HomeMy WebLinkAboutBuilding Permit 00-0450
DATE RECEIVED CITY OF PRIOR LAKE
BUILDING PERMIT,
MAY 2 6 2000 TEMPORARY CERTIFICATE OF
ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White
2. Pink
3. Yellow
File
City
Applicant
Permit NO.-.iXJ .0450
DIRECTIONS
SPACES NUMBERED 1 THRU 17 MUST BE FILLED IN
BEFORE PERMIT IS ISSUED (Please Print or Type and sign at bottom)
1. DATE
5-']/6- CD
BUILDING INFORMATION
11. SIZE OF STRUCTURE
(Height) (Width) (Depth)
2. SITE ADDRESS :3 2d3 /Alcro---/L l:>uti'- J;nk
3. LEGAL DESCRIPTION
, BLOCK ;;:J PID c:Q;s - 337 -() 3Q. - tJ
\,JJ'\flL c:~r6l Al)O~
12. NO. OF STORIES
LOT
13. TYPE OF CONSTRUCTION
ADDITION
4. OWNER
(Address)
(Name)
(Tel. No.)
14. FLOOR AREA APPORTIONMENT USE
5. ARCHITECT
(Name)
(Address)
(Tel. No.)
6.~/~jJ73wf~&;;'~SS) 2lJ:J~-' 9b~ :e'Z"}1/>J:J--
/'P~ . ~ / - hv
7. TYPE OF W~ Fireplace 0 Septic 0 Deck 0 Re' gO Porch 0
New Constructi~ Alterations 0 Addition 0 Finish Attic 0 Re-siding 0 Finish Basement 0
Chimney a Misc.
8. PROPERTY AREA OR ACRES 9. PROPERTY DIMENSIONS 1 O. CULVERT SIZE
Sq. Ft. Width Depth Yes No
I hereby certify that I have fumis 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
d h all nstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the
or . Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ~Rb-~
License No. Date
15. NUMBER OF OCCUPANTS OR SEATS
OCCUPANTS
SEATS
16. PROJECT COSTNALUE
'j .
,-"",-?(')" ['{ ;J(..j
17. COMPLETION DATE
..
FOR ADMINISTRATIVE USE
SETBACKS: Required
Actual
MATERIAL FILED WITH APPLICATION
SOIL TESTS
o ENERGY DATA
o
Front
Back
Side
Side
PILING LOGS 0 PERCOLATION TESTS 0
BUILDING DEPARTMENT VALUATION
OFF STREET PARKING
SPACES REO.
SPACES ON PLAN
PERMIT VALUATION ~.~_ c;;O
PLANS & SPECS 0
SURVEY 0
PLOT PLAN 0
SETS
COPIES
~~o
USE OF BUILDING
TYPE OF CONSTRUCTION: I II III IV V
Occupancy Group A B E F HIM R S U
Division 1 2 3 4
Permit Fee ................................... $
Amount Brought Forward .................. $
Park Support Fee ........................... $
SAC .. . .. . .. . .. . . . . . . . . . .. . . .. . .. . .. . . . . .. . .. $
Collective Street Fee ....................... $
Sewer Tap ................................... $
.t $
I
Pressure Reducer .......................... $
Meter Horn................................... $
Water Meter ................................. $
Sewer & Water Connection Fee ........... $
City:
~.QO
I~ ( I!J{!) . ~
f
lJl.3'7. 2..~
f. tl c.tl. ":l.l
I 25".00
Plan Check Fee............................. $
State Surcharge ............................. $
?D. "/J
Penalty....................................... $
Plumbing Permit Fee ....................... $
~
to (0,
2. SO .C>O
I, ~. t1.O.-
1M.~o
Mechanical Permit Fee ..................... $
Sewer & Water Permit ...................... $
Water Tower Fee ........................... $
Water Tap ................................... $
Builder's Deposit ............................ $k-S'O 0 · 00
Other......................................... $
Paid ~~I~u;.;~..9i.......~~~~~.i~;~o$ ~::!,:/&1
i . -
Date t? IR / {l) By
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zonin/Ordi~ance and may procee~s requested. This document when
~Ign ~ ~he ~ PI~nner constitutes a temporary Certif}cate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate of Occupancy must be issued.
"w.~{JA~ tp- S-~t9b
"City Planner Date Special Conditions if any
Issued
24 hour notice for all inspections (952) 447-9850
.,,~i""~
)1)- Dl:<;D
..
The Center of the Lake Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT M\ -\t e...\.\ ~&-.J.i Dm' ~~_X~ ((}^0,~t \ VIe
APPLICATION RECEIVED \\\.Cl..V\ Q h'-~ t\
<J --
The Building, Engineering, and Planning Departm~nts have reviewed the building permit
application for construction activity which is proposed at:
, ..~~O S f \) (' 0(". f) k..; \} vf
_ ;j T., '" - V ( ......- _,
~
Accepted With Corrections
Accepted
Denied
~~
Date:
{;; - 6"':. Be>
Reviewed By:
Comments:
;t-lf ;r r M.tIJ<.i 'v\A.U.AA. {'v~ W tJ'I ~ ciX :V-~.;i
J}~M"J l~ -l-~ ~v ~~r9-UJ'W W~
,::,1;
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."
.
\JD vO l,Sl)
Tht ('tnltr of Iht t.b Country
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT M.I t-,- e",\.."-\n.f-el.t ~:~\Jrl (~-t. \ nc.
APPLICATION RECEIVED ~ Qe.., ~
() -
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
c 3dD 5 ~ ~. [)--\ ,,"c..
Accepted
Denied
Accepted With Corrections
Reviewed By:
Comments:
Date:
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."
...
.~~
"- ~/
Ct'''lt'f of lht lab Counlry' .
Yl vOL~ .
White - Building
Canary -. Engineering
Pink - Planning
BUILDING PERMIT APPLICATION, DEPARTMENT CHECKLIST
- .
. NAME OF APPLICANT M.I 1-'- ~-\nt"-.Jt ful\o r-S .. (Qf(\~t-. \Y\c.
APPLICATION RECEIVED. ..\!vJ..;A de-, ~
(),
The Building,; 'Engineering, and Planning Departme'nts have reviewed _ the building permit
application for construction activity' which is proposed at: '
.:d6S{AJ (TD(r~ tlf,[ [)-:\ -rf ...
Accepted ./
Den'ied
Accepted With Corrections
_ Reviewed By: J,.)t4&.;".U E.MItE~"'I4N,J
Date:, ~/lIrl.o
Comments: - Sf! ' ,. I ",f4Wl"""'TloAJ 0 ~ .,. ~ ~ RE.tlEJt, e S '.AE--
SEE. ~....~ ~ J. ~NAt. Q.aAOE:. '}JS'!Gl1DN I JJF'o/lp4tft4Til),u
Z. ~'UfDltJ~ {i4,J
:S. EA..s \O~ r. 0 JrtLot..- -1"1 CA$ \I ""E$
4. ERos, J)/J C. D,..s-m. 0'- Pc..;:fA
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
(
o
ORSAT TEST
.
Job Address .-:?eJ(dS" WA:?P Pvc<:; D~,
Heating Contractor S//18/f E
Date ?.-//-~t::/ Pressure 3,5hJr i
r .rcent02 7%
Percent C02 g ~
PercentCO
Stock Temp/ t'~ 6
.
-..
!
~
FROM : SABER Heating and A/C
PHONE NO. : 6124738565
Aug. 31 2000 11:37AM P2 "
Iii I ! f I ' J ~ II r l.J I , .t', .f I ij j~ ~
Ii IL~! I.~~ )~I~~~
- ... r t r "1(' - ~ Jl/ll ? - ~ Q . l
J f . . .ao ~ if' ~ ? .z;. ~:> -' 6 \).l 0 I
'I I, i ~~ g;.t~r~~.J.~ ,Ige
Is I iii ~ p ~ 9J f ? a. ,It
I . f. I.. I .el~~~i) ~ f I
.ra ~ .. f f Ifl'I',.".!f -r- r.t ~.: ' ;!.s;
~ ~? ff JI - .'__' I ~'_ ~, ~ ~ I ~ It
G>:E)< , I ~_ ~ ~ .~ . I
i~~ I~ I ~ ~ - ., ~ . ~
=i · . . - . I :..__' . '6 6'
I Ilr- ~ ii' . ~ ~
1 I rill, I, III' it ii' , J. ,I J i
/1 ,.11 I J f I;J" I'. I. ;
~tl!il J i ii , J f IIIIII~ I j. ,
J~ JIIII' ! .,Ii I I, . I J
10~ .; Ii. 9 151J I I. If!~~
5 ii t i .! ! II I .1 fil
.-_ _......_ ..... .....'" ft.~.'..'TQ ~.J ,~,,'W IIII'T ..,.A....1t
CITY OF PRIOR UU{E I
v~/q~
CITY OF PRIOR. LAK~ ~ ~~:L ~~li_
r:b:; NG PERMlf!.o # .<' JD - 0 <-IS1J
Applicant: \ ''l.'' / . Phone: Lfl.::J. '':::;)'\~I
Address: ~ "0 uo.tJ' Jl () " -
Signature:
Legal Description: Lot \ Block eX Sub l J i '\(7. J:. ~ ~ ~
Site Address:_, ~ ~ lj(/pj:., tM-..
Building Permit # (l.D- PID # ~S- - 33/- 0 3Cf- 0
NOTE: This permit will not be processed without complete information.
10/21/99 THU 13:14 FAX 6124474245
~)
~
'IIr (""",,, n' '.... I....r Co"',,,)
~JUL I 2 2000
FIXTURE UNITS
Quantity ... .
Type of Fixture Quantity
~ Bath Tub with or without shower ~~
, Dishwasher (
I Floor Drain
3 Lavatory (bathroom sink) I
( Laundry Tray (1 or 2 compartment sink)
( Shower Stall
I Sinks
Bar Sink
3 Water Closet (toilet)
FEE SCHEDULE
Industrial, Commercial & Multi-Family
(1 % of job cost, $39.50 minimum)
Residential, New One & Two Family
Residential, Additions & Alterations
State Surcharge
$99.50
$39.50
GRAND TOTAL
~OOl
Type of Fixture
Rough-ins
Water Heater
Water Softner
Stand Pipe (washing machine)
Sewage Ejector
Backflow Assembly (APZ, Double Check, PVB)
Backflow Assembly Test
Lawn Sprinkler
Other
$
$
$
$
D~~~
.50 f))~'
$ ..,--
This permit is granted upon the express condition lhat said
conlrnctor. shall comply in all rc.~pccts wilh the ordin.1nccs
of lhcy8t:l~C Plumbing C a the amer menl!; thereof.
I ~ B 1FT O. DATE
(_ A ,,"'. ~ I lQST
~for all inspet's 24 hours in advance.
16200 Eagle Creek A v. S.E., ~ Lake, Minnesota 55372 I Ph. (612) 447-4230 I FAX (612) 447-4245
An Equal Opportunity Employer
CITY OF PRIOR LAKE MC
16200 Eagle Creek Av. S.E. Permit No. an" ().4SD
Prior Lake, MN 55372
PIO # 9-5"'- ~ 3 ~ - O:SCf- 0
Lot
Owner's Name
Address
ALL I t.o F JlLEslnJ;. olb A F I eE-~l De! c-" 'I?.1\~
Heating Contractor Q:tr ('fl'-) N' (J'12;:fH f==A I J:L \/'"1 l!5-1.~ Av G' .
Address ~~ V1 L-L-Lg, fVtN S-S7 J 3
.
Telephone # bS1-h~3- an I
Furnace Make & Model u.e d N C::::> I f) AIR CONDITIONER' UNITS CANNOT
. ENCROACH INTO SIDEYARD SETBACKS.
Model Size ~ T t2-L.
TYPE OF SYSTEM
Warm Air Plants
Gravity
Mechanical
Air Conditioning
Vent. System
HEATING OR POWER PLANT
Steam
Hot Water
Radiation
Special Devices
Other Devices
Conn. Load
Fuel r.., a .A Flue Size
Supply Openings
Return Openings
Input
Edr.
Output 4 ~! rf7Tn
Cfm.
TYPE OF WORK
Alterations
Replacement
x
New Construction
Est. Comp. Date "1 / ~ e.' J r JD
I I -
Est. Cost $ II t7V ~ c;i) Building Permit # (JO - crz-r~U
HEATING PERMIT FEE $ / '~WITH hUt'
STATE SURCHARGE $, / .50 eu\\..DtlG pER
TOTAL PERMIT FEES $, /
Repair
Receipt #
--
...... \
TYPE OF STRUCTURE
1. Pink File
2. Green City
3. Yellow Contractor
Single Family
Commercial
y
". '\.
Multi-Family
Other
Two-Family
Industrial
Public
Fee Schedule
Industrial, Commercial & Multi-Family
Residential, Heating & AC
Residential, Heating Only
Residential, Gas Fireplace
Residential, Additions & Alterations
Residential, AC Only
1 % of jOD-:-~fJ$3g.r50 minimum)
$99.50\ j.': '
$64.50
$39.50 JUL I 1 2000
$39.50
$39.50
Remember to add the State Surcharge on the bottom of this application.
The price of your heating permit includes one rough-in and one final inspection.
Additional inspections will be billed at $35.00 each.
House Heating Test Record must be submitted with building oermit Dumber before build-
ing certificate of occupancy will be issued.
HEAT CALCULATIONS 8J=()UIRED with number of supply and return openings listed per
room with CFM's per opening. New structures or additions send floor plan with supply
and return locations shown. HEAT LOSS CALCULATIONS, PAYMENT AND
APPLICATIONS MAY BE MAILED TO THE CITY OF PRIOR LAKE, 16200 EAGLE
CREEK AVE. S.E. PRIOR LAKE, MN 55372.
City Hall business hours are 8 a.m. - 4:30 p.m.
ALL WORK MUST BE INSPECTED (ROUGH-IN AND FINAL) - CALL CITY HALL
Phone: (952) 447-9850
Fax:(952)447~245
I hereby apply for a mechanical systems permit and I acknowledge that the
, information above is complete and accurate; that the work will be in conformance
with the ordinances and codes of the city and with the state building/mechanical
codes; that this form does not become a permit until signed by the BUILDING
OFFICIAL; that the work will be in accordance with the approved plan in the
case of all work which requires review and approval of plans.
~ql'~_ 7;O/~
/ A . ~~n~ign;ture I ., Date
~ (//('u~'-?' ~A~/";'~r\~~ 7~d/2~
D Buildin6 Off?,s Signature / Date
10/09/00 MON 12:12 FAX 6128902753
STO~~h~ EXCAVATING
I4J 001
l;IIIEltII . MJ!:
,..u.o- ~ AII9Uc:A..,
GOLD . aT.,
CITY OF PRIOR LAKE NO. 00, ()4-~
SEWER AND WATER PERMIT
NOTE: Sewer and Water
contra.ctors must
be reqistered
with the City.
APPLIC1\NT: DC Mechanical/Scocker Excavating
PHONE:
890-4241
10/09/00
ADDRESS:
824~st. 125th St~~
~" /1 /1" \'.,.
SIGNATURE: (b(/ ..
I - ~... ,
SITE ADDRESS: 3203 Woad Duc.k Drm
55378 DATE:
BLDG. PERMIT # OO.o~6V
PIO# Zo..337-o3t:j....o
FILL IN THE BLANKS
1. Estimated length of water service
feet".
2. Size of water service
inch(es) .
J. Location of any couplinqs 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
.~=~=~=~~=~~~=-~--~-~-~=~==~=~~:~~~==;=~=;=~=~===~===-~~~=~~~==~==
BY
permit when approved.
IO.q.oiJ
I
DATE:
This
::;'iiji;'=====--:;:==='---=
~-~~:=--:~~~=~;--~===~~~~~~~~~~~----~~--=~
FEES:
s
S
$
35.00
.50
35.50
sewer and water line connection permit.
Surcharge
TOTAL
* Fee for either seWer or water individually is $2Q.00 plus
$ ~50 surcharge.
* Sewer and water permits issued for neW construction must be
recorded on the buildinq permit card at the time of issuance
to insure that no ,duplicate sewer and water permits are
issued. -
DATE PAID
AMOUNT PAID -~~.t~~
-*..~\l\G
REC'D BY .,.---l\
RECEIPT #
16200 Eagle Creek Av_ S.E-~ Prior Lake~ Minnesota 55372/ Ph- (612) 447-4230 /FAX. (612) 447-4245
An Equal Opp,ortunity Employer
. .. .._.....~"....~..........,.'...............'F.......d....~., ...'.\io:.J,_....._~.._-.,..'.........:r.-......'..:..~.I.....~"",..-.""......._,.;.,_.,..'..."..._...-.......,..,__..~,'"_.,~......r..,~~....~~..............'~..~._....... ..........., ..:...~.- ..
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 3:)0--3 lA)~ D\le.k. 1)r-\~
NATURE OF WORK t\Je.u.,
USE OF BUILDING ~~C
PERMIT NO. 00 ...O~50 DATE ISSUED (,-'5-~~o.
CONTRACTOR M..t\y l CS\~U ~ O~ PHotJE.uSI-6S~- 1'1~ I
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUWNT \ \
INSP ~ \ DATE
FOOTING _ 10_ \~ "
9 I fbs'
FOUNDATION (Prior to Backfill) ~w ~ . cJaJ Nw
PLACE NO CONCRETE UNTIL OV~HAS B S)IGNED
. ROUGH - INS
SEWER I WATER I SEPTIC efr, tn b/rd?/iw
FRAMING V 'J ~I ) I V
INSULATION (:1 ~.?..4z1
ELECTRICAL rJ
PLUMBING Ia:r-. 7b%I/?D
HEATING (if required) A~~' 11i'8/ to
FIREPLACE ~.. 7p..7I~
GAS LINE AIR TEST tp' 91~(~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
MIMI. d~
FINALS
GRADING (Prior to Soddin_g)
BUILDING1'~~ JI/, 1M; ~
{ .. .
ELECTRICAL
PLUMBING
HEATING
DO NOT
~. (,,}/4}OI
/!) \ /7.;' I
/ fj/ 9 /~-I /b<-) b.;, I d / '7/ PO
f ! fj:h !fJ!1 if~
. I
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.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (612) 447-9850
.J
~.:;,
~
3z 03 .;;f: uut ~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING ~ 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING W14.TERHOOKUP
o INSULATION EWER HOOKUP
o FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
DATE
TIME
4' J cJ1j
uv. 0 ~~--o
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTSffl ~ ~, tJ,.ftt.e~vf ~/1
fjz) ktA~k-.-~ ~ . .~. .~
n~- d<<:t; r~
~.~~ ~ -<<X ~r~'
~ ) '. ~ <lJ-..^
l..-_
1 , G~
I 1 U<--- /J ~
. I I ~ (' FYI) -(j.Y.-A . fLb-
:pI /J ,OtJ~ ~ y~ _ /(), ~
~u_y w( ,o~~c./
4:'. M~ ~ f'ilC 32.' ~
5~' AT. -'~~~,
~
-~
o WORK SATISFACTORY, PROCEED
?5 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: h Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
lM/~ ()
/()/oa
ADDRESS
3 Zo,-~
W d tJ D ~ ~C..AL JX'L I
OWNER
CONTR.
PHONE NO.
PERMIT NO.
(!) - L-js-c
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
~PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS~~ ~ ~ ~ ~
~ h Ve.. ~ ~ f.rV~ T:C.O, ~
.( :4-4~~ ' v
~~~~
t1
~~~
~ - llf vJ~ Ur --~4
o WORK SATISFACTORY, PROCEED
A CORRECT ACTION AND PROCEED
/ 0 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 & SAFETYl
INSNOTI
DATE TIME
CITY OF PRIOR LAKE , ')
INSPECTION NOTICE SCHEDULED Id'\ -cl4) ~
ADDRESS ~lo3 'WeJ Dv6/(.. Dr.
OWNER CONTR. j/I, 'He'! si~ ,,(1.
PHONE NO. PERMIT NO. -61) - '-I SO
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
ozP-FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~ILLlNG
. 0 C01iPtAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
GruI~ - C) K
GLJ Ib i3n7~ 0 ~
~
cl#'
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:d~ ____ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
/NSliOTl
-
DATE TIME
CITY OF PRIOR LAKE
INSPECTION -NOTICE
SCHEDULED
~!h '.'thJ
ADDRESS ..3 Z 03
vJ () () l) D U. L./<:"
OWNER
CONTR.
PHONE NO.
PERMIT NO.
0-'/'50
o EX/GRAD/FILLING
o COMPLAINT
IJf'\D FIREPLACE RI
I\'cy R FIREPLACE FINAL
o GASLlNE AIR TST
o
o FOOTING 0 PLUMBING RI
o FOUNDATWO 0 MECH RI
o FRAMING &. \ 0 WATER HOOKUP
o INSULA TI f'4 0 SEWER HOOKUP
}g FINAL t1\Sl 0 PLUMBING FINAL
o SITE INSPECTION C!J) ~ MECH FINAL
COMMENTS: 1)\... ~ ~ .
(Th ~ ~ a-U n-/~ ,
~~O-txu-~ ~ ~
-. - " , r " .
@~_. ~~ ~ ~#w-\...)~
~~~~
()
",,,,"""~~,,,,,~;::-rP::;'''''-
~~
Ukrt.QJ.\_ ~ ~~ UJo r!FA,
o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. ~ ( Owner/Contr.
CALL,. 447-9'50 FO~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTI