HomeMy WebLinkAboutBuilding Permit 99-0624
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CITY OF PRIOR LAKE
J 1Department of Jiuilbing 3Jn~pection
~Final Permitted 0 Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section 307 of the Uniform Building Code
certifying that at the time of issuance this structure was in compliance with the various ordinances afthe
City of Prior Lake regulating building construction or use. For the following:
Use Classificatioll'
SINGLE FAMILY
R3
Type Construction
VN
Fire Zone
Bldg. PennitNo 99-624
N! A Zoning D;slrict Rl SD
.....__..:-....~y Type
Lega1Descrip"''''~ 1'l 1l~ Q6~"D'Q1;'Q'QV QTnr:',l<' 'It;m AnnT'T'T())J
Owner of Building Site Address ~4q4R
Contractor's~'.'" ~ 'P... METRO CLAJ.,~ HOMES
ROBERTI D. llUTCHINSt Yr' PI
T ' Ity anner
BUildi,g Officf"l I /
Dale: (? 1/2. J I/) I Dale:
.~ I C-POST ~ A .CONSPICUOUS PLACE
l1Tr.m.AND r.'!'.
0_
JENNI TOVAR
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 1 AC\ 4?J w.,~(evwJ C:t
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o 1FOUNDATION
o FRAMING
~NSULATlO'"
NAL r'\
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
J...DjT~. _ TIME
t.~ if
qq. G.Z4
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
---
rir __;--11
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",ORKSATISFACT o PROCEED
o CORRECT ACTION A PROCEED
o CORRECT K, CALL ~EINSPECTION BEFORE COVERING
Inspector: ) Owner/Contr:
CALL J7-9850 FOR tHE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE RE~TSARE FOR YOUR PERSONAL HEALTH & SAFETYl
lNSNOTl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
14q4-6
SCHEOULED (rf~,hC;
HtGHLf\I\JO
2.:00
OWNER
CONTR.
PERMIT NO. Cj q - &:, 24-
PHONE NO.
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATIQ!f.A. A 0 SEWER HOOKUP 0 FIREPLACE FINAL
~INAL N'" ,,0 PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION ~CH FINAL 0
COMMENTS: tl po" () 86ou.... ~ .<:; ok....
~) f:i O.r( 1vur:o.VI;;::Apt'1
. ~ F Y't)S IlY\ cprctrO \ I
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o WORK SATISFACTORY, PROCEED
~ CZ'RREC A TION AND PROCEED
VRRE T W . CA FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 4< 7-S 160 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE Rbf!!IREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lNSNOTl
ADDRESS
/ij9~8
DATE TIME
SCHEDULED 7~1
If1 GIf t../i IV 0
C!.-T
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
q 9-fcV:;-
o FOOTING
o FRAMING
o INSULATION
o FINAL
o FOUNDA liON
o DEMOLITION
o FIRE PREV.
o PLUMBING RI
MECHANICAL
WATER HOOKUP
SEWER HOOKUP
o EPTIC INSTALL
o PLUMBING FINAL
o SITE INSPECTION
o EXC/GRADIFILLING
o LKSHOR~ETLAND
o COMPLAINT
o SEPTIC FINAL
o FIREPLACE
o
COMMENTS:
[,Cj' ~ 4;)
~,ff_.
I~Cj' /,( {'AtJd:- LA ~<V1-- ~- 4t?~
."-/- '//r -J-- II r 't1P'.
P'"\ Cv.~;.,o r. n. -f' p_ A <I -"''<k-Y.JL
~~~d ~?~j
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L_r,-A/'fr'A',.d' ~ ~~-.'"'.'~-
ulffu
1-
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rI WORK SATISFAC , PROCEED
o CORRECT ACTION NO PROCEED
o CORRECT W;)r\ C~LL FOR REIN$PECTION BEFORE COVERING
Inspector: 1~)f I Owner/Contr:
CALL 447.1230 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
----I
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS I '-l q 'f 8
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
SCHEDULED
~;flc-&
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
~ ~EWER HOOKUP
n~ PLUMBING FINAL
o MECH FINAL
COMMENTS: .^I
J.l \1 b~ c..XA',,^-
~r~
o~
.[)}
\\~
V
DATE TIME
10 ~5 - <f:J
to :ii\
Mt:.--
q'i ~(,:z4
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/
/
/tMTI"'~~"~~'
o CORREC A AND PROCEED
o CORRE FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
TS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl
,.
..
-_~..:lo
.Permit#
---------~_.-
'JobAdd,...L5L<i"O ;-/;rtiJD"d rl
'Hooting Controcto< METR6 AIR
"TeSlers/Signature r_,/
/
Q!!! !1m:!
"Gas Une g
Pressurized
Inspected
PERFORMANCE TEST
.PercenIC~ ~~ '10/0 "Percent CO
7.{~/(')
.. Percent O2
.Stack Temp.
Finallnspeclion
Pounds
~
1'.
()f'lo
df}. 't C
Date
."
CITY OF PRIOR LAKE
BUILDING PERMIT,
TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
DATE RECEI\(ED
S/25/Jr
. DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
2. SITE A/D9R.E E~, ' /. b-J J / ./
</'-i:tl;t. H7?::#//:/N'JJ ~ I
3. LEGAL DESCRIPTION
LOT::1 BLOCK _ ..:s>
/4:J5phEt'Z/2 V
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit No.BP
qq-hzl
BUILDING INFORMATION
11. SIZE O~TRUCTURE
(He'ght) / '-7 (W'dIh)/"'(J (Depth):,,\/)
12. NO. OF STOR)ES,~
13. T'!fE OF CO~STRUC!~ . /
d '^"7 / c.. 1'/:)41/ ('-/
14. FLOO~K4NMENTU5E
ADDITION
PID 2Fi -3tJ2--,1Z0-{)
/~7C? . .s~
5. ARCH)TEC1j ,eNaY'e) /7J .
fi&5g //i'4/0.r
6. BU~ ~(Nemn / / / (Address) 15. NUMBER OF OCCUPANTS OR SEATS
//(Ct/K'LJ L;/d!iS7t!... 1.../O/7/g$.. OCCUPANTS .Y
7. 'TYPE OF WORK Fireplace 0: Septic 0: Deck LJ Re-roofing 0: Porch CI SEATS
Newconstruction)(. AlterationsLJ Addition 0 Finish Attic CJ Re-sidingO Finish Basement 0 16. PROJEC. \JUd~NALUE
Chimney(::J Misc. ((..f 2. ,?-OD
8. PROPERTY AREA OR ACRES _ 19. PROPERTY DIMENSIONS. /10. CULVE~E 17. COMPLEllON DATE
Sq.FI 30,L/Lf7SQ I-TtWidth ~ Depth 23S-;t./S Yes (No) -.lulL! ,30, 199q
I hereby certify that I h tumi d info 's applica n which is t best of my knowledge true and correct. I also certify that r am the owner or authorized agent for
the abo ntion rope and all con on will form to xistlng state and local laws and will proceed in accordance with submitted plans. I am aware that the
buildin ial -revoke is pe it for just us Fu onf,1 reby agree that the city official or a designee may enter upon the property to perform ne~~ ins~.
X ;A/r. . . f _ 93,;:?..Q :5'/2
- ~ - UCer1seNo. - , Date
4. OWNER
(Name)
(Address)
(Address)
(Tel. No.)
-,#'J:.1J70,UJ
, / / (Tel. NJ)
"Y~.5F/';/ fX)
I
FOR ADMINISTRATIVE USE
Water Tap ................................... $
Builder's Deposit ............................ $ J. t:; Oc> _1")7)
Other ......................................... $
Total Due .............................. $1X4S. 7 L
Paid 7g '1<'. 7 z.. Receipt ~o. 3S"M (p
Date 7/~/q1 Bv ~
This is to certify !hat the request in the above awlication and accompanying documents is in accordance with the City Zoning'Ordinance and may proceed/s requested. This document when
s~ CIty P1~er constitutes a temporaty Certili'f'te 01 Zon~complience and jIows constructiJr:Fnce. Berora j>Ccupanc;1. a ~rtifrcate of Occupancy must be issued.
_,t.. _ . :.lA.A.#1-,_ _Id -2-1. 'ti 4-.P p _' . _ _ r),v ,LJltl/~ _
City fanner Date"'-- Special Conditions if any
SETBACKS: Required
Actual
Front
Back
Side
BUILDING DEPARTMENT VALUATiON
OFF STREET PARKING
SPACES REQ.
USE OF BUILDING
SFD
SPACES ON PLAN
PERMIT VALUATION .JJ.1l.0Gt'l.OCJ
TYPE OF __h.,) ......-UCTlON: I II III I~
Occupancy Group ~;,:o ~ & I M G? S U
Perm" Fee ................................... $ I..~'), .'2C;-
'1[ '14.cf7
p, ~ .5(")
tOO.Q7
/ OC' .('y')
3;,50
tf:o ,Olr
City:
Plan Checking Fee ......................... $
~\'?1\qq
19 'V/'t
State Surcharge ............................. $
Paneity .J?!/~.............................. $
Sop"'-l"'e," ~. $
.1.-J\.~:::r...................
Other ..s:~......................... $
i..E-E......................$
By
r Building Permit When Approved.
Date (".'2-'17
Issued
24 hour notice for all inspections 447-4230
Side
MATERIAL FILED WITH APPLICATION
SOIL TESTS (::J ENERGY DATA LJ
PILING LOGS 0 PERCOLATION TESTS 0
PLANS & SPECS (J
SETS
COPIES
SURVEY
PLOT PLAN
LJ
LJ
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC ......................................... $
Collector Street Fee ....................... $
Sewer Tap ................................... $
License Check Fee .....,................... $
Pressure Reducer ..iL~................. $
Meter Hom... .....CJ~ty................... $
Water Meter ......:0....................... $
Sewer & Water Connection Fee ........... $
WaterTowerFee ........................... $
~ c;n .C}?'!
/bt:::-r'l.("')TI
45. tV
l2.C;.C9tJ
/ I '2L:>" . 00
1)fV) . t.JO
GREEN - .....E
YELLOW - APPLICANT
GOLD - ell'l
CITY OF PRIOR LAKE NO. 07q-&~~
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contractors must
be registered
with the City.
APPLICANT: - --J ~ck5 Xc-
ADDRESS:_}Lf/ ~\,\ J( ~//I LOlli) /
SIGNATURE: ( 1JJ J..T :(J 1 JA J...
SITE ADDRESS: /L,J9~8 -iJ6/1L~N"D
PIlbNE:
1d(,)IY~-:b
7//4/91
PERMIT # 9'9-024-
DATE:
BLDG.
FILL IN THE
GT. PID#
R/sD
BLANKS
2.5-342... - 02-0-0
1. Estimated length of water service
feet.
2. Size of water service
inch(es).
3. Location of any couplings from structure
feet.
4. Type of sewer pipe. ABS
PVC
cast Iron
5. Estimated length of sewer line
feet.
6. Clean out (if required), located at
structure.
feet
from
==================================================================
This
your permit
when approved.
7 lit./. /99
DATE:
BY
==================================================================
FEES:
$
$
$
35.00
.50
35.50
Sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either sewer or water individually is $t1.~o plus
$ .50 surcharge. --
* Sewer and water permits issued for new construction must be
recorded on the building permit card at the time of issuance
to insure that no duplicate sewer and water permits are
issued.
DATE PAID
7- Fl-fCj
AMOUNT PAl D _ ~ ',NI't\-\ ":\"
G P' pEHW"
REC'D BY S\"LO\~G
RECEIPT #
'6200 Eagle Creek Av. S.E., Prior Lake, Minnesota 55372/ Ph. (612) 447-4230/ FAX (612) 447-4245
An Equal Opportunity Employer
,.,..,_r,;>l":"" '~,' ;,'"0"l'"';.""~,-..(j~... At'..~~'__';;''''~
<..,~.~
"".'!';;.......~,,!l\;,.,.- lAl'"o'_; -~~- "i.'!X< . - . ......'!'~"".
. W'.." " '.' ',iip,"""'-',JP'f" ',. ,,-<<>r~,_'P!ljit1AJ~.~:.\lI" -"~h....""'~~''''lf'J.-:N1IjIjt<l.",,,,, :
/-, 1.","//
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White - Building
Canary - Engineering
Pink - PIBnning
Thr Crnlrr of lhr Llaf Counlry
BUiLDING PERMiT AP~ATION DI;PARTII/If:NT CHECKLlSr
NAME OF APPLICANT,
APPLICATION RECEIVED,
(:- 1'..-' (
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((' .
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/.'.//:.' -...,/.
..
,
/
.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
, ,
--;
,1/ ,/ ,/{;/:,/LJ i' J
I ,.- {... I .' '_..' J
Accepted
,/
.c
Accepted With Corrections
Denied
~ . . III ~ .
~-~
Date:
t ,.;!---v?Ct
Reviewed By:
Comments:
2-L( r-r i/lAb-K.:\tW.JvIA. r...l';;'vt'~ I.--O~ X i\Vc~
LJ~ (_u\Ni (' .AAovb,~ At~ ,~t::. <;.&rk ~~r!:vJ./~'
"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 lor cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid,"
1i~1
q9 -02-4-
ThrCtnlrrorlhrl.abCountry
White - Building
Canary - Engineering
Pink - Planning
~UILDING PERMIT APPliCATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
/VI c I KO ~L-ASS I C/
5/Z5/Qc;
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
J4Qt./--A HIGH LI1/'JD ~T
Accepted
Accepted With Corrections ~
Denied {J
Reviewed BY:@ 6.-y~
Comments:
~ ~ a~O-A
Date: (D-2-'7'7
~~~~
"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."
'i.','...,'_'_"
99 - & 2-4-
T.... Cl'ltl.... 0' IIII' 1II1r.r C....r,
White - Building
Canary - Engineering
Pink - Planning
BUilDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/'/67kO CL-rl-SS 10
5/25/C;q
, t
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
14Qt./-h /-I/6HLIlND r!-T
Accepted
./
Accepted With Corrections
Denied
Reviewed By: tJ4L~ FWA..-<<M"" ",AJ
Date: r../u/"
Comments: R.""nFJ:: MUST" 8..-
{!",1JuE'r'EO Tn AAlI> AL-"',Jr. OtUI,NAr.c:
t'\,.,.O tJTlL..'T"Y r::~~"'r< ,c,,=: ~ J4,~
RtAc.:ru.~, .
~f.)111uE"""'A" 1.J11InJ_
r"1.UST"
aE A .....Ak.'..."... "F
:24/ r.;:l -r;.,E P~o'G.c.TY Lu..JE
~E..E
,.....sF'oil\ll~....no...J ~,J f:l(;(}ER.."!.~ SLJJE
<or:. AT'rAtIolM€..rrs, : I. hAl"'L Q"An. /AJ~.",u I""'o".....no,u 2. (.;'''Al>''V'- Pt.AtI
L..~"~,o...J C!."ur/I.oL v'1~A<"'n.~o;
<I Fn os 'n'" (' nooJT'A.oL-. P. 14"/
"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
1&200 Eagle Creek Av. S.E. Permft No. qq - (p z4-
Prior Lake, MN 55372 .
HEATING APPLICATION I PERMIT
: Dale 1 ~~-C\ ~ PID' ~5-.34Z.- Oz.o~o
Site Address \'\0..'" ~ \\ i '\ ~ \ "'''' ~ C\- IZ/G.f)
~ ,
~ Lot L Block 3 Addition .l&iJ'PI1GeeV /C.1c:>6G. 3/fl./?
~ OWn8f'sName {\~T>'\:\ ~~U.l:.c \\C\h.ll.>
Address '6,",0--:) \\~~--lm ((I a C1-\. ~"... OJ ~ll.
Healing Contractor \'\. {~ ~'r- ~'<\ I..
Addre.. \ \n ~ ~ (1 ~ L\ lOfl...A..~ V l Vr: u"" \. t., K.L
Telephonell ~~I- ~\~'"
Furnace Mek8 Ii ModelU 1)" oX.
ModeISiH~ i;) '" \'(". '1/1.\-\1\\\
Conn. Load S \:) ")"'1
~\-'f, C"
Fuel IV V, Flue Size ::J
Supply Openings
D
6
0.1 "\ \ .\.'ll:5D
Return Openings
~ Input l.'h.\%()
a:
o
DC
f-
W
E
Edr.
C1m.
,,,,-\\ ~
TYPE D~ !!lVll'n't11
~1m Ai, Planls~
Gravily
Mechanical
Air Condijionlng
Vent. Sy!1em .
HEATING OR POWER PLANT
Steam
Hot Water
Radialian
Special Devic...
Other Devices
E
\?r Allerallons
'"
OJ
Reptacem ant
TYPE OF WORK
New Conlllrucllan
.'t
Repair
Eat. Comp. Om
Building Permit It. q; ~ - . .(. l) d \..-\
m Est. Cost $
m
m
.-< H.EAIING PE.Rm FEE $
m
STATE SURCHARGE $
~
~
~
.50
TOTAL PERMITFEES .
",
:..,r.
:.'~j:~
"'-FwD-wmt~,
lBUILDING'~
Receipt.
TYPE Qf STRUCTURE
I. .PDk
1-.
3. Yellow
Yd,
CIlJ
CcoIIo....
Single FamHy X
Commercial
Two.Family
Indus1rial
Multi-Famiy
Public . Olher
Fee Schedule
I ndustrial, Commercial & Mult~Family
Residential, Heating & AC
Reeidentfal, Heating Only
Residential, Gas Fireplace
Residential, AddKions & Alterations
Residentiai, AC Only
1% 01 lob cost ($39.50 minimum)
$99.50
$64.50
$39.5D
$39.50
$39.50
Remember to add Ihe Slate Surcharge on 1IIa bollam 01 this eppllcatlon.
The price 01 your hsaling permil Includes one rough.in and one final inspection.
Additional inspllClions will be billed at $35.00 each.
HOOSB Healing Test Record must be submitted wKh bulldin" J!l!!!IIlI h'''''''''' before build-
Ing certificate 0' occupancy will be Issued.
tifAIt:A1 CUI ATION!: Rr=OlIlRF'1 wilh number 01 supply and return openings listed per
room with CFM's per opening. New structures or additions send Iloor plan with supply
and I8\Um lacadons shown. HEAT LOSS CALCULATIONS. PAYMENT AND
APPUCATlONS MAY BE MAILED TO THE CITY OF PRIOR lAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE. MN 55372.
City Hall busln_ houl$ are B a.m. . 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-lN AND FINAL) . CALL CITY HALL
447-4230
I hereby apply lor a mechanical systems permit and I acknowledge Ihetlhe
'information above I. complete and accurale; tllatthe work will be in conformance
with the ordinances and codes of the city and with the ".'ate buiicftng/mecllanical
. code.; \hat this lorm does not become a permit unlil slgnpd by the BUILDING
OFFICIAL: Ihalthe work wlll be in accordance with Ihe approved plan in tile
case 01 all work which requl/u review and approval of plans.
~\\-. . I I, ,-q-~ '1
p~~. . Oale;.
"7/ / Z,/9'1
Dale
CITY OF PRIOR LAKE
PLUMBING PERMIT PPNo. 99-"'24-
APPlicant*J'I/) iO/J/IIjd:;). ...,4r_~~, Phone: 4'3 -d"t-'VJ
Address: /S.tA..1/J I?AkkA:/._V14t1 ~" CfW4;Y,UJ..I7., "--rJL,Il._, -.L.r:s-~
Signature: hll:' L VXc.~~-'-'~g;
. ..' ,r- If:I9I5 ~t;elC. ~/I.) =
Legal Descnptlon: ot ~ 610 _3 Sub .fiea A~Af. Cjc:.
SiteAddress:~..,tR' l..~jAL)) (lLnJ..T; 0#1/50
Building Permit # Qq.71Z4- PID # 2.6-,34Z-- OZ.O~O
NOTE: This permit will not be processed without complete information.
FIXTURE UNITS
n. Cftllft' 01 I.... Lab COlIn.".
I Quantity Type of Fixture I
I :L Bath Tub with or without shower I
I I Dishwasher I
I I Floor Drain I
I 1- Lavatory (bathroom sink) I
I / Laundry Tray (1 or 2 compartment sink) I
I / Shower Stail I
I I Sinks I
I Bar Sink I
I -.3 Water Closet (toiiet) I
FEE SCHEDULE
Industrial. Commercial & Multi-Family
(1% of job cost. $39.50 minimum)
Residential. New One & Two Family
Residential, Additions & Alterations
State Surcharge
I. BIuo
2. GoI4
J. Yellow
FIle
Cily
App6cut
Quantity
Type of Fixture
...3
/
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Saci<flow Assembly (RPZ, Double Check, PV8)
8ackflow Assembly Test
Lawn Sprinkler
Other
~ fum.,n
/
/
$99.50
$39.50
$
$ 99 S7l
$
GRAND TOTAL
.50 ~
$ /OO.(){) VI
$
This permit is granted upon the express condition that said
contractor. shall comply in all respects with the ordinances
of the State Plumb' e and the amC9dments thereof.
, . - . 7/zal.,., DATE
i!9 A TIEST
Call for inspections 24 hours in advance.
16200 Eagle Creek Av. S.E.. Prior Lake, Minnesota 55372/ Ph. (612) 447-4230 / FAX (612) 447-4245
An Equal Opponunity Employer
- - -- .._-_._-~~..-
DEPARTMENT OF
BUILDING AND INSPECTION
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 144Wp, U "r~ [J (Lt.
NATUREOFWORK "y".., ('~~l"-f""'~,
USE OF BUILDING SFIl
PERMIT NO. C;C)-c..'2..--f DATEISSUED (,-2-77
CONTRACTOR /l-Vtt-tl C I ",,",,,'C {~/
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCU ENT
ro~~ ~~~
I FOUNDATION (Prior to Backfill) 1/ V ?/J<Sj9\ 11 I
PLACE NO CONCRETE UwtlL ABOV-E HAS BEEN SIGNED
ROUGH - INS
. SEWER I WATER-fSEPTIC~ f\~
FRAMING . - v ~
INSULATION @ f>rv..0t ,~,~.<-f1 ~,
ELECTRICAL
PLUMBING (:v '?/Jo; q-q ~
HEATING (if required) 1! . . I 1) '1.....1-01 ~
FIREPLACE VJj.,hJ11 A.j, -.,1...S"~-1"J
GAS LINE AIR TEST (I · l. I) q~ I-~q
COVER NO WORK UNTIL ABOVE HAS ~ EN SIGNED
I~ I ~ I
FINALS
/AJG &/k')iIU
INS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
DATE
j
!~ 1':1- ~')
'lrJ--tf'\
0;-),-'71
rn , , { 11\-..
. J ')0 tfl/1f Of.f .'
OCCUpy UNTIL ABOVE H~S BEE~ ISIGNED
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850