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Home My WebLink AboutBldg Permit 04-0571 & 0987 O~ PllJO+ .:.. <:' ,., ~ ~ ' ~ u '" """,..so" ~-1f' (Please tvpe or print and sign at bottom) ADDRESS 3299 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Date Rec' d tJ.;-9. ~~ White Pink Yellow FI L,,(?; //1/' 04.057/ I PERMIT NO. Of-. 0987 I File Cily Applicant W/t--O r/CJ,e46 ~r1SJ jl/d ZONING (office use) IC/ LEGAL DESCRIPTION (office use only) &,1!:! LOT/Z-BLOCK 2..... ADDITION W'l-Of OWNER (Name) (Address) PID 25: +/2...6/ t - 0 (Phone) {lOR-P BUILDER (Company Name) (Contact Name) ,r PIS 6- (9,O.BOi KtJTW:;'~ IJoUS'JA!6.- G-A 10 It- dL/S'17 Appu-. (Address) 9SJ -'13)-11/3;) (Phone) (Phone) G~LL (.,/2 - 3,-:; &'-~ 1'1 /l VALL6Y TYPE OF WORK D New Construction DDeck DPorch ORe-Roofing DAddition DAlteration DUtility Connection D Misc. CODE: llclI.R.C. OI.B.C. Type of ~nstruction: I II III IV V A B Occnpancy Gronp: A B E F HIM R S U Division: 1 Z 3 4 5 ORe-Siding ~ower Level Finish i Jti1j. PROJECTCOST/VALUE S (excluding land) o Fireplace I hereby certiry that I have tiJrnished 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 Ihe above mentloned~ and t1fl onstructton Will conform to all eXlStmg state and local laws and Will proceed In accordance With submitted plans I am aware thaI the bUlldmg otficlal can revoke th s p rmlt for u use Pm thet more I hereby agree that the CIty offiCIal or a deSignee may enter upon the property to perform needed tnspectlOns X (.t"Cl O~.&<L _ t- - \' I Signature Contractor's LIcense No ~ s.~ ~- Permit Valuation Permit Fee Plan Check Fee State Surcharge Penalty Plumbing Permit Fee M~chanical Permit Fee Sewer & Water Permit Fee Gas Fireplace Permit Fee $ $ $ $ $ $ $ $ I- (J,lI.DO J-1.~ Park Support Fee # SAC # Water Meter Size 5/8"; I"; t' Ct)- S- ~- 't- .57J Pressure Reducer Sewer/Water Connection Fee # # 4tJ.VV Water Tower Fee Builder's Deposit Other $ $ ~5. 2.6 TOTAL DUE This Application Becomes Your Building Pennit When Approved '~jic;ar~ ~~r Paid Date '15. -z,.s- f.X'~ /I I Receibf 'No. B"'" _ (/ hlH 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 temporary Certificate of Zoning compliance and allows construction to commence Before occupancy, a Certificate of Occupancy must be issued Planning Director Date 24 hour notice for all inspections (952) 447~9850. fax (952) 447-4245 16200 Eagle Creek Avenue Prior Lake. MN 55372 Special Conditions, if any CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT J - iff-(}lj I PERMIT NO. 04- _ 0571 I 1. White 2. Pink 3. Yellow File City Applicant (Please type or print and silm. at bottom) ADD~1-q4 UJLl&- H-~Pafft$ I ~m;G(Officeu,,) I LEGAL DESCRIPTION (office use only) LOT I'Z.BLOCK 2-- ADDITION -1li.t ItJtft!~ h1L~tfih PID (}5-t/I;;L--- Olb-~ ~':e~R 1Jt{ II er t.;.ffltgw.;f!r~;/ ~ (Phone)(0I2) 328 - :z/8?l (AddreSS)f!O, ~X Z-<lm ~ I~, ;Yll/, ~/ycr- _ I ;~v \..-/ / BUILDER ./-,./..I \ "vI ~ . tJ.. n ~r r/ -) ..... C CO (Name)~j I !-t'r ~511 ~ j7t..Utt ~ (Phone) \..(pI2-: 3.?-tJ <:2-/ {) 3 _ (ConlacIName) ~eJ-7 hi r<,dfIPy--.. (Phone) (6/2-/3zf?-:2-/8)( (Address) fI&, bej';-ZJf5 I. iYdI<!:rU~, Mil), . / . I -If' , TYPE OF WORK XNew Construction DDeck Dporch ORe-Roofing ORe-Siding DLower Level Finish 0 Fireplace DAddition DAlteration DUtility Connection PROJECT COST IV ALUE (excluding land) $ ;7? 96. 70 I . / 55/ VI- o Misc. 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~ authorized agent for the above-mentioned roperty a that all construction will conform to all existing state and local laws and will proceed in accordance wi S mitt plans. I am aware that the b tling offi can revoke this permit ~t cause. Furthermore, I hereby agree that the city official or a designee y nterup they.vy<.., e e illS e s /7 /5'" ~/C5 f-- . I Contractor's License No. ~, Date I Permit Valuation a ljq, DO(),-- I Park Support Fee # $ I I Permit Fee $ .;[ & L/ '7 ,S- 0 I SAC # $ /350.-1 ~ I Plan Check Fee $ I J../ laO- C2'? I Water Meter Size 5/8" (1 'j $ ,:::?t1I).- I I State Surcharge $ /t./q,.sO I Pressure Reducer $ "It). - I 1 Penalty $ - 1 City SAC and WAC # $ 1 a-a~ . -- 1 I Plumbing Permit Fee $ 100 - I Water Tower Fee # $ /)t(J. --- 1 I Mechanical Permit Fee $ 100- - 1 Builder's Deposit $ 1500, - 1 I Sewer & Water Permit Fee $ 35-50 I Other $ I I Gas Fireplace Permit Fee $ t.!1), - 1 TOTAL DUE &a-..e /p,/1. '#- $ 9253.38 I . wy-(,:;~z; ./ /) Paid ~1-55. .H I Receipjfi o. </1; q 0/ cr Date {;. 14-, (! 'f-' I BVQ-'" Bllt1'ding Official Date e request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document C' Pbnner con,titute> , /2J certifiC'Zf~~~7ce ,nd ,,"ows conmuction 10 commence. Before occuponcy, , Certific,te of Occup,ncy must be Date , Special Conditions. if any 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 . ~ Construction for Single or Two-family Dwellings in R-1 or R-2 Districts Review~d bitt) Date:{r 8 -0 f " r..' Builcjing Fermit # . PI!A Address:~'17 t.J:ltR ~ {J/~ \--," Legal: L f,2-, B 2-- Subdivision: LJ:1 J.r Cp Existing Str~tllJ'e? YES I NO CONFORMS TO ZONING ORDINANCE , Yard Setbacks: NA I FAIL~MPL~ I. Front Yard (can be 20' if avq. w/in 150') . Side Yards I. Sidewall exceeding 50' requires additional side 2" setback for every l' over 50' in lenqth I. Rear Yard I. Patio Door: provide for minimum 10' deck or sign statement indicatinq no deck will be built in the future I. From 100 year flood elevation ofwetland/NURP pond . From OHW (Prior or Spring Lake) , Floor Area Ratio: NA I FAILS1&91iIPLlE~ 'Yard Encroachments: NA/FAILS/~ I Eaves and Gutters no more than 2 feet in width and no closer than 5 feet to a lot line (Easements). I AlC and other equipment cannot encroach on interior side yards. , Tree Preservation: NAI FAILS I COMPLIES I. Total caliper inches I. Permit 25% Removal I. Calper Inches Removed t. Caliper Inches Preserved I. Replacement L:\TEMPLA TE\BLDGLlST.DOC Zoning: Existing Nonconforming Structure? YES I NO YES NO Standard ~ 25' if a~ street Proposed ~8.) /2.'~1 /2.~1 c)(<::. ()L.- tJ;f . A/It 75' or setback average of adjacent structures, but no less than 50' .30 Maximum . IS Standard Proposed J,,.J E tJ~t-Io Standard Proposed 11,:1 - , Driveway: NA 1 FAILS( COMPLlE.S) Standard Proposed I " Maximum width at property line 24' Zo' I" Required setback 5' from side lot line or 11~,(.f I 30' from r-o-w on corner lots I " Maximum slope 10% 7.4% I " All parking areas to be paved including R.V or spaces adiacent to the garaqe ~ I . Location to match subdivision qradinq plan ~ , Buildln9 Hel~ht:tCaMPLlE~ FAILS 35' Maximum "....h... , Shoreland DlstrlctrrN~1 FAILS 1 COMPLIES Standard Proposed I Minimum lot area (square feet) 7,500 Rip, 7,999 Non-rip I Minimum lot width 50' Rip, 57.3' Non-rip I Shore land alterations I Impervious surface 30% Maximum , Bluff In Shorelan~1 FAILS I COMPLIES Standard Proposed I. Setback from top of bluff By planning dept. I . Bluff impact zone 20' From Top of Bluff I . Enqineerinq certification submitted/approved By City Enqineer . , I . Gradinq in bluff or bluff impact zone No importinq/exportinq - Floodplai\: N~ FAILS I COMPLIES Standard Proposed " 100 yeil:Nt6od elevation 908,9' Prior Lake 914.4' Sprinq Lake I" Lowest floor elevation 909.9' Prior Lake 1 915.4' Sprinq Lake . Proposed lowest floor elevation Must be l' above flood elevation for new and existing structures. If existing structure was constructed 9/19190-11/22/97 then additional foot is not required. I. Elevations 15 feet from structure Must be flood elevation or hiqher I. Road 'acc~s's rr1:Ust be no more than 2 feet below 907.9' for Prior Lake Requlatorv Flood Protection Elevation 913.4' for Sprinq Lake ! Accessory Structurel'NAI FAILS 1 COMPLIES Standard Proposed . Size '-" 832 sq.ft. or 25% rear yard I . Not located in front yard (Materials) I . Side yard and rear yard setbacks 10' I . Maximum heiqht 15' I . Materials compatible with principle structure L:\TEMPLA TE\BLDGLIST.DOC ~~ Thr (-..n't. nr th.. I..k.. ('oun1l1' 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: "\ ,- i " i Accepted Accepted With Corrections ,< Denied /J) / !/ ' .' / ..Y ;/' ....-~.L/ . / Date: {; - 23 01/' Reviewed By: i / Comments: I, //~r, 'A'}( (",ll//1 r ,'.?r1.. /(Jr~.~..., _ ~ -.,.J-; .;i.C. ~'~_L-C ~ /4~kr ~~ ~ . /vI ( .,-2 l!~ ;:t; ~~ , -e.- ~4.~ ~ "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." ~~ 1.hr Crnlnof th..I...... Counlry c)Vhih~ .. Bllilrt~ Canary - Engineering Pink - Planning BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST . NAME OF APPLICANT ~~ y:;I.crU-<1//U C- lj- APPLICATION RECEIVED ~-- ;;2f>- cj The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: -3~C;9 wAd ~P~. Accepted Accepted With Corrections ~ Denied Reviewed By: (~~~ Date: (p- B - 0;/ Comments: l.~JJ ~ .J.LjJ-A "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." ~~ White - Builflina c ~anarv.. Enainee~ Pink - Planning Tht' ("tnlrr of lht' L.kto ("ounlry BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST NAME OF APPLICANT APPLICATION RECEIVED ,':>:~--r;''''''~>,7 " .:'''-' A ./ / ' - <,I The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: I ., C'\. / Accepted x Accepted With Corrections Denied Reviewed By: .1Y7fJ-- [5 Date: h--/t)-O'l Comments: ~p-'p- Reverse Side for Additional Information! See Attachments: 1) Gradinl! 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." o~~ +1"'oVEa01.'" CITY OF PRIOR LAKE HEATING/AIR CONDITIONING/FIREPLACE PERMIT Date Rec'd 1. z.3.04- L Pink 2,(fteen 3. Yellow ~:~ I PERMIT NO. riA. o,r::7/ I Apphcant v..,-. ~ (Please.!>1'!: or Print and SiWl at bottom) ADDRESS 3299 WILD HORSE PATH I ZONING(officeuse) I LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PIDZ~ 4-/Z .0/(, ,0 OWNER (Name) BUTLER HOUSING (Phone) 952-431-4132 (Address) P.O. BOX 24597 - Apple Valley, MN. 55124 APPLICANT (Namp' RAY N. WELTER HEATING COMPANY (Phone) 612-825-6867 (Address) 4637 Chicago Ave. So. - l.'iPLS., lilN. 55407 (Addtess) (City) (Zip Code) (Contact Person) WARR OR roNNIE, ~ /1 (Phone) 612-825-6867 APPLICANT SIGNATURE ~# j all. DATE 7-22-04 APPLICANT P~A& COMPLETE BELOW [!JNEW CONSTRUCTION 0 REPLACEMENT 0 AL TERA TIONS FURNACE MAKE AND MODEL TRANE - TUX080 FUEL NAT GAS FLUE SIZE 3" RETURN OPENINGS 7 INPUT 80,000 OUTPUT 72,000 TYPE OF SYSTEM Il9Warm Air Plants OGravity IZJ Mechanical !!JAir Conditioning OVent. System HEATING OR POWER PLANT o Steam o Hot Water D Radiation o Special Devices o Other Devices EYpO Renewa~rE '~,..L,J.. UU Q,.,I..J..) PLEASE NOTE: Air Conditioner Units Cannot Encroach into Required Side Yard Setbacks FIREPLACE MAKE AND MODEL Industrial, Commercial & Multi-Family FEE SCHEDULE 1 % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 Residential, Additions & Alterations $64.50 Residential, AC Only 539,50 Residential, Heating & Ale (New Construction) Residential. Heating Only (New Construction) $39.50 $39.50 HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE Building Permit # 04-, () 57 / B Y .,,--- $ -' p~IO Oe.~ $ ~o 11/'-" $ ./" Bv ,;' Estimated Cost $ (Office Use Only) This Application Becomes Your Building Permit When Approved Building Official Date P~ Da~. ~. 04- IRec~ I"' tm 24 bonr notice for all inspections (952) 447-9850, fax (952) 447-4245 16200 Eagle Creek Avenue, Prior Lake, MN 55372 08/02/2004 10:13 9527585942 WELTER BLAYLOCK PAGE 01 Date Rec'd CITY OF PRIOR LAKE PLUMBING PERMIT ; ~~~ ~:~ I PERMlT NO. U. c:- n ) J. Verllow ,$,Pllllelllfl1 ~I V / II (Plcase~ ortlrint and ~ilt'l atboaom) I AD;~q4 W;lc\ HCYSe. ftlfh, ~iv ~e.- I ZONING (oftk,,,,,) I LEGAL DESCRlPTION (ollice u"" only) ~:;~7ANJJd-lcf(:j Z IC:-/DJ .-rJ1r: (Address) 15D q .c. ;/;rJ. ,:u; 1.'3 (Ad~~;; '1 (Contact Person) ,9.eAJe... Vdz -;[/1 I APPLICANT SIGNATURE ~ @}.M (/ I . APPLICANT PLEASE COMPLETE BELOW Type of Fixture I Quantity Bath Tub with or without shower Dishwasher Floor Drain I Lavatory (Bathroom Sink) I I Laundry Tray (lor 2 compartment sink Shower Stall Sinks Bar Sinlc Water Closet (Toilet) LOT OWNER (Name) (Address) Quantity ..-2. / .:L t. .2.... XI 14 BLOCK ADDITION PID Bu.:f-I i/ +-f 00>1(, q oj (Phon/j9J L/3/ 'LjJ5;r UYiJ (PhOne)('q~~) <J?~ (City) 7~ - 5'~rrt') I (phone) 55'"3 '?'7 (Zip Code) lPld- ;3)/ ~vlt;1 DATE 7-30-- JC>'-j' Type of Fixture I Rough-ins Water Heater I Water Softner I Stand Pipe (Washing Machine) I Sewage Ejector Backflow Assembly I Backflow Assembly Test Lawn Sprinkler I Other / FEE SCHEDULE Industrial. Commercial & Multi-f.""lY I % of job cost with a S39jO minimum R..idcnlial. New One & Two-family 59'1.30 Residential. Additions &. Altc:rations S39.50 (Orne!: Use Only) Estimated Cost $ Buil<litJg Penn it # PLUMBING PERMIT FEE $ STATE SURCHARGE $ TOTAL PERMITT FEE $ .5Q {;"',..,~~~..~ -,"".' , 1 ,.' '.,'1.' . .~.....:J witd~Jlr '"I~r"~" · ., . "''1.J, Y!l..... ""-.:""V-"" J_ . ,"I!Q~ ~;..~( _,~\',f ~. This Application Becomes Your Bull<ling Permit When Approved Building Omelal ~~ ;~~~~4~II~ceiPt No U~ LJ 24 hour notiee for.U in.peetion. (952) 447_! 850. r.. (952) 447-4245 16200 Eagle CreckA'\I~.. 5.1.., PTiOf L.~1dN ~<'72-171" DAte CITY OF PRIOR LAKE HEATING/AIR CONDlTIONING/FIREPLACE PERMIT Date Rec'd llW1l3:d (Please tvPe or mint an.d S1~' at bottom) ADD rnsS"j.N.l 'III 1\.1 3299 Ir:rm~RSE p, \.55 HILA-\. UlVd ;~;:." ~:;y I PERMIT NO'O,I' 057/1 J. Yellow Apphcant 't ' I ZONING (office use) LEGAL DESCRIPTIO~ (office use only) LOT BLOCK ADDITION PID OWNER (Name BUTLER HOUSING CORP (Phone) (Address) APPLICANT (Name) AT J JRD FIRESIDE DRA FIRESIDE HRA RTH & HOME (Phone) 651.633.2561 (Address) 2700 NORTH F AIRVIEW AVENUE (Address) ROSEVILLE (City) 55113_ (Zip Code) (Contact Person) BRENDA HUSTON (Phone) _651.633-2561 APPLICANT SIGNATURE BRENDA 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 OWarm Air Plants OGravity o Mechanical DAir 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 FEE SCHEDULE 1 % of job cost Residential, Gas Fireplace $39.50 minimum $99.50 $64.50 $39.50 Residential, Heating & Ale (New Construction) Residential, Heating Only (New Construction) Residential, Additions & Alterations Residential, AC Only $39.50 $39.50 Estimated Cost $ HEATING PERMIT FEE STATE SURCHARGE TOTAL PERMIT FEE Building Permit # $ $ $ PAtDWfYH .50 9U1r F:rf\'~ ,"~.,. ...u..,,,, ,"&.:t.MfT (Office Use Only) _.. - - -r:1 This Application Becomes Your Building Permit When Approved '\'~ WI-O;~ l: ~ ~o~ Ill' By Buildine Official Date J L AU l:J 24 hour notice for all inspections (952) 4 17-9850, fax (952) 447-4245 jBy J Receipt No. PRIOR LAKE INSPECTION RECORD SITE ADDRESS 3~C;q /~;/e:I /lorSc P4~~ NATURE OF WORK ~ USE OF BUILDING ..."<F D PERMIT NO. ~ ~ - o:y:jf p~TE IS~UED CONTRACTOR 8&f,/e.1' LYd."~ PHON6/.i1. ~')'I. ~/~'I NOTE: THIS IS NOT A PERMIT FOR ANY OF rttE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT ~r?JPECrOR ~ I'd DATE I FOUNDATION (Prior to Backfill) I #' tG.c2l? PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS ~ Q-.2P fV(7 .:u~ PL? ".~;> g--(2 "rA; 'if- (J -ur; '(-;:1 'a/ I COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED - - '..~/t'~IT"~1JiL.E7I~ tY~ '7"-2P J FINALS ~~-rjll-t,~ /(fLl GRADING (Prior to Sodding) BUILDING ~ -Jo $ -1- ~ ELECTRICAL 'i PLUMBING HEATING DO NOT I FOOTING SEWER I WATER I SEPTIC FRAMING INSULATION ELECTRICAL PLUMBING HEATING (if required) FIREPLACE GAS LINE AIR TEST OEPARTMENT OF BUILDING AND INSPECTION E>- /3-Ul/ ~~Q /l1'" ./ f/4P ~ ':;,23': oJ-, ((I) ) u/~/tr;, , I' fil. OCCUPY UNTIL AS'OVE NOTICE "7"~iJ HAS BEEN SIGNED 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 . ' (ITedifit~fe Df @ttUp~nt\l CITY OF PRIOR LAKE ~~padm~uf of ~uilMug Jlusprdiou pFinal Permitted I:] Conditional C.O. Expires This Certificate issued pursuant to the requirements of Section 110 of the [J Residential! [J 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 04-0571 Use Classification Bldg. Pennit No,_ R3 VN Rl Owner of Building _ BUTLER H0tfsING Contractor's Name & Address I ROBERT D. HUTCHtNo/ i !, /Building Official / I I . r/' ;' _ Type Constructioo_ Zoning District Ll2, B2, THE WILDS SIXTH ADDITION 3299 WILD HORSE PASS Site Address CORPORATION, P.O. BOX 24597, APPLE DON RYE Occupancy Type Legal Description City Planner_ Date: Date: ADDRESS ,? .l~c,. /'" OCCUPANT - I..~ <. 'I " ~" HEAT LOSS . DA~E HTG. 'NST.. SOLD BY R.14. , I 1'1"1. ( A / Z- I b-r INSTALLED BY EI.ctric:ol Work By I Ga. Line By TYPE OF HE" T GA _ FA _HW _STE"M _SP"CE HTR. _UNIT HTR. _OTHER _ GAS DESIGN CONVERSION MAKE f e f4 J1 i/?:: MAKE OF BURNEP Mod.1 .,.. U" (')~(';0(,! ) 11i> Mod.1 s..i.l 'II ).1 ") :T1-.. r;. 7/_ Mo.. B TU R.ting _ INPUT ~,,;: MAKE OF FURN"CF Mod.1 HOUSE HEATING TEST , I r /'/0.;.... ! "'\ , , J~ RECORD I~ ' /."" .",\,,... APT. _ FLOOll_ CITY OWNER SUBUR B CONTROLS THERMOSTAT{)' C, V.I.. I. .' f) Limit \ ^,' V?~. limit Setting J.c; 'lj Fan Setting 1-' t I...... ft1 , pu.. Typ" / r --r'- PiI.t Mok. 1 / - '::> - ,I Pilot Mod.l Pilot Timing L.W. Cut 011 ;;<- (' Pr...ur. _ __: - " Input CFH_4:J);,(0t:.(1 Stack Temp. _1_./ ".... F.... .~3$ '. ..." ,..H~""",~","~~'''4 ~~'.-.I~';.,,~.--. Vent Size KINO OF LINER Draft Hood Fi Iten Size Ch imMY locotion Chimney Con.truction SIZF _ R.gulo~, _ ~urnb., _ InliN Outside. HONF Heat Plug. . P.reont CO S? ' 0 ~ /-.. ',<~' P.rcent 02---:J) Percen' CO Smoke Bomb ~ Wiring Droft T ..t Tog Door Pre.."r. lighting Inat. Oat. T.sted .7'-" ..::.!'~'-'(i(1 I CQmpany Tosting- v:J P '.' /'./j1 k /. "/,,,- . '/i'"" ,!tl- I r HarM of T...er _ .. ~"-)I"^, .. ..' .. 'r:, <..Jr ~ ""''''' " ~,kl';;.JJ..';;";i;,;""". L..'-""":...:~ !...~-" ":li~' .....1, '~f~,~,I.~:;:;;:,,-\,~:(,,- ~"~.,, '. /'_';;~o'';i'>'''..':..Wi~~~J/'. DATE TIME CITY OF PRIOR LAKE .I'f::'/~ INSPECTION NOTICE SCHEDULED ~~ ADDRESS :s 2.. CJ~ w-d ,\ \~_ OWNER CONTR. PHONE NO. PERMIT NO. 'I - c;7/ o FOOTING o FOUNDATION o FRAMING o INSULATION ".,e-FINAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL o EXIGRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLINE AIR TST o COMMENTS: Q\~~D ~~, 'v / ~RK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRE~' ALL FOR REINSPECTION BEFORE COVERING Inspector: Owner/Contr: CAL ,J7.9 0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH <I SAFETY! INVlOTl s-z]-Q.) ?;;tt9 /,j,II fIol'3!- !Jc;JJ CONlR. ~I 1<, J.lneJ6f!y r")/,/- 59 ( CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED ADDRESS OWNER PHONE NO. PERMIT NO. o FOOTING o FOUNDATION o FRAMING o INSULATION )\'1'tHAL o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP o PLUMBING FINAL o MECH FINAL COMMENTS: ((,/~ ~r~l'"')j( DATE Tille ~ ~FILLlNG o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o K -t- k.' It/lU We. //5 f VI ~ l<.Ge ~ORK 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! INSNOn CITY OF PRIOR LAKE INSPECTION NOTICE ADDRESS 3!J{ft OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION DATE nME SCHEDULED q.3rJ..o V I 4)ilJ /-{t>~....i' CONTR. PERMIT NO. 4- <:;7/ - -. o EXIGRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o o PLUMBING RI o MECH Rl o WATER HOOKUP o SEWER HOOKUP ~PLUMBING FINAL o MECH FINAL I. 'L. %. l1~. 5. COMMENTS: ~. J. Mcu:^ L iJa';-:QA l~~_ ~ ~ 'et;;;,,,.t IAA t o..~~ ,'W;,o. W'l-"fBJ7 ~JA.o.).L _ Cu~ I 0~i~ . (.""\, s..-.o ~D^ ~:rAJ". .O~ \t1'...t...- /'L"~ L / ('1 - l:2.r:v-., "-j I _ 0 JiPRK SATISFACTORY. PROCEED )I( CORRECT ACTION AND PROCEED C ~'''~'M~'_=~'~_'''' Inspect : Owner/Contr: C -9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY! ,"""'"