HomeMy WebLinkAboutRequest for bldg inspection INTERAGENCY R�QUEST FOR BUILDING INSPECTIONS
To: RETURN TO:
Building Inspector Division of Licensing �
City Addiction, Intervention,Recovery MN Department of Human Services
Resources of Minnesota PO Box 64242
2389 Blaine Ave,PO Box 21 St. Paul, MN 55164-0242
Navarre,MN 55392 FAX: (651)439-7673
Prior to issuing a license, verification is required that a facility is in compliance with appropriate state oF local
building codes. An inspection is required for all proposed facilities located in a code area which involves new
construction, major renovating, ar change in occupancy{i.e. any facility not currentiy used for the proposed
usage,) Please comp{ete the information requested and retum to the Licensing Division with any orders
attached. A copy of orders should also be provided to the program.
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PROGRAM INFORMATION
Date:April 7, 2014
Name/address of facility: Addiction, Intervention, Recovery Resources of Minnesota, 2389
Blaine Ave, PO Box 21, Navarre, MN 55392
Proposed use: To provide chemical dependency treatment services
Name/phone number of contact person: Mary Ellen Mackenna McNutt at 612-720-3470
Area of facility to be used: Unknown at this time
Numbers and age ranges of participants:Ages 18—75 years old, both genders
Does the facility plan ta serve handicapped individuals? Unknown�at this time
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BUILDING CODE REQUEST:
[ ] Not applicable: facility located in a non-coded area bf state.
Signature of Local OfFicial: � � � Date: `�-�� ' �y�I
Title: ������r�rr� rJ Y� Li,r� l,
The facility is located in a code area ' , ' , �e�ese��a�sy-+:e.
[�`j Facility meets requirements
[ ] Facility does not meet requirements and cannot be occupied until ordars are met
[ ] Facility does not meet requirements, but may temporarily be occupied untif (date)
pending completion of orders.
Signature of Building Code Inspector:
DATE ''1�'�7" ��N Certificate Number: (2 8�
Comments: