HomeMy WebLinkAboutBuilding Permit 04-0595
q'lease tyee or Drint and sien at bottom)
ADDRESS
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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<::.....
LEGAL DESCRIPTION (office use only)
LOT\~ BLOCK ~ ADDITION""'- <>-"'....~
OWNER
(Name) S. '? <::.. L
(Address)
BillLDER
(Name) ~ L""", ""'-~--."-
(Contact Name) ~ e..<: ....-.
. (Address) \ I!:.'" 'So
,-"'->.............'>.
'?'--'"Lo.... ~<;......~,,--_
TYPE OF WORK
liC New Construction
'P Fireplace
PROJECT COST IV ALUE (excluding land) $
o Misc.
DLower Level Finish
Date Rec' d
S. I~ 04-
1. White File I PERMIT NO
2. P;.k c;~ . ,,4- . 0695""
3. Yellow Applicant
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(Phone)
ZONING (office "50)
Je./
PIDZ.S: 39.5". 6~7.0
(phone) \a So"
(Phone) \", ':..
Q~~~~
ODeck
OPorch
ORe. Roofing
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ORe.Siding
Dutility Connection
3c.,7.00tl.DO
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 Y.....Y......J 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
enter upon the Y.-Y"'''J to perform needed inspections.
X \.)c:....-",,,,- ~~"-~~S-
Signature
Pennit Valualion
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
,'II'_'S to 7. ooo.()o I
I $
I $
$
$
$
$
$
$
~~ss: '5"'0 I
"7 Z&..O'/l:
18'5.';:-0
100 . 0-0
100.0(}
~~~ 5'0
40. 00
This Application Becomes Your Building Permit When Approved
~~~
Building OfficiO!
G/'3/ D'(
, D&te
OAddition
OAlteration
'--'--I...~(~..,'-\.
Date
# 1$
# I $ , '3 S- 0.0 0
1$ 000.00
$ 70,QO
# $ I '2..00. 00
# $ 700 I 00
$ I'SCO.oo
$
$ C? 9(,0- 5?'J
17
I ReceiptA>(o. 4-'7a-o'f
B(jA-
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 -----rY-<-J Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~..~ ~/S/ocf If~ ~~-/;;;
Planning Director Date Special Conditions, if any
24 bour notice for all inspections (952) 447.9850, fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
\ '-'.S ~
Contractor's License No.
I Park Support Fee
I SAC
I Water Meter Size 5/8(;.1";)
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
I Paid o/o/uO.Sf?
I Date ~jljl~
I
I
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<:White . 'l!uildiiih
Canary - Engineering
Pink - Planning
Thf (-t'nlpr of lhf I..kt' ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
\AI EtJ<; fv1 J4 tJ I'J HOH 6S
.
5.13.04-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
374-3 .j t;.FFEg.s eoUe-1
Accepted
Accepted With Corrections
/'
Denied
~ ~~f1~
~JL.J. ILL!..As . -1l~
Date:
Co 12-/0 'f
I I
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."
~~
~,
Th~ (."nln or Iht' I..akt' ("oun'!')'
White . Building
Canarv . En'lineering
a'"~ . Planm"l1;;>
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APpLICATION RECEIVED
\0 E I\; ~ [I.- I f I 10 I\J
:=.-;. /_> (4-
/-1 C ~'J C ~
.
. The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I ~ -/4-"3 JEFFt.-T:: c CU~ {
Accepted
,~.~
Oenied
Accepted With Corrections
/"
Reviewed By:
Comments: M.
v
~
. I. _
Date: (a (2- (/l4
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"The issuance or granting of a permit or approval of plans, specifications and
computatio~ 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."
~~
<::f'itA .. Allllrlir,n
anarv - EnfllneerinD
Pmk L _ I"lil"nlng
Thr ("'"Irr of lhr 1.lkf Counlry
f!UILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~\J E fJ<; ivl I-I ~ flJ
5,1::04-
1-1 G ~J t:. '-'=
.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
37,4-3 J'EFFEI2.S CJ.)uel
Accepted
.~
Accepted With Corrections
Denied
Reviewed By:
fi1Lf ,3
Date:
(.../~(Ylf
Comments: $.... R..v..r~.. Ride for Additinn::lllnfnrmation!
See Attachments: 1) Grading Plan. 2) Erosion Control Measures
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction, Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid,"
I
GENZ RYAN PLUMBING AND HEATING
CITY OF PRIOR LAKE
SEWER AND WATER PERMIT
(f'leue ~ orllrinfandliJ...rb"""",)
IADD~14~ \J~lfefti ~ &r
",-J effelZt JouJtv
ADr.23. 2004 3:20PM
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. LEGAL DESCRIPTION (o/lice '* olJly)
LOT 15 BLOC< 3 ADDmON
OWNER
(Name) Wensmann Homes
(Address) _1895 Plaza Dr Ste 200
(.Addl'...)
APPUCANT
(Name) Genz-Rvan Plumbine: & Heat1na
No,2829
P, 2/4
J)$te Rec'd
I ""'" Vi. rPi ,.,.
i :,..... ~.... I - ERMIT NOli ., set ~
ZONlNG (oI5a: ""')
Pro
(PhoD~ 651-905-3709
Eagan. MN 55122
(CiIy) (Zip Code)
(Phone) 651-423-1144
(Address) li745 ~" R"h,,>:~ Trl R,,~'iJDllIDl~ _ "N ~506.8
(Addrut) C II (City) (Zip Cod<)
(ComactPerson) _ en Ri&h Tel- 5 J (Phone) 651-421-114.."
',-.JCANTSlGNATURl! (tJ Jj7/fF) 3t1 //./1 DATE .L/-.23--fJL/
APPLICANT PLEASE COMPLETE BELOW
Size of water service inches.
Location of any couplings from structure
Type of sewer pipe. 0 AB,C 0 PVC
Estimated length of sewer line feet.
',Clean out (u required) located at -.:... feet from structure.
feet.
o Cast Iron
FEE SCHEDULE
Residential sewer and water line connection $35.50 Industrial, Com'l &: Multi-family 1% of job cost W1.tb a $39.50 minimum
Sewer COtlllection only $17.50 Water connection only S 17.50
Estimated Cost $
Building Permit #
L
24 hour notice r.r oU inspec1i.... (952) 447-98 ;0, fox (952) 4474246
By
SEWER AND W A'I'ER PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT nE
(omte u.. o.lyl
I This Application Becomes YOW' BuildiDg Permit When Appl'Oved
...".
Bllildlng 0111';01
D...
$
$
$
.50
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"Apr.n 2004 3:21PM GENZ RVAN PLUMBING AND HEATING No.2829
f~~ CITY OF PRIOR LAKE PLUMBING PERMIT
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q'Jc.... "tE!. orm1nrancl....... atbo"""')
ADD~SS
,1'14.?'; lJe#ePJ mJI<~ W
P. 3/4, 'd
__.."'.......ec
I.... ....
2.. Gold Cicy
J.V,Uow Applia;w
I PERl\'.U.ll"lu.q_ 5<
ZONING (ot&ct...)
LEGAL DESCRlPI'ION (oJ5ce use O1I1yj
LOT /rJ.aLOCK '- q ADDITION (, / p,#e.Jf. ( (fly /It, )
OWNER
(Name) Wensmann Homes
(Address) 1895 Plaza Dr
APPLICANT
(Name) Genz-Ryan Plumbing & Heating
PlD
(l'hone) 651-905-3709
Eagan, MN 55122
(phone) 651-423-1144
(Ad~) 14745 So Robert Trl Rosemount. MN
(~s) ; (City)
(Contact PeISon) {)f1 JetJn &. /1 J (Phone) 651-423-1144
APPLICANT SIGNATURE (Jf IIJ4:fi) <-:f!ffjj/j DATE 4?J.3fJt!
I
I
I
I
I
I
I
I
I
I
QUllIItity
Jl.
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LI
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55068
(Zip Code)
"
APPLICANT PLEASE COMPLETE BELOW
I Type of Fixture
I Bath Tub with or without shower
I Dishwasher
I Floor Drain
1 Lavatory (Bathroom Sink)
I LaundrY Tray (lor 2 compartment sink
I Shower Stall
I Sinks
I Bar Sink
I Water Closet (Toilet)
I
I
I
I
I
i
I
I
I
i
Qaan1ity
?
I
fIJ:
r
I Type of Fixtu.re
I Rough-ins
I Water Heater
I Water Soflner
I Stand Pipe (Washing Machine)
I Sewage Ejector
BackfJow Assembly
I Backflow Assembly Test
I Lawn Sprinkler
I Other
FEE SL.DJ!;J}UlE
lndustna~ Conune:e,aJ & MuIti-famdy I % of job cost WIth a $39,50 minimum R.cs1dcnllaJ. New One & Two.Family $99,,50
Rc3idcnliaJ, Additions Be Altetations $39,,50
Estimated Cost $
Building Permit #
PLUMBlliG PERMIT FEE $
STATE SURCHARGE $
TOTAL PERMIT FEE $
(Orne. Us. Ooly)
This ApplicatioD Becomes Your Building Permit WheD Approved
B.ildlag Olllci.1
Da..
_50
~~~
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JUN 2 \l ,\JUIf I
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;!4 ho.r notice !'or III in.pe<tions (ll52) 447-985 fax (952) 447-4~
6'1~
p, 4/4
UateRec'd
I_
. ""'"
J.YeIbu
s..... fPERMlTNOil"~
~M!or_mdsll!ll"_1II1
/ADD37Ll1lJefkJeJ ~ 0 ~
LEGAL DESCRrPnON (o.&icc use ~)
LOT/If BLO~ ~ ADDmON Jeff02S cftJ~)
OWNER.
~~) ~pn~m~~n U~~~C
ZONJNG (_....)
PID
(phon~ h~'_Qn~_~7n~
,(Add:ress) 1895 Plaza Dr 5te 200
Eagan. MN 55122
APPLICANT
(Name)~7.-R"...n Plumhin~ U.."j,in,"
(Add:ra~ 14745 50 Rober" Trl
I (Address)
(Contact Penon) .-0/17 ;e/rffi ~( l'
APPUCANTSIGNA~ ('!J -' f _~)
~hon~ ~,l_b?~_l'bb
Rosemount, MN
(Chy)
55068
(Zip Code)
~ b/)(Phon:A~<'-b4-R':8--{){//
,. .:,.
, '",.,
APPLICANT PLEASE COMPLETE BELOW
r-
" pllNEW CON5JRUCTION if};~ _ 0 ALTERATIONS
FURNACE MAn: AND MODEL Ul1ngy- f} - Ol..~ FUEl f7c:r..-r-l1ao
FLUESIZE RETURNOPBNINGS INPUT /;2.5:'000 OUTPUT /1C:;,/)/)f1
TYPE OF SYSTEM HEATING OR POWER PLANT
ElWarm Air Plants 0 Stcom
OGravily 0 Hot W.......
o Mc:cbanicaJ 0 lWliation
~ C_..J;':"_mg 0 Special Devioes
OVent. Sys= 0 Other DeviCO:!l
FIRl!PLACE MAlO! AND MODEL
FEE SCllEDULE
IndWlrial, Commercial &. Mulrl-Fllllily 1% of;ob cost Residential. Clos Fireplace
$39.'0 minimum
Residential, Healing " AlC (New COnstrlloticn) $99.'0 Residenlial, Additions &. AI1lnIions
RaidOlllial, Heating Only (New Construclion) $64.'0 ResidelltiaJ, AC Only
Esmnared Cost S Building Pennlt #
HEATING PERMIT FEE
STATE SURCEARGE
TOTAL PERMIT :FE:E
$
$
$
.50
(r,......,. Use .Only)
r ..' .
i _..'" AppIiatioD Becomes Your Building Permit When Approved
PLEASJt NOTE:
Ait Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
$39.50
$39.'0
~ I $39.'0
~'\~
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re~ lfu ~ u IiI ~ iff :ceipt No.
l~eJUN 25 2004 ~I
Building OIIieia.
Da..
24 hour notice for all inspections (m) 447.98 ~y'" (951) 4474245
r
CITY OF PRIOR LAKE
HE,ATING/AIR CONDITIONlNG/FIREPLACE PERMIT
Date Rec'd
(Please!VV< or vrint and slm at bottom)
ADDRESS
; ~ ~::y I PERMIT NO.^,,- OI!f:.IJII:
3. Yellow Appheant v:r:... :;;;I~
ZONING (office "50)
3743 JEFFERS COURT
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
PID
OWNER
(Name WRNSMANN HOMES
(Phone)
(Address)
APPLICANT
(Name) ALLIED FIRESIDE DBA FTRF~I.llillIEARTH & tiQME
(Phone)
651-633-2561
(Address)
2700 NORTH FAIRVIEW A VENUP
, (Address)
ROSEVILLE
(City)
';5113_
(Zip Code)
(Contact Person)
BRENDA HUSTON
(Phone) _651-633-2561
APPLICANT SIGNATURE
BRFNIJA HUSTON
DATE
7/21/04
APPLICANT PLEASE COMPLETE BELOW
xD NEW CONSTRUCTION 0 REPLACEMENT 0 ALTERATIONS
FURNACE MAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT
OWann Air Plants
OGravity
o Mechanical
OAir Conditioning
OVent. System
o Steam
o Hot Water
o Radiation
o Special Devices
o Other Devices
PLEASE NOTE:
Air Conditioner Units
Cannot Encroach into
Required Side Yard
Setbacks
FIREPLACE MAKE AND MODEL
HEAT N GLO 6000TR-OAK
Industrial, Commercial & Multi-Family
Residential, Heating & NC (New Construction)
Residential, Heating Only (New Construction)
FEE SCHEDULE
1% of job cost Residential, Gas Fireplace
$39.50 minimum
$99.50 Residential, Additions & Alterations
$64,50 Residential, AC Only
$39.50
$39,50
$39.50
Estimated Cost $
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
Building Permit #
$
$
$
.50 ~~1)'}I1"""'IJ
~~';'~ . >.IVJ/ r.
- ...hl!foilJ6NG PE;~~1j;'
roo @ ~ ~ \fl ~ C 'l.eceipt No.
~at~Ul 2 9 2004 cd ly
(ornc. Us. Only)
This Application Becomes Your Building Permit When Approved
BuildiDR: Oflicial
Date
24 hour notice for all inspection. (952) 447-! ~50. fax (952) 447-4245
By
'--=-
05/,11/2004 17:21
5515819488
PIONEER ENG
PAGE 01/03
.
...**..
* PIDNEER
~ engineering
* ....*.
Civil engineers . Land Plann.rs . Land Surveyors . Landscepe Archltec:lts
Nate Briese / Berne Feidt
City ofPrlor Lake
16200 Eagle Creek Avenue
Prior Lake, Minnesota 55372-1714
Re: Jeffers South, Lot 15, Block 3
Prior Lake, Minnesota
P.E.# 102179
SENT BY FAX #952-447-4263
June 11, 2003
~~@~GIJJ~\I
m JUN 1 .. 2004 l \
By
Dear Nate:
I have reviewed the Certificate of Survey prepared Pioneer Ensineering for the lot in question. The.
Grading Plan proposed a Lookout/Side Lookout Lot; garage lef1:(bigh side) . The Builder, Wensmann
Homes, proposes to add a Walkout in the southwest comer. In order to do this, Wensmann Homes is
pi-opoBiug to wse the garage elevation from 962.5 to 963'.0 (10% grade on drive), add two steps in the
prage, and a<!ni.,g one step up from the basement elevation(955.7) to the walkout grade (956.3). See
attached Certificate of Survey and Grading Plan.
I bave reviewed the proposed grading plan for this lot and found that the drainage for this lot follows the
ove:rall Grading Plan. Providing positive drainage in excess of2% away from the building to the rear
yard and to the street. The driveway is steep but within the Cities ,t'..........eters. Catohbasin #130 sits on
the western property line with an elevation of 954. 7. a small 0.5' berm (955.2) will be constructed west
of the catchbasin to ,direct stormwater into the catchbasin. This allows for 1.]' of freeboard to the
'overflow. With the swale continuing to the west past the catcl:1basin this is adequate protection.
If you have any questions or require any additional information please feel free to call.
Sincerely,
7;Qf.A
Nicholas Polta
cc: Terry Wensmann, Wensmann Homes
2422 em.rprle. Or1ve. Mendola Helghts, MlnneSOlll 55120. (651) 681-1914. Fax 681-9466
625 Highway 10 N.e.. Blaine, Mlnnesola 55434. (763)783-1880. Fill( 783-1683
-.
PRIOR LAKE DEPARTMENT OF
J;KJJLDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS $'l1 J. ..:JEF:Fsu- CQ" 11..1
NATURE OF WORK NGW ~~1\
USE OF BUILDING StE:j) .
PERMIT NO. Q4-.osqS- DATE ISSUED ~
CONTRACTOR ~t..\ ~~ PHONE/AZ-UI-,?J.1j,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
/ ~!lPECTOR DATE
'FOOTING II I/P I ~ ~<I .. 0)..0-
I FOUNDATION (Prior to Backfill) I ~~ ~ :.i'b I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH. INS
~6~~
I,:> c.. ( t1b
#A' ,.-~
! SEWER I WATER I SEPTIC
FRAMING
INSULATION
I ELECTRICAL
I PLUMBING ~~ 6'-<.r-
I HEATING (if required) . ( ffJ '
, FIREPLACE ~ .
I GAS LINE AIR TEST \N'd (I}> dip .....~ ~ 5'
.. .,.. ...
. COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
.
I i I I
FINALS
#L5 //.~~4-
GRADING (Prior to Sodding)
BUILDING 7'~ +. 8- \.tI{'
ELECTRICAL \
PLUMBING
HEATING
DO NOT OCCUpy
6/'/~
. .
-
~
UNTIL ABOVE
NOTICE
/<?~ / ~P'"
~ /.;. s-
HAS BEEN SIGNED
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until ail 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
@:nfifitaft of (@ttupantl!
CITY OF PRIOR LAKE
~rpnrtttttnf of '!JinilMng Jfnsptdion
~al Permitted D Conditional C.O. Expires
This Certificate issued pursuant to the requirements of Section no of the D 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
Use Classification
Bldg. Permit No.
R3
tl
VN
Zoning District
Occupancy Type
Type ConstructioD_
LIS. B3. JEFFERS SOUTH
Legal Description
3743
Owner of Buildmg Site Address
Contractor's Name & AddressWENSMANN H~/J 1895 PLAZA DRIVE.
!OBERT D. HUTCHINS I ( r- CltyPiaoner
.... / /Building Official V f
Date: l 11 fA Date:
/ . (.1
JEFFERS COURT
EAGAN. MINNESOTA
DON RYE
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551)2
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....
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 3?V 1
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE nME
SCHEDULED ~
. LJlbc; C1'
CONTR.
PERMIT NO.
c{ - () C/~~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADlFIUING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~~~AIRTST
/} I AI) n(
~HJp/~~ cf:dl({
./"
~K SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o COR T m' CALL FOR REINSPECTION BEFORE COVERING
IJ/ OwnerlContr.
"j;;("SO FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
"'-
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
uaNOTI
DATE
nA~f
sl1~ ~ J~ (J;f.-
~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
1
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
~MECH FINAL
COMMENTS:
nilE
q-%
o EXIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
~~~AIRTST
.d' WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRUfiK. CALL FOR REINSPECTION BEFORE COVERING
Inspector. Owner/Centr.
CALI: B8S/FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.
CODE REQrlREMENTS ARE FOR YOUR PERSONAL HEALffl & SAFETY/
J -,
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
3~t.I'<,
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
DATE
SCHEDULED ~
"J.Jt,~ CP;..M
TIME
CONTR.
PERMIT NO.
(j-s~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
,tl:.PLUMBING FINAL
o MECH FINAL
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
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1..GI,w ~('(~
3. 1k,...,&,.,. '^"'t.... ~:-_ "I< wl...-arl ~I
~WORKSATISFACTORY.PROCEED
Jl'fORRECT ACTION AND PROCEED
o CORREru.RK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. I, OwnerlContr:
CAL M..sso FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
_n
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
37'13 :r~ c.-f-
OWNER
PHONE NO.
CONTR.
PERMIT NO.
[] FOOTING
[] FOUNDATION
[] FRAMING
riil SULATION
INAL
SITE INSPECTION
[] PLUMBING RI
[] MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL
[] MECH FINAL
COMMENTS:
( ." < &_ (/:) I!--
DATE TIME
11-ltJ-~
W(/1J~no1 H(),."",s
tJt.f-$'1r
..)l(..~UNG
0""...11" ..ui'RT
[] FIREPLACE RI
[] FIREPLACE FINAL
[] GASLINE AIR TST
[]
~ wnRK SATISFACTORY. PROCEED
[] CORRECT ACTION AND PROCEED
[] CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. ~ Owner/Contr:
CALL "7.9850 FOR THE NEXT INSPECTION U HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
llaNO"
"
Job Address 3'743 Je,f:.k;s cr,
Heating Contractor ~ ~ ~,
Name of Tester
Date I zh IOY
"7.e
D
g'.O
1111 ·
Percent O.
Percent CO
Percent C02
Stack Temp
Combustion air Is adequately supplied per
UMC,~. 606 ~<..s;
Inpul>i/~,~ ~T...