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1350 Rest Point Circle, Mound, Minnesota <br />June 9, 2022 (Rev. June 16, 2022) <br />Page | 5 <br /> <br /> <br /> <br /> <br /> <br />RequiredInspectionsofRetainingWalls <br />(forCityBuildingOfficial) <br /> <br />ProjectName/Address:_____________________________________ <br /> <br />_____________________________________ <br /> <br />PermitNumber:_____________________________________ <br /> <br /> <br />Pleasechooseoneofthefollowing: <br /> <br />_____1.Noinspectionsarerequired. <br /> <br />_____2.Thecitywillperformallneededinspections. <br /> <br />_____3.TheretainingwallengineerͲofͲrecordmustcompletethefollowing: <br /> <br />_____Finalsitevisitwithwallcompletionletter.Contractor’sStatementof <br />Conformanceisacceptedinlieuofperiodicsitevisitsduringconstruction. <br /> <br />_____Periodicsitevisitswithawallcompletionletterthatincludesdocumentationof <br />theengineer’sconstructionobservations. <br />Numberofinspectionsrequiredbybuildingofficial:________________ <br /> <br />______________________________________________ <br />SignatureofBuildingOfficialorAuthorizingPersonnel <br /> <br />_____________________________________________________________________________________ <br />PrintedName/PhoneNumber <br /> <br />________________________________ <br />Date <br />