE..
ZONING (office use)
Pun
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK / ADDITION 5~A/& SaJT?-i. ([:l -;;(~fjJC~IDZS"-<t"$O -CO 3-0
. .-.,.) /)/r-J
OWNER __
(Name) _~cOVd ~/~a.-/
(Phone)
(Address)
BUILDER.-;;;? ~ /
(Company Name) /7rnc..CA-rF ~t!S (Phone) ~-~- ~ cy~ ..,
(Contact Name) ~Vlr .HeA~ (Phone) "'S"Z-~-o//7"
(Address) Z/</f'3 ~1l'~Ad4~I4~U/t..a./~A4.. ......>t.J'4'1
TYPE OF WORK !3"'ffew Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: ~.R.C. DI.B.C. o Misc.
Type of onstrnction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
PROJECTCOST/VALUE $ Z/OJCOO
(excluding land)
I hereby certify that I have furnished mformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
above-mentIoned property and that all construction will conform to all eXlStmg state and local laws and wlll proceed in accordance with submitted plans. I am aware that the bulldmg
~'ticial can re e thIS ;7~cause Furthermore, I hereby agree that the City Offi;~-;~~~ ~er upon the property to perform ~7~nh~:
/ - Signarure Contractor's License No. I , Date
Permit Valuation .-I/Z/O, 000,00 Park Support Fee # $ 1
Permit Fee $ . SAC # $ (<:;$0,00
! 7 } '3 I SO Size 5/8'8
Plan Check Fee $ III ~ . 1~ Water Meter $ 3z.s-,o 0 I
State Surcharge $ lo!>',oo Pressure Reducer $ IOO,OD I
Penalty $ Sewer/Water Connection Fee # $ / s ()t'), () D I
Plumbing Permit Fee $ / ()(), 0;0 Water Tower Fee # $ I DO /) , 0 tJ I
Mechanical Permit Fee $ /O(), DO Builder's Deposit $ 1500,'00 I
Sewer & Water Permit Fee $ 3~ c.:;-O Other $ I
Gas Fireplace Permit Fee $ J./(),OO TOTAL DUE ~ 3.2-B.Oh $ 9. /8 Z. 78 I
.; 1/
This Application Becomes Your Building Permit When Approved Paid ~ / Jz" -/4 i Rec/l1pt No. 51/84-
~ ~ (fILL/Ot" Date 3. 'Z.J"wO (, I B{l J
~
Builulllg Olflclaf , Date
ThIS IS to certify that the request m the above applicatIOn and accompanymg documents IS m accordance with the City Zoning Ordinance and may proceed as requested. Tim document
:::~P1"""~m",'.,~ C,,,"co" of 'S"/;;"lo" ~o"' '''"''''''"Z'"'':';;''''""'' " Ceme"",, "f om',""~ m.." ",.
. Planning Director . Date . Special ~
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 R.2 Districts
Reviewed by: ~ ~ Date:. 3/ z. 7 (0 (0
Building Permit #
Address: ,;:; b ~ 7
Legal: L 3 , B '
PID:
,
w~~
Zoning:
Existing Structure? YES IdED
Subdivision: J;ti.,.L "j ~ @ ft... r,J~-~~
Existing Nonconforming Structure? YES 1@2___'_____~__
CONFORMS TO ZONING
ORDINANCE
~
NO
i
, Yard Setbacks: NAI FAILS/(t"OMPLlES')
I e Front Yard (can be 20' if avg. w/in 150')
e Side Yards
Standard
25'
10'1
25' if abutting a street
Proposed' .''''.-C.
2.S.l)'
e Sidewall exceeding 50' requires additional side 2"
setback for every l' over 50' in length
I e Rear Yard
e Patio Door: provide for minimum 10' deck or sign
statement indicatinq no deck will be built in the future
e From 100 year flood elevation of We.t!~ncl/NURP
pond . .
e From OHW (Prior or Spring Lake),
10' setback +
2"/1' over 50'
25' '
1 A' sidel
25' rear
30'
44 ''''7il~:
,,~;'ljr 8t=-
"I"71,,.,.",,:ilir~. . ~"'J
''';i.:47JfIicJ~- ".. --y-'
fV~ ,.J-t?f::7::,
'-IJt;J;}~Jf!XC""
75' or setback average of
adjacent structures, but no
less than 50'
.N A.. .-o~."",.'
I Floor Area Ratio: NA I FAILS (CO'MPU@
.30 Maximum
f pJA f'-LA 0",:,,,, " j,
~ lreeoPreser.V'ation{~ FAILS f COMPUES:
l e. Totafcaliperinches
I. Permit 250fiiRemoval
I ... CaliperJrrches Removed
I. eH . CaliperJnches Preserved
I., Replacement
'Yard Encroachments~ NAI FAILs(!CO~--
: _Faves anc:f:Gutters: no more than 2. feet in width ar:lCf: no
. c!osertfJartSfeetta a !otlfne.(EasementsY. P.~', ."
; ALCandother::equipment cannot encroacb,onin!enor .
I side:yards.-
Standard:
I,
Ii
t
Staridard
.' J -- P-ropCJse&':;~g"'Xf ~.j
~-
%:1
~
"'r
L\TENrPLA TE"BLDGLlST.DOC
I Driveway: NA / FAILS((C.e5MPLJE~
I. Maximum width at property line
· Required setback
· Maximum slope
· All parking areas to be paved including R-Vor
spaces adjacent to the garage
I. Location to match subdivision grading plan
---....
I Building Height:(COMPLlES)FAILS
~
i Shoreland Distri~t."'~~AILS / COMPLJES '
Minimum lot area (square feet)
I Minimum lot width
I Shoreland alterations
I Impervious surface
, Bluff in Shoreland:(N~FAILS / COMPLIES
I-
· Setback from top of bluff
I. Bluff impact zone
I. Engineering certification submitted/approved
I. Grading in bluff or bluff impact zone
I Floodplain~AijFAILS / COMPLIES
· 100 yek"od elevation
· Lowest floor elevation
· Proposed lowest floor elevation
· Elevations 15 feet from structure
· Road access must be no more than 2 feet below
Regulatory Flood Protection Elevation
'-''', Accessory structure@AILsrCOMPLlES
I.. Size-
I. Notlocated in front yard (Materials)
I. Side yard and rearyard setbacks
I. Maximum height
I. Materials compatible with principle structure
L: 'TElvIPL-\ TE'BLDGL1STDOC
Standard
908.9' Prior Lake
914.4' Spring Lake
909.9' Prior Lake /
915.4' Spring Lake
Must be l' above flood
elevation for new and existing
structures. If existing,
structure was constructed
. 9/1 9/90'- flJ22l9Z.' tfieri^~:'
additi6I1arr6oflSnonequrre(f~~ "':"h"
Must be fIoocfel~"C2tfqn:9f,
-." JTigfieit:;~-=:c"'" ,"
907.91 forp'rior Lake
913:4' fat S'i:itfl1\:f[aRe;
P '. , . d;~:"-,>::;, . i, "
. -ropose "'4-~,,-. ~;."',
.. '.j~~1~i:;t2f,
'"
I Standard r
832 sq.ft. or 25% rear yard
la',;" .. .
15'
:.ill
White - Building
(,CanltrY - E:~q1rl~~
Pink - Planning
BUILDINO"F'ERMIT APPLICATION DEPARTMENT GHI:CKlJSI
NAME OF APPLICANT - f ~{j
APPLICATION RECEIVED \.~ f fS / h
- I /
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which i~ proposed at:
(;?~~7- (tlddcJ I~
Accepted
x
Accepted With Corrections
Denied
Reviewed By: . ~'I ~
Date:
3 -ll-06
Comments: See Reverse Side for Additional Information!
, See ~t~~~hments: I) Gn1;ding Plan. 2lErosion 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."
White - Building
Canary - Engineering
cPlnk _ - Plann~
-
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
.! ,.
i
!
/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
)o..~_.__
Accepted
Accepted With Corrections
./
Denied
Reviewed By: &".L ~~ Date: 3/2.. z. fe <0
Comments: If}J aLf ~~. ~_()..., ,'" ~~- j
~ ~_~ ~ 0#.-/ ~ ~,!. ~ I /ZL;t4" ...
'''/ .J
I~~ ~f~~J~,J)~~
/l../..%f~ ~,
"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."
Pink
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT '(.f ~~-{) .
APPLICATION RECEIVED ~ f ~ / ?-!
-.I /
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which i~ proposed at:
d ~ (07- (i.Jjh~J ~'lY-
Accepted
Accepted With Corrections
~
Denied
Comments:
Reviewed By: ~
~
~~t~d ~
~'.j ~,
~~
/ .J
~
c:z-L( .-A_/~~
Date: '3/.:J-;;;;J- / a ~
" .
~~
'-
~ ~
.~
~ ~ 1/ -...) 61- ~
~.
"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."
CITY OF PRIOR LAKE
HEATING/AIR CONDITIONINGIFIREPLACE PERMIT
Date Rec'd
(P1~e type or print and sign at bottom)
ADDRESS
~~;~ ~!~ I PERMITNO.Oc, 6204-J'
J. Yellow ^ppln:on, .
c2GG 7
w/lfJ.~
/AAJ~
ZONING (office
1I:lC)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
AD DillON
PlD
. OWNER /J7 n n
(Name) r1.4/2(.4 r r-
IrAl'??ec:.
(phone) q <i?s: - $"'9 $'9
(Address) .L I:(; /
APPLICANT/,_ n
(Name) UJlt.JI-/1rt/!p ~)
r1//l
(Phone)
....y t:t> - hfl ':J 4-
(Address)
dl;;)/~
Enl-ch)
(Address)
f}ue,
rn~
<bli}. )
5s6;;)-!f
(Zip Code)
(Contact Person) _ (Phone)
APPUCANfSIGNATIJRE ~~ ~Lf'~~L/) DATE ..._~ - ;5-~
__ ~ APPLI~ANT PLEASE COMPLETE BELO_W
-'- r ~w CONSTRUCTlON U REPLACEMENT 0 ALTERATIONS.
. FUR."iACE MAKE AND MODEL mil ){-1 7iI ;( (') S{() ('. 9~ _ FUEL t1)4!-
FLUE SIZE J II ;?UC RETURN OPENINGS . INPUT..Ib; ()(')!:) OUTPUT ~
TYPE OF SYSTEM REA TING OR POWER PLMT
DWarm Air Planl~
DGravity
o Mechanical
~ OAir Conditioning
(_V DVcnt. System 1 J
r'IREPLACE l\-lAKE AND MODEL ~ /
OSIl:am
o Hot Water
o Radiation
D Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Unit.>
Cannot Encroach into
Required Side Yard
Setbacks
Indmtrial, Comroc;rc:ial & Multi-Family
I() U $[ -.7sh
J'EE SCHEDULE
1 % of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50
$64.50
$39.50
ResideDtial, Heating & Ale (New CODstruction)
Residential, Heating Only (New ConslIUctioo)
(Office U"" Only)
Estimated Cost $
REA TfNG PElUvIIT FEE
STATE SURCHARGE
TOTAL PERMIT }'EE
Building Permit #
$
$
$
.SQ
fO. ~o~
'6\)\\J
Residential, Additions & Altemlion8
Residential, AC Only
This AppliClltiOQ Becomes Your Building Permit When Apprm,'ed
Buildim: Official
I Paid
Date
Receipt No.
Dak
By
24 hour DOtiC~ for all inspections (952) .u7-9850, fax (952) 447-4245
lc)c)~
HIV a3:110HINW
9L~9c)9tlS9 IVd ~~:11 NOW 900~:CO:to
Date Rec'd
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
(Please type or print and sign at bottom)
ADDRESS
-)&~l (-VI L{)S
I Green File PERMIT NO ~ L{
2 Yellow City . '__ 10
3. Gold Applicant ~
LIl)
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT ..l BLOCK 1 ADDITION S .;~ E/t C ~J b S c
PID
OWNER n ._?_
(Name) K.. A I c- C C;: t'
(Phone)
(Address)
(Address)
(City)
(Zip Code)
APPLICANT t:. j I C. f v /'
(Name) ':! L. L rt L- ,^ L ,
(Address) ~ 3 1 b JON f S
(Address)
(Contact Person) (S. L:\."t C ~...( ..
APPLICANT SIGNATURE ~l.~~~~
~
fL ..
(Phone) C{ 5). - .6-S { - 715 ::?
a L DC ,11\ '1:.--vG r-C,J ~ j-L!?
(City) (Zip Code)
(Phone) fo /J ~ 5'1 t-?13,y
DATE --0 t .10 "
APPLICANT PLEASE COMPLETE BELOW
Size of water service I (( inches.
Location of any couplings from structure- feet.
Type of sewer pipe. D ABC ( lZL PVC D Cast Iron
Estimated length of sewer line S \" feet.
Clean out (if required) located at - feet from structure.
Residential sewer and water line connection
Sewer connection only
FEE SCHEDULE
$35.50 Industrial, Com'l & Multi-family 1% of job cost with a $39.50 minimum
$17.50 Water connection only $17.50
('~ ("
Estimated Cost $ &'-ro.
Building Permit #
SEWER AND WATER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
$
$
$
.50
This Application Becomes Your Building Permit When Approved
Paid
&1 fJ' ~tNO
C/- ~- & Bye:;
(Office Use Only)
Date
Building Official
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
A~R-28-2006 13:15
I- r.'t..JM . r Hr<:1" Ilr'll.l I '.Jl' r w...< ""' I"'"
CITY OF PRIOR LAkE
9524474245
P.01/01
Dl1Ite Rec'd
CITY OF PRIOR LAKE PLUMBING PERMIT
I "I"' \?;l. \ PERMIT NO. 01. oz-c4
20 Gold Clrv (p
" Yel""" "ppliWlI
(P\l:lL'le me or Ilrml and sivn at bottom)
ADDRESS ZONING (o/T'lC4 UfC)
d... k fLl1
Lt) ~ \el.>
L..~
LEGAL DESCRIPTION (oflic:c use only)
ADDmON
.,
P!D
LOT
BLOCK
OWNER ('('
eN ame) l.t o.-b.l c.. Y'\
-../
'(Addrcu) ;:).., 4. <6 A
I~ lI\'I. C tJ
C~r-e V\ M~(L
(.Phone)
~ ve..~ _~.i~~' I~.O~.-
J....~\~~ l 'e_ m "
c:c:dlj..;t
. APPLICANT I
(Name) ~ l"'r.~; Pll6.XV\V->II""J
j'
(Address) ;:1.1 D?:a..L..J r,V\ L.p.p..-: li'\ ~ ~
(Address~ I
(Cont'i1ct Person) j'j '^'" bc~ ......,.
APPLIC^NTSIGNATURE~ ~J~J)' L ~
Co\. "'-to. \;1 j , (Phone)
(.\L-~ ~r'~.I\Y"\~k.... YVl,^ ~S.D~u..
(City) I (Zip Code)
(phone) loS 1- 4 t, 3.- n< .~ ~
.__ DATE ~- ri..2>-6<.n.
APPLICANT PLEASE COMPLETE BELOW
QUllntitJ'
QUllntity
f
\
,
Y
\
[
I
\
,:?
Type of Fixture
Bath Tub with or withoul shower
Dishwasher
f'ioor Drain
Lav~tClrYTB!lthroom Sink)
Laundry Tray (lor 2 compartment sink
Shower Stall
~inks
fiar Sink
Water Closet (Toilet)
Type or Fllture
\
\
I
Rough.ins
WatC!r Heater
Water Softller
StRnd Pipe (W3$lifng Machine)
Sewage Ejector
Backflow Assembly
Back-now Assembly Test
La.wn Sprink.ler
Other
--
FEE SCHEDULE
tndllstrilll. Commercial &. Multi.fa.mily 1% of job C(l:lt with II $39.50 minimum RcsidCIlLl!l1. New One &. TWll.Fomily 5:99.50
'Rc~idenlia]. AddlLions. It. AltCflllil>ns $39.50
Building Permit tl
(Ol11te {J~. Ollly)
This ApplicatIon Becomes Your Building Permit When APproved
Paid
.50 PAlO WITH
. SUtl.DINGPERMtT
~
'..ll\ecolPt No.
By
PLUMBING Pr. FEE
STATE SURCHARGE.
TOTAL PERMIT FEE
BlIlIlIi~ omclP.1
D.lt
I DllIIAY U 9 2006
2.. hOur ftOlice ror allln,ptctloftJ (~Sl) <t47-~850. f*lt ('52) 447-424.5
161DO bele Crull: Ave.. S.t.. Prior L.B2.'-R!:~_~}lJ._l."l!l
TOTAL P. 01
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
.
SITEADDRESS J "',,? W,LIJr ~ .
NATURE OF WORK N~ (""7: lJ,JL,.L. ';iJl;V~1I.. , li.Ut)
USE OF BUILDING S. ~ 1>. _
PERMIT NO. OrP . 0204- DATE ISSUED 3/1~., .
CONTRACTOR ~ ,...~ PHONE · 'IT-I./fr!
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR IjATE /
Ii! , I Y/J/o~
FOUNDATION (Prior to Backfill) Iii '7') <i<' V I
PLACE NO CONCRETE UNTIL ABOVE H'AS BEEN SIGNED
ROUGH) INS
\ r$ .ls-j/~
~ ,~/"(.a / ,
/~ I <57/ /~b
(/f/) I C/1f4/
.1 /"
SEWER I WATER I SEPTIC
FRAMING tV ~ {J...t 1
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE VfRJJ ft) r.\C
- ~)rr 1.11'-&/
GAS LINE AIR TEST ~G.'''' J?P;~/~
.. I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
W1fr ~ NIIIII'PJIlI4I' Il::f;j f!J
, FINALS
}~
FOOTING
GRAr?ING (PrjQr to Sodding)
BUILDING (!~ +c, 't..J.t)(~
ELECTRICAL I
PLUMBING
HEATING
DO NOT OCCUpy
WL
b;j.~{,
71 It /J/()f,
I J
! ., (
. . I
we. J I/g 7/rr/v I / /
~~,. I }/2r~p
UNTIL ABOVE HAS BEE~ S(GNED
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.
FOR ALL INSPECTIONS (952) 447-9850
@ertifirate of @rrupanrll
CITY OF PRIOR LAKE
~tparfmtuf of ~uil~iug JIusptrfiou
ctFinal Permitted
D Conditional e.O. Expires
This Certificate issued pursuant to the requirements of Section IIO of the U 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 ,::; 1/ C; L C f',-I!-/ / L l/ Bldg. Permit No. C C. c z. eo4-
,
Occupancy Type
AO_~'
Type Construction
Ii /.
Zoning District_
I.J (., 1--
Legal Description
L"::, L I
~ TEll LJ A(1 .~ f. L- i/-i /1 T 711E It-It-/.)::; 2ND
Site Address Z &- & 7 i I I L- U::- L-r1 (\/6
Owner of Building _
Contractor's Name & Address ;(.',--; 72 Li7 f fO- //(I'It:;.~o 2 i -f- C ,?, 0/C:c N'I-/ ~H J"/ i t:-..
...., ,'"/' I J
AL D (c r- ;). f/ 1./ /el-ll / :.::: ,F _ City Planner Ji-I/\ t. ICh ;/-:-1 ex:.
Building Official
Date:
Date:
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
7(,P ~ If
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~SULATION
FINAL
o SITE INSPECTION
COMMENTS:
-L
~jJ
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~
TIME
(p,
?()/f
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS~NE. AIR TST
o )'~r
GntA'~ ~t ~
o WORK SATISFACTORY, PROCEED
" CORREC TION AND PROCEED
o COR CT WO LL FOR REINSPECTION BEFORE COVERING
Inspe
Owner/Contr:
CfLL ~7- FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CO'>>.E4EQUlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
S-I'IfXJ
ADDRESS
~ '67 w,'IA Ln.
PHONE NO.
PERMIT NO.
Rt,/~J~
~-oZ.Ol{
I?!EXI~LLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
OWNER
CONTR.
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:
Gm~- t>K
Lv/6&J"oL
!1\ 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 & SAFETY!
INSliOTI
DATE TIME
CITY OF PRIOR LAKE *.M
INSPECTION NOTICE SCHEDULED
ADDRESS 2f 0 Co 1 ~).'~ L..0
OWNER CONTR.
PHONE NO. PERMIT NO. C- - ?r; <-I
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
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 ;K:.PLUMBING FINAL o GAS LINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
,. T....<oWl. ~~ ~/V~
'2 . G lo.e. Ci~ ~
~~~
'-\. Caj) ~ ~ ~ \t\A '<tt)
t; I .1kJc ~dp ~ -s",k
o WORK SATISFACTORY, PROCEED
.)tCORRECT ACTION AND PROCEED
o CORR T K. LL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
44 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
V
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSlVOTI