HomeMy WebLinkAboutBldg Permit 01-0623
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
f&,.f&,-O/
(Please.!'Pe or OJ int and sien at bottom)
ADDRESS
'Wh;" F;to I PERMIT
2. Pink City
3. Yellow Applicant
I~s IS;
W t \d~
View
LEGAL DES 2RIPTION (office use only)
LOT.) BLOCK Co ADDITION
lhe.. wllds
OWNER r
(Name)~r:tl'l"'~) 4=" MOr-hl\"'_
P{!l"'_1 .(>eJr
_ (Phone)
(Address)
BUILDER I r
(Name)-l..J~ GW\<;'WUC.:t-WV\ ~C-_
(Contact Narre) 'l"P1I\V\i C. l.n .....,...{YV\ n rIc..
(Address) \')'01;) bk,..,y"1 t-11Y1V)e..-ton~a
ZONING (office use)
PuD
PIDQs-;;)..9'l- 05d.- -()
(Phone) g ~~ -'1.44 - qA qq
(Phone) ~ -qd-4 -G Aqq
K""
TYPE OF W( lRK
KNew Construction
DLower Level Finish
oDeck
oPorch
ORe-Roofing
o Fireplace
DAddition
OAlteration
PROJECTCOST/VALUE (exdudingland) $ =:....~JCO<!:>
OUtility Connection
o Misc_
C;;S~4s-
ORe-Siding
I hereby certifY tl at 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 or the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitt lans. I am aw e building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
en 0 the pre perry t nee d inspections.
1/1.:.3
Signature ~ ~ ~ Contractor's License No.
I Permit Valuatio 1 I ~CO,ccC. e:t:::)f I Park Support Fee
I Permit Fee 1 $ =?l:l~ I SAC Size 5/8"U);
I Plan Check Fee $ 2.1 Ct."l<l ) Water Meter
I State Surcharge $ :J .<)0 . r;n I I Pressure Reducer
I Penalty $ I I Sewer/Water Connection Fee
I Plumbing Perm: t Fee 1$ loo.on I I Water Tower Fee
I Mechanical Per. nit Fee I $ I()(). cO I I Builder's Deposit
I Sewer & Water ?ermit Fee I $ .3$"-_5"(\ I lather
I Gas Fi~place P ~rmit Fee I $ L/t') . (V,) I I TOTAL DUE
!J:J I
. a OJ ~tes Your Buil:P~;;:'A;proved I Paid II, ,S-gJ, jq
I Date . /"-JC;-Oi
S~cial Date
b ~C-.> --0 I
Date
# $ RSo .CX)
# $ l. I .'5'(J .C)O
1 $ ';2sO . CO I
1 $ 1:7 /') _ at::L
# 1$ 1.':lCV,J""
# 1 $ . '1m .ClO
$ /, "'ir'9O . CJO
$ ,"
I $ 1/,58/. Iq
,
I Receipt No. ,",? 7' f{S.,;}
By U-C-
iJ
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
:~~I 'i~ Plann" ==empo,,,, certi~te;~~ini ';~mce md allows ,onstruction to 'ommence. Before ocoupmcy, a C~ate ofO'oupmcy must be
b"o, Dak Special ondilio s, ifmy _ ~ .
24 hour notice for all inspections (952) 447-9850, fax (~52) 447-4245 ~~
Tilt ("l'nll'l nf 1111' L.kf <"ounlry
White . Building
Canary . Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NJ .ME OF APPLICANT L ..~ f' \1 ! /
AFPLlCATION RECEIVED /, Ii? / () /
,
The Building, Engineering, and Planning Departments have reviewed the building permit
ap Jlication for construction activity which is proposed at: I
,
(1./'"..../ <,-
.- ~
///
C..2.J'.()---
Ac :epted
~
Accepted With Corrections
Denied _
Re viewed By: ?;fAA-
Comments:
~i)UjWM 1--L/ p- v:tv~~ tJ'icJi;r
_# ~ I ()~ 0Vi) v..l,.cJ{tJJ
'(jD ~~ ~l
~ ~~ --:.....
Date:
(,p/a/o (
"Tt Ie issuance or granting of a permit or approval of plans, specifications and
corrnputations shall not be construed to be a permit for, or an approval of, any violation of
an:' of the provisions of this code or of any other ordinance of the jurisdiction. Permits
pre suming to give authority to violate or cancel the provisions of this code or other
ore inances of the jurisdiction shall not be valid."
Th~ C-~nl~1 of lh~ L.k~ ('oUnll')'
White . Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NhME OF APPLICANT U.c y (~[)jJsfr-
AF 'PLICATION RECEIVED ~~ It:> / {} /
I / '
He Building, Engineering, and Planning Departments have reviewed the building permit
ap plication for construction activity which is proposed at: (
I LIS-iS- U/d/,jl~ U fiJ2-(;.r-
Ac.cepted
Accepted With Corrections Y
DE nied -; 11
RE viewed By: l~ ~
Date: (,.-1'2 .2.,.,J
Cc mments:
Qra&. all lltta.~ L~
"Tile issuance or granting of a permit or approval of plans, specifications and
co nputations shall not be construed to be a permit for, or an approval of, any violation of
an { of the provisions of this code or of any other ordinance of the jurisdiction. Permits
pr!suming to give authority to violate or cancel the provisions of this code or other
orTinances of the jurisdiction shall not be valid,"
&~~
0l-- ~),~
White - Building
Canary - Engineering
Pink - Planning
Thll' Cll'olrl of lh~ L.kr {'ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NJ.ME OF APPLICANT Lee Y /t;jJc,rr
AF PLICATION RECEIVED i 0/ () /
Th e Building, Engineering, and Planning Departments have reviewed the building permit
ap Jlication for construction activity which is proposed at: (
I L/5"7 )- U-J ~~~ U AJ2-( V-
Ac cepted
x
Accepted With Corrections
De nied
Re viewed By:
A,f!B
Date:
/, - /3 -0 I
Cc mments:
See Reverse Side for Additional Information!
Drivew","y ffI(j.~ +
+0 ru.h!!
').4' mC,x Off Droper--I.v /,'t?e,_
. - ,
,(
-,
""y-<.,.~""
.
See Attachments: 1) Grading Plan, 2) Erosion Control Measures
::l\ Erosion Control Plan
"Tile issuance or granting of a permit or approval of plans, specifications and
co nputations shall not be construed to be a permit for, or an approval of, any violation of
anv of the provisions of this code or of any other ordinance of the jurisdiction. Permits
pnilsuming to give authority to violate or cancel the provisions of this code or other
ordlinances of the jurisdiction shall not be valid."
07/30/01 MON. .09: 06 FAX 6124474liL._
CITY OF PRIOR LAKE
Ii!: 001
CITY OF PRIOR LAKE .
HEATING/AIR CONDITIONING/FlREPLACE PERMIT
Date Rec'Il
.
~~ P.I!. Of1JriDt ai" ldanatbtdmm'
ADDR BSS .
/0/& '7p- u/Jd~ //!~
i ;,:.:;, \ PERMIT NO. 1- { - C1-3 I
J,YtIHlW "",\cInI lp
"
L.UiAt /
/
\ ZONING I_""l \
. PUO
LEGA ~ DESCR: mON <otII..... onll'J
LOT }--WX: ~ & womoN 0fw. LV 1 O~
p~:;,5-1J.7 -OLJ'-O
~':fA ~4:/ \ eCH .:.-:T
(Add11~S)/."o?/.;:{ Nu-y -7/-AJI",CT
APPL lCA."lT' - .
(NIIIJ.\ #:J)16.el/ _..KJ. n,}::;' (Phooe) ,9S-;1- 9S'~---,9f199
(AA4HSI)..Li3ii3.V<; ra'.t--.,./!,LA-- .<:d --;::?.vr"'<:u.l~ ,--~,1 >!;""_~~?
I (AddtoII) (CIlYJ (Zip CodeJ
(CoIllLCtPersonI _~~J4/,c. .J<1/J"'f/.// . (Phone) 9<>:=L-/'.v"::.._'i;)O_/
APPIICANTSI )NATlJIUl.c!-.. ___ ~ - ~1!' X--.;:J::>--c:?'/
- 1- -
PLEASE COMPLETE BELOW
@AWCONSTllUCnON 0 REPLACEMENT 0 Al.TERAnONS .
FURlIACEMA!BANDMOOEL ''RN'o,,,.,f- ~_~rnMl4voYl<-/cvl FUEL /VXJ /
r""'J #" I
FLUl:SlZE r!V,C- -S RE'lURNvr..,....<iS '-I INPUT /000<70 OUTPUT 9:;/(700
-I ' - -- l#
'IY1'll OF ..... ,.,,;.4 HEATING OllPOWllR PUNT
.. ~""" Air Plants 0 SleIIIl
C;;':~icaI ~~=
Air CondltianiDa special Devices A.Y)I>.(J
lilt System ~er OeYiees
(PhOllC)
,!'VI ...... "'~;/-n.....V.h /' .,,<.-,.,..y~363Y'
PLEAR Non::
Air COIld\tloDer Unill
Call1lot~h into .
Requim Stele YlIl'Cl
5e\tlIICks
FtlUPLACB M.' KE AND MODEL
r.4Q: lrial, comml till '" Mu1l1-FIlII;ly
Resi len,I.I. Heall' ~ '" AlC (New CcnotNcti<lnJ
It.,; lenlial. Heall' B Only (New COllSlnlction)
PEE SCHEDVLE
1% .rjob 00ft Rest4en~al. O..l'ireplol:e
539.so minill\Ufll
$99.5\l
$64.~O
539.50
HEA TINO pERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FJ!:E
$
$
S
$39.so
539.50
lJl.J!..~ ~..qllh._
<JIJ\', "V/h_
(3 Iii,'"
7Il/l,fl1-
Residential. Ad4idon. 4; Al\elOlio"
Residallial. AC Only
E!limated Ccsl $
Buildin& Permit #
.50
(on" v.. Onl)') .
Bul14 F I 06Ie111
I PlIid
D.le . I Dale &' .....- d':;;> - 0/ _ By Gw= .->
, ('-""
14 ho.r ooli" for all i..,oetio.. ("2) 447-98:10, fas (952) 447~
R.eCIllpl NO_
1 ~I. Appllclllloll Becomlll Y Ollr Balldlllll P.rmlt WlaIn Approval
Sent By: PLYMOUTH PLUMBING AND HEATING; 763 5331121 ;
Aug-2B-01 10:12;
Page 2/2
~~ PR/i3;9-~
iT'
&e~\
,,~
CITY OF PRIOR LA~E t ~:l. . ~"oaat
PLUMBING PERMIT PPNo_ OJ-~;;13
APPlicant:~1 MO~ '{)ILI",^"\-,~l. .Phon~u~'lf1"~~.. 3C.C::;7
Address: a' }; ~-f--~ . ~ .Vic::.~
~ .. -
Signalur . '-._ ~._
Legal Descrin: Lot 7--:-. lock . ,C;ub 7Ur:; /llJ/L'O..5:.
Site Address: \U,""rzc:; W ... -t.e.u.)
8uildingPermit# f)/- O,.,,_~ PID# 2-5-7J17-0SZ.-0
NOTE; This permit will not be processed without complete information.
FIXTURE UNITS
T~~ C::~.l<'r ,,' I.. l~ if COllnl...,
Quantity
~
I
\
Co.
\
:l
I
,
t-j
Type of Fixture
Balh Tub with or without shower
auantity
Type of Fixture
Bar Sink
\
3
Rougl'Hns
Water: Heater
Water Soflner
Stand'Pipe (washing machine)
Sewage Ejector
Backflct.v Assembly (RPZ, Doubl&~heck, PVB)
Backflbw Assembly Test
Lawn ~prinkler
Other.
Dishwasher
Floor Drain
Lavatory (bathroom sink)
Laundry Tray (1 or 2 compartment sink)
Shower Stall
Sinks
\
\
\
\
Waler Closet (toile1)
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
This pemdt is granted upon the cJIopress cnnditicn that said
(;unlrat:lQT, shaH cotnPIY~l,respeClS wHh the ordinances
l,lf the State ~g C mendme.nls thereof.
------ l'I.EC _ fj-z8.ol DATE
--- .. < - _AmST
I
Call for all insp,,?,ions 24 hours in advance.
[6200 EOlgJe CreekAv. S.E.. Prior Lake, Minnesota 55372/ Ph. (612) 447-42)0/ FAX (612) 447-4245
An Equal Opportunity Employer
i~~ ":::,:~;: ~~~ctt;~~~=PLACE P~"
""',IIr"r;;:8g'\'"
P.001/OOl
U1C.ua ~ u
: ~ ~~ lPERMlT NO. /-G'~ j
J. VII!.,.. A""'lIIIl1t t::7"-J
lPlense.!\?i! or pr III aII.d Iii'!fl at ba1tOm)
ADDRESS
1~57S U)~ lh'U-J
ZONING (qf!l<c .M)
(puD
pwJ}5- .J-97- (5;1-6
c1P1
. (Phone)
<AddresS)
APPLlCANr .
(No",.) ALLIED FIRESIDE OBA FIRESIOE CORNER
(Phone) 651-633-'256]-
APPLICAN''i'SIGNATURE
1
/-L~
i?('~rJTT,r.R MT\T
(City)
651-633-2561
(phone)
&:.1;."';1
(Ad<lress) 2 700 N _ FAIRVTF.w~rT1}
(Ad4t<so)
BRENDA Hl]STON /J
(Contact Penon) Y ./
f:)/ld..1'J
(Zip Code)
DATE
q./td<li
,
APPLICANT PLEASE COMPLETE BELOW
E3f'lEW CONSTRUCTION' 0 REPT.ACEMENT 0 AT. TERA TIONS
FURNACE MAKii: AND MODEL . FUEL
FT.VE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATJ:NG OR POWER pLANT
OWIIIT!I Ai, Plonts 0 Sl<om
OOr.vlty 0 Hot WDJ'"
D Mec:honical J Ro.dl.ollon
OAI, Condilionlng :J Sp.oiBi Dcvh:es
FIREPLACE MAK~:: :~:L 4t ~ G (,. J :;:oes k'1.
PLEASE NOTE;
Air Conditioner Units
Cannot En.croach inlo
IUqui.red Side Yard
Setbw;ks
.
lndumilll. COI ,merolal & Multi-Family
FEE SCHEDULE
I % of job ooS! "'O$ld",,1Iol. 0.. Flreplaco
$39.S0 minimum
599.S0 Resiclcntial. AddW.n, & Allerwons
564.51) ResldentioJ, AC Only
$39.50
Rcsidenli41. Heating & AlC (Now C.n'l11JcPun)
R<sldendoJ. H ..,ing Only (New Construction)
$3950
$39.'0
Estimated Co,t $
Building Permit #
HEATING PERMIT FEE
STATE SURCHARGE
TOTAL PERMIT FEE
5
$
5
_so
PAID WITH ......,
. BUILDING PER.v'/T
~
(om.. 1)..0, Iy)
Thi. Apl" icoriDD Becomes Yuur Dnildl.ng Permit When Approved
811 Ildln~ arnol.1
D.l<:
I Paid
I Date 9- //-() /
Receipt No.
B~
24 bour nntlo. fo,.1I In'pec:tlon' (95:1) 447.91150, filx (95:1) 447-424S
PRIOR LAKE DEPARTMENT OF
. BUILDING AND INSPECTION
;.
INSPECTION RECORD
SITE ADDRESS 1'-l57S IAI .. It...is U/t>U)
NATURE OF WORK U-llU I
USE ::>F BUILDING s_t=A
PERr~IT NO. ()J- Of'oZ3 DATE ISSUED c.-/ ;5.200,
CONTRACTOR L~,\ ~ - PHONE CiS2-QYQ-9<1fJr.'t-
NOTE: THIS IS NOT--a PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOCITING I 't>~'NSPECTOR / I (..\o;l~:~,'\T;,
, FOL NDATION (Prior to Backfill) I ~ \tL r----:rl/J 0/
PLACE NO CONCRETE UNTIL ABOVEIHAS BEEN SIG"NED
ROUGH - INS . ,
SEViER/WATER/SEPTIC I ~ \~~ 'Zim.oJ
FRAiMING I . ~.'JI~ ~ dl
INSULATION I ~ IJn~ C! ~ '0\
ELE CTRICAL I ( r J
PLUMBING I 1::> U(A.yf 0 ?'D. 0 I
HEA TlNG (if required) .1 r5 \ I'll....! t (,1-: II p,' () (
FIREiPLACE I -\b \\n...u, I I
GAgLlNEAIRTEST ~L~F I 'tJ{i..Vt( I Q!t8jo(
~ I [. ...
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
.#'iJ
GR)l DING (Prior to Sodding)
BUIl.DING
ELE' :TRICAL
PLU ""BING
HEAlTlNG
DO NOT OCCUpy
J/-2:~ .62_. --/
""K \la.wr 1~ln)OI m\~,0' f
I I I' \}
I ~~J 1~)H:2L
I 1,\ ~,
UNTIL ABOVE HAS B EN SIGNED
NOTICE
1rhis card must be posted near an electrical service cabinet prior to rough-in inspections
Ind maintained until all inspections have been approved. On buildings and additions
"here no service cabinet is available, care! shall !:>e placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
(<I. j:""., \-." "v.'.<-,d .,-d'"-r'~..'.'.'.:G,,,:,.itr 1'fi1iiii~~~'''~.. t........,...~.~..:.~'..~~I.-.-.. '.--
( -T(""')J'~t}':;"':"'" "..x .......r....~.. ;;_:~'rU:'~1:'.~~'f'>br.'" _,~'i
l:~ QLt,!;f.cau of OOCtlqlllllty ~ :
:~~~ CJ.J. ~ OF P~~R LA~ It)
:.~~i Iltpartmtnt of .utlbmg )n~ptdlOn I ~~...~
();l:. 1m Final Pennitted 0 Conditional C.O. Expires' ~
I~(~
( ..; This Certificate issued PUTSUQ1It to the requirements of Section 307 of the Uniform Building Code
......;.;- certifying that althe time ofissumu:e this structure was in complionce with the various ordinances of the
l"l"'. : City of Prior lAIu regulJJling building construction or lISe. For the following:
(I~. ;;.. i SINGLE FAMILY
'1'}. Use Clusificatior Bldg. Pennit Nt',
; ~ Occuponcy Type R3 Type ConsllUCtion VN _ Fin: Zone N / A Zoning District PUD
I....:
(~',.
I~~
ti
\ ',~ ~
r:
,:1'
01-0623
Legal t _ .-.:,
L2,
B6, THE HILDS
Owner of Building
LECY CONSTR.,
ContnctOl"s Name & Address
f1f
Site Address
14575 WILDS VIEW
15012 HIGHWAY 7, MINNETONKA
55345
ROBERT D. HUTCHINS
Building otIk:ial
If 1 OL
r,ty Planner
DON RYE
o.te:
o.te:
POST IN A CONSPICUOUS PLACE
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED 1t/2-7/0' M.. 0 0
~ /)2...L0
ADDRESS
/'-157.'>"
COMMENTS:
Of r1 t)(J~\
krJ J81O(/()~
I., I I
- ~vtO \
Sol ?i)'l~ +r.pp~
OWNER
PHONE NO_
o FOOTING
o FOUNDATION
o FRAMING
f\...E INSULATION
n ).'l FINAL
ff SITE INSPECTION
~
~)
CONTR.
PERMIT NO.
IJI-tJ/,:,:A5
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
It MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
ei ~ (~1r
f~r ~+e;f-
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o cORRE~R' ~ALL FOR REINSPEcTlON BEFORE COVERING
Inspector: h A \ tf.)J..lJ Owner/Contr:
CALL 447-9850 FOR THE~EXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSHOTJ
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
ADDRESS
/-Y 57 S-
SCHEDULED /~~I
tV~ Jd.vJ
It): Yo
OWNER
CONTR.
PHONE NO.
PERMIT NO.
tJl - 6 2 -5
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
A- qPLUMBING FINAL
, ki MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
IIIA.aAA {J 'A.A...t"~ (i'C--
~Jev- ~eJ1lerL
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: <JS...\ )0 ..tA.iI Owner/Contr:
CALL 447-985"0 FOR T~E NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTJ
CA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
11- }J-oz---
OWNER
/'-1575 !/ViiI> l/,cv
CONTR. La, v (nnf.1.
PERMIT NO_ f) t -~2 3
ADDRESS
PHONE NO.
o FOOTING
o FOUNDA nON
o FRAMING
o INSULA nON
~AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
,':Nf'E~ILLlNG
~ D't:OMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
/7,'Ct,MS - c9t
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
lnspector:~ ~-- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
JNSNOT/
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED
/1.-3
V/,cpJ
/ ~ }1//0.LJ J'
CONTR_
PERMIT NO_
(J/- Oc,Z3
o PLUMBING RI 0 EX/GRAD/FILLING
o MEcH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GAS LINE AIR TST
s:;/~ (ft
\11/
{Lose
.,.-- I I r--
r ! f..-,/V
iK WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: M I ~ 3-(/L; Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl