HomeMy WebLinkAbout2015 - 01168 - plumbing CITY OF ORONO I I I 1 I 111 II I i 11111111 I i 11111I11
* 2015 - 01168 *
2750 KELLEY PARKWAY DATE ISSUED: 09/15/2015
ORONO, MN 55356-
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 2160 WAYZATA BLVD W
PIN : 34-118-23-21-0002
LEGAL DESC : UNPLATTED 34 118 23
: LOT 000 BLOCK 000
PERMIT TYPE : PLUMBING(>$500)
PROPERTY TYPE : COMMERCIAL-BUSINESS
CONSTRUCTION TYPE : FIXTURES-MULTIPLE
NOTE: (2)WATER CLOSETS,(2)LAVATORIES,(1)KITCHEN SINK,(2)FLOOR DRAINS,(1)WATER HEATER
VALUATION OF PLUMBING 5000
APPLICANT PLUMBING FIXTURE FEE 62.50
STATE SURCHARGE PLBG(VALUATION) 2.50
AMERICAN MECHANICAL CO,INC. MAIL-IN FEE 2.00
7120 71ST AVE.N.
PO BOX 205 TOTAL 67.00
LORETTO,MN 55357- Payment(s)
(612)750-0278 CREDIT CARD 6203 67.00
OWNER
Orono Station West
ERICKSON,BRAD
2486 BOBOLINK RD
LONG LAKE,MN 55356-
AGREEMENT AND SWORN STATEMENT
The work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvals,and the
State Building Code. This permit is for only the work described and does
not grant permission for additional or related work which requires separate
permits. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expire and become null and void if construction authorized is not
commenced within 180 days of the date of issuance,or if construction is
suspended for a period of 180 days at any time after work has commenced.
The applicant is responsible for assuring all required inspections are
requested in conformance with the State Building Code.This permit may be
revoked at any time for due cause.
( v ) �1 9 75X5_
Applicant Permitee Signature Date Issu d B ignature Date
t FO CITY USE OILY 4//6757
�
``ll City of Orono �i /„Off/
((ii?'-°1\%\m,,
? P 5 Hoy nb Darr R tl Permit a t!/
'_-511 Kcllc>Parkoca�
Cr-stat Day.MN 55321 Approved By: Amount S: / r
(952i_4u_thmi-Mani
et
\Z. ) 1 itilltfr1`1521249-1hi5-Fat
CITY OF ORONO-PLUMBING PERMIT
- I4
,kr O ,\ (All Commercial Permits Must be Approved by the State Prior to City Approval)
Imp:, www.dllinn.Dis/CCI.I)PDF( a pluntbplanrel.app.WE
GENERAL INFORMATION
i. You may apply for plumbing permits by mail or in person at the City offices. Applications will he
reviewed and a permit will he issued within two working days.
2. Permit cards will he sent by return mail after a review is completed. PERMITS ARE NOT
VALID UNTIL YOU RECEIVE A PERMIT. WORK MUST NOT BEGIN UNTIL THE
PERMIT CARD IS POSTED ON THE JOB SITE.
3. Plumbing permits may he issued ONLY to licensed plumbing contractors and to prupeny owners
residing in the dwelling.
4. When any new construction ur remodeling is involved.a separate building permit must he
obtained.
5. All work must be done in accordance with State Code requirements.
6. All work must be inspected and air tested before it is covered. Call 1952)249-4600.
(24-48 hour notice required)
TYPE OF PERMIT 1
(Check All That Apply) J
❑Residential ,ummercial(Approval Required)
0 New 0 Additional 0 Repairs 0 Replace
❑ In Accessory Structure'
*You will need prior approval and may need CUP (Per Orono City Code.Chapter 78.Article IV I
Job Site'Owner Information:
Site Address: 2//40 10.01 aiy'zd
p1/Q
Owner: g4f).4(/7r,S./y I/Jcc,AJ Mailing Address:
City: Zip:
Home Phone: Alternate Phone:
Contractor Information:
Contractor. /1]!i,[v/r 9(Lf)tlotot( Contact Person:
LIS:4,,►z,i 1 e'✓
Address: ? z)C State Bond : fe 6Wif7
/
City: [,OITiCOZip: .xpiration Date: tk_f_i_____
Phone: /./-7s.z)- 476? Alternate Phone:
❑ Insurance-Current: L'S
I J
PLUMBING FIXTURES BEING INSTALLED
FIXTURE j BSMT 1st OM1' OTHER FLXTURE BSMT I5T 2'° OTHER
TYPE j FL FL TYPE FL FL
1
jWater Closet 2 Floor Drains
2.
Lavatory Ejector
Bathtub Laundry Tray 1
Shower Washer
Kitchen Sink ' Water Heater
Disposal Water Softener
I Dishwasher Wet Bar
Sillcocks 1 Miscellaneous
PERMIT FEE CALCULATION(S)
BASED OFF-2002 STATE STATUE
❑ Yes.this section applies
The replacement ut only one Residential fixture or appliance that meets all three of the following
requirements.
I Does not require modification to electrical or gas service.
2. Has a total cost of 5500.00 or less.excluding the cost of the fixture or appliance:and
3 Is improved.installed or replaced by the homeowner or licensed plumbing contractor.
Skip next section.if this applies: Cost of Permit S 15.00
State Surcharge S I.00
Mail-In Fee ill Applicable' S 2.00
Total Permit Fee S
(Permit Fees Continued On\ext Page)
PERMIT FEE CALCULATION(S)—JOBS OVER$5A0.00
If above does not apply;follow guidelines below:
1 CONTRACT PRICE 'is 1.25",.of contract price with a(M Inimum Fee of$50.00)
Ste° ,.0125 S
contract price i 1 minimum 550.00)
2. STATE SURCHARGE
xn
-7100 - r 0005 S ,7
contract pncc
3. POSTAGE&HANDLING(Only on Matl-In Applications) , S 2.00
4. TOTAL PERMIT FEE(Add Lines 1-3 Above) S
• ' CONTRACT PRICE or JOB COST means the actual or estimated dollar amount charged for the
permitted work including materials.labor.profit,and other fixed costs his the amount to he charged
to the customer for the work done. If any matenal.equipment.labor or installations are furnished by
the owner.tenant or any other party.the reasonable market value of such items must be added to the
estimated cost or contract price for permit fee purposes. In the event that there is a dispute on the
amount of the job cost,the City may request the submission of a signed copy of the actual contract.
PLUMBING PERMIT APPLICATION AGREEMENT
The undersigned hereby applies to the City for issuance of a Plumbing Permit, agrees to do all
work in strict accordance the ordi ccs of the City and the regulations of the State of
Minnesota. and certifies at 11 stat ,,cis made on this application arc complete. true and
correct. j
Applicant's Signature J Date: 9id /r
i
i
443 Lafayette Road N. ) MINNESOTA DEPARTMENT OF (651)284-5005
SL.Paul,Minnesota 55155 LABOR & INDUSTRY 1$002.6'5`
www.d0.mn.gov
Division of Construction Codes and Licensing
,REPORT ON PLANS
Plans and specifications on plumbing:Orono Station West,2160 Wayzata Blvd W.Orono.Hennepin County.
Minnesota,Plan No.PLB 1508-00306
OWNERSHIP: Brad&Christy Erickson.2486 Bobolink Road.Long Lake.MN 55356-9533
SUBMI I i ER: American Mechanical Co Inc..PO Box 205.Loretto.MN 55357
Plans Dated: August 27.2015
Date Received: August 31,2015
Date Approved: September 9.2015
SCOPE: This review is limited to the provisions of the Minnesota Plumbing Code,as amended.The review is
based upon the supposition that the data on which the design is based is correct. Approval is contingent upon
requirements included in this report. A copy of the approved plans,specifications,and this Report on Plans
must be retained at the project location for future reference.
INSPECTIONS: All plumbing installations must be tested and inspected m accordance with the requirements of
the Minnesota Plumbing Code. No plumbing work may be covered prior to completing the required tests and
inspections. The contractor/installer must obtain an inspection permit from the Minnesota Department of Labor
and Industry when an installation is for a state owned facility,Minnesota Department of Health licensed healthcare
facility.or a project in an area where there is no local administrative authority. To schedule inspections.contact
the state plumbing standards representative fur your region. For your regional inspector's contact information,visit
our website at http:'/www.dli.mn.gov'CCLD'CCLDContactus.asp
REQUIREMENTS:
1. Verify that the existing water supply and waste systems are sized to accommodate the added fixtures(see
Minnesota Rules.part 4715.3800 and part 4715.2310).
2. Water supply connections to fixtures or equipment which have submerged inlets.or inlets below the spill line
of the fixture or equipment.must be provided with an air gap arrangement.approved backflow preventer or
backflow preventer assembly as specified in Minnesota Rules,parts 4715.2000.4715 2010.and 4715.1310.
Post-mix-type carbonated beverage machines must have a stainless steel double-check valve with an
intermediate atmospheric vent listed to ASSE 1022 preceding the carbonator. No copper tubing may be
installed downstream of the backflow preventer serving the post-mix carbonator to preclude copper
poisoning 1 see Minnesota Rules,part 4715.2163).
This shall include the potable water connections to the following:
a. A post-mix soda system.
b. An ice machine.
c. CUIICe machines �RilEI CL
},
This information can be provided to you in alternative formats(Braillelarge print or audio).
An Equal Opportunity Employer
Reviewed for Code
Compliance Cid of Orono
Date l ,.
Reviewer `w 4v.
Orono Station West
Plumbing
Plan No.PLB 1508-00306
Page 2
September 9,2015
d. Cappuccino machine.
e. Slushie Machine.
Each fixture or piece of equipment must be protected individually. A single backflow preventer may not
serve more than one piece of equipment.
The Watts.Model SD3 is an example of a stainless steel double-cheek valve with an intermediate
atmospheric vent(DC'ViAV)listed to ASSE Standard 1022.which is approved for the installations listed
above.
Please note that the Watts.Model 90.(DCViAV).listed to ASSE 1012(approved for the noncarbonated
installations listed above).does not comply with the January 4.2014.Reduction in Lead Drinking Water Act.
The Watts.Model 9BD does not appear to be listed to ASSE Standard 1012 or 1022
3 Based on the Minnesota Plumbing Code.a plumbing system includes all potable water supplies.distribution
pipes.and potable water treatment and using equipment(see Minnesota Rules,part 4715.0100.subpart 81).
All portions of the water treatment and water distribution systems up to the beverage dispensers must be
installed by a licensed and bonded plumber.
4. Indirect waste pipes from appliances,devices,or equipment not regularly classed as plumbing fixtures,but
which are equipped with drainage outlets,must he trapped.but the traps need not be vented. The waste pipe
must be at least 3 4 inches in size.but not less than the size of the outlet or tail piece of the equipment served
(see Minnesota Rules.part 4715.15101.
5. A full-way valve must be provided on the cold water supply line to the water heater(see Minnesota Rules.
part 4715.1800).
6. Tankless-and instantaneous-type water heaters require pressure relief valves only. instantaneous electric
water heaters that have UL approval for use without a relief vale,and that have space containing the heating
element of less than 3 inches in diameter.may be installed without a pressure relief valve(see Minnesota
Rules,part 4715.2230).
7. A water heater with a tank capacity up to 6 gallons may be concealed in a ceiling tithe water heater has a
corrosion resistant overflow pan with 4-inch minimum side walls. The outlet may not be smaller than the
water heater supply line and must continue full-size to a point of safe disposal below the ceiling. Access to
the water heater must not require tools see Minnesota Rules.pan 4715.2240). The relief rah pipe should
be routed independently to a point of'safe disposal below the ceiling.
8. Water closets in public bathrooms must have elongated bowls with open-front seats(see Minnesota Rules.
part 4715.1420).
9. The horizontal distance between cleanouts may not exceed 50 feet for pipe 3 inches or less in size,and not
over 100 feet for pipe 4 inches and greater in size(see Minnesota Rules,part 4715.1010).
10. It is recommended that a cleanout be provided where new waste and vent piping connects with existing
plumbing to facilitate required testing of the new installation.
Orono Station West
Plumbing
Plan No.PLB1508-00306
Page 3
September 9,2015
11. The copper water distribution piping must meet ASTM Standard B88 see Minnesota Rules.
part 4715.0520). Solder and flux for potable water systems shall contain less than 0.2 percent lead. Solder
other than 95-5 tin antimony or 96-4 tin silver must be approved by the administrative authority prior to use.
Joints must include noncorrosive paste-type flux complying with ASTM BR 13-00.
12. PVC plastic pipe used for the dram,waste,and vent system shall comply with ASTM Standard D2665,
D2949 or F891 (see Minnesota Rules,pan 4715.0570 through pan 4715.0600). PVC solvent weld joints
must include a primer of contrasting color to the pipe and cement(see Minnesota Rules,part 4715.0810.
subpart 2). Plastic pipe must be installed in accordance with Minnesota Rules,part 4715.0550 through
part 4715.0600. Above-grade horizontal runs cannot exceed 35 feet in total length.
13. Cross-link polyethylene(PEX)tubing must meet Minnesota Rules.pan 4715.0520:
a. The tubing system must comply with ASTM F877 and F876.
b. When installed as a system in accordance with ASTM F877.the system tubing and finings must be of
the same manufacturer and be marked as required.
c. When not installed as a system,the fittings must be marked with ASTM F1807.F1960.F2080.F2098-
01.or F2159. The tubing must list the fitting and tubing standard.
d. Installers must he factory trained and possess a card documenting completion of training.
14. Above-grade horizontal plumbing piping must be supported as follows(see Minnesota Rules.
part 4715.1430.subpart 4):
a. Plastic pipe:ut least every 32 inches.
b. Copper tubing(I!.-inch or less):at least every 6 feet.
15. The water distribution system shall be disinfected per Minnesota Rules.part 4715.2250.
16. The plumbing system shall be tested in accordance with Minnesota Rules.part 4715.2820.
17. Complete plans and specifications must be submitted to and approved by the Minnesota Department of
Agriculture. Contact the Dairy.Food.Feed&Meat Inspection Division at 651201-6027 regarding
information necessary for their plan review and licensing requirements.
NOTES:
1. The scope of this project consists of the remodel of an existing building. The plumbing installation includes
a counter sink,coffee machines.cappuccino machines.a post-mix soda system,an ice maker.two lavatories.
a urinal.two tank-type water closets,two floor drains.an instantaneous water heater.and a 6-gallon water
heater.
2. This facility is served by existing municipal sewer and water service connections.
3 The plans and specifications were prepared by a licensed plumber. Only the plumber who has prepared the
plans may use the plans for construction If another plumber is contracted to install the plumbing.they must
submit their own plans and specifications for the project.
4. The 2012 Minnesota Plumbing Code is available on our website at:ww•w.dli.mn.gov,CCLD'Plumbtng.asp
Orono Station West
Plumbing
Plan No.PLB 1508-00306
Page 4
September 9,2015
Authorization for construction in accordance with the approved plans may be withdrawn if the plumbing
installation is not undertaken within a period of two years. Plan approval does not necessarily mean that
recommendations or requirements for change will not be made at some later time when changed conditions.
additional information,or advanced knowledge make improvements necessary.
Approved:
Manse A.Widmer
Public Health Engmeer
Plumbing Plan Review and Inspections Unit
651'284-5887.marise.widmerfrastatc.mn.us
cc: American Mechanical Co Inc. .
Brad&Christy Erickson
City of Orono Building Official
MDA Food Inspection Division Via E-Mail
File
1` - i r5 ,�
� ^ i G
/ +z .s
-Z'S is
, alai i
. / v , s o
` � q�[[ S V 2
=ri
S
�!1Q 'E
3 d - v r_ Y r-:.
\ , z 1 , - .•
1
d •
R
4.
S ^y
• '5 •
M n
v
P
"urs
G.
r"\ • IP. v
en E..7/.... ..0••. ...... .....\•3
w
4
..---4.% c
1� ' o / \� _
Q r r
j
I
I !
C Tomer/
DATE TIME
CITY OF ORONO CALLED IN C
INSPECTION NOTICE SCHEDULED &/j / j4? /ti-r-71
NO. c�.L.I1�' CO LETED
ADDRESS `)r rc 9tfi� 2_i 'D Lti.)Ac zU fnt (V
cfr
OWNER TELEPHONE NO.
CONTRACTORR:),
�1A
32 DESCRIPTION '-'0 k K-11A_b E1 OF I
W ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
Q0 POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
O0 FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
is ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
W 0 AS BUILT-SURVEY 0 EWER HOOK-UP 0 FOUNDATION/REMOVAL
.a ❑ DEMO-SITE SEPTIC INSTALL
2 OWNER/CONTRACTOR TO MEET YO YES_NO
ti)• COMMENTS:
cc
W
Q.cc
O
or,-- airla v 13, (10-0.fleil-e1-.6
Lu
cc
Q
2
W
z
W
CC
CI tW 0 WORK SATISFACTORY:PROCEED PROJECT COMPLETE
CCW
0 CORRECT WORK 8 PROCEED ❑ IS E CERTIFICATE OF OCCUPANCY
CI ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner • . • • on site:
Inspect. J� ` _/0
White Copy/Inspector's File Canary Copy/Site Notice
V
9-i
DATE TIME
CITY OF ORONO CALLED IN / i.
INSPECTION NOTICEHEDULED 9-/b-t s 3:(3c)
PERMIT NO. ad 5 O//e23OMP ETED// �))
ADDRESS C / !O 0 I (A), 4' i (C
OWNER - TELE HONE F -'a 21 F. �' D Oz7er
CONTRACTOR ' 721 I-Ca-i M C' ' / - ,, /
�
Pio I t g_Le 'DESCRIPTION •
W ❑ FOOTING 0 DEMO AL •.EPTIC FINAL
Q ❑ POURED WALL 0 PLU . G RI IF EXCAV/GRADING/FILLING
C 0 FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
1, ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
.4C• 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
i ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
✓ ❑ DEMO-SITE 0 SEPTIC INSTALL
IC 2 OWNER/CONTRACTOR TO MEET YOU:_YES_NO
y COMMENTS:
A. feC it, kec 4 E,,,,./4„ fro c/,
C hee
cc
14. Goy,* s71i c/-ea&t.re a j Q d
Q gpt� ar,. t^ pt 4-cied
W --Pe, AcL9 a k -ri 1 1:ii_
V �,�i(-do �keo?S �! - to&v'-Pt r
C a(17ite o 'y / u)c42' 4d co& �/� �i,o e�Xe
o -ev-frit it'
Wu O WORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
W CORRECT WORK&PROCEED
i ❑ISSUE CERTIFICATE OF OCCUPANCY
0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORE COVERING PERMANENT
❑CORRECT UNSAFE CONDITIONWITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
STOP ORDER POSTED.CALL INSPECTOR ❑CITATION ISSUED
2t�
0 INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
• -. . . • .. on site: -
In . : i .� �_Aar
White Copy/Inspector's File Canary Copy/Site Notice
-0-?" 4, )-4 :t- 41CY 1/
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION NOTICE SCHEDULED iv--i
l B rY)
PERMIT NO. ")l S-CA 11A COMPLETED
ADDRESS 11 if:,C LA-%OL_ t-i a- /3 J
OWNER TELEPHONE NO. h1-373
CONTRACTOR -rr'Lf ?).__, Il-a_ 1-1
DESCRIPTION •_-t-1 MO i►'la I
W 0 FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
41.
❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
ct 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
= ❑
F. INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q 0 FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
, ❑ DEMO-SITE ❑ PTIC INSTALL
2 OWNER/CONTRACTOR TO MEET YOU:YES_NO
cam., COMMENTS:
cc
W
a
cc
id^.`1 - 6;0,-9circ'c(
o /
W
4. Uh, 'g_, 6-77-,,z- 6(.7 (c), i c
cc
zCy.. ) kil+c,li < r �lC,� c--Ccccss ;l�/�
W
W
niiiAwcv�' S/:_c/?`:� --c 14:-1/y1,i''`6177;
c d
J
a
IQ ❑WORK SATISFACTORY:PROCEED OJECT COMPLETE
CC
LU
0 CORRECT WORK&PROCEED ❑ISS E CERTIFICATE OF OCCUPANCY
CI ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
BEFORE COVERING
PERMANENT
❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN ❑CITATION ISSUED
O STOP ORDER POSTED.CALL INSPECTOR
ID INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contra site:
Inspector. �� .�/- L �G71
Wh e Copyllnspector's File Canary CopylSite Notice
` DATE TIME
CITY OF ORONO CALLED IN
INSPECTION OTICE SCHEDULED 1 o/I + i) _ %3.,-
PERMIT NO S COMPLETED
ADDRESS Z I Lo (AjcL-C1.7ci R/Ild w
OWNER TELEPHONE NO.95? 4I -3-737
CONTRACTORJ . v i_c Ch
31. DESCRIPTION DL bl)
L (17)I -10.�-
L, ❑ FOOTING 0 DEMO-FINAL 0 SEPTIC FINAL
14.
❑ POURED WALL 0 PLUMBING RI 0 EXCAV/GRADING/FILLING
O ❑ FOUNDATION WATERPROOF 0 PLUMBING FINAL 0 TREE REMOVAL
❑ RADON SLAB 0 MECHANICAL RI 0 SITE INSPECTION
Q 0 FRAMING 0 MECHANICAL FINAL 0 RATED WALLS
• ❑ INSULATION 0 WOOD BURNER/FIREPLACE 0 COMPLAINT
Q ❑ FINAL 0 WATER HOOK-UP 0 FOLLOW-UP
W ❑ AS BUILT-SURVEY 0 SEWER HOOK-UP 0 FOUNDATION/REMOVAL
✓ ❑ DEMO-SITE EPTIC INSTALL
Z OWNER/CONTRACTOR TO MEET YOU: YES_NO
O COMMENTS: ,------
cc
W
a ,
o 'ice ub^e_ 7 evil " /c
0
. i p L.
z v;r 1— WG `f--- /a 6,‘5 , — �,^r,Ice j
l 2'- fly' d/^oit,/ S
IQ
cc
j
WWORK SATISFACTORY:PROCEED ❑ PROJECT COMPLETE
❑ RRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
0 CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
u BEFORE COVERING PERMANENT
0 CORRECT UNSAFE CONDITION WITHIN HOURS. ❑PHOTO TAKEN
INSPECTOR WILL RETURN
0 CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. (952) 249-4600
Owner/Contra on site:-7h,
Inspector. t-(
White Copyllnspector's File Canary Copy/Site Notice