HomeMy WebLinkAbout2012-00038 (addn/remodel/repair) CITY OF ORONO PERMIT NO.: 20�2-0003s
2750 KELLEY PARKWAY
ORONO, MN 55356- DATE ISSUED: OU24/2012
(952) 249-4600 FAX: (952) 249-4616
ADDRESS : 4050 BAYSIDE RD
P1N : 06-117-23-11-0004
LEGAL DESC : POPOV ADDN
: LOT 002 BLOCK 001
PERMIT TYPE : ADDITION/REMODEL/REPAIR
PROPERTY TYPE : RESIDENTIAL
CONSTRUCTION TYPE : ADDN /REMODEL/REPAIR
ACTIVITY : 434-RESIDENTIAL
VALUATION : $ 10,200.00
NOTE: SEPERATE PERMITS REQU[RED: MECHANICAL, ELECTRICAL(STATE)
ADDITION TO GARAGE
IN LIEU OF AN AS-BUILT SURVEY,A LETTER FROM A SURVEYOR VERIFYING THE ADDITION WAS CONSTRUCTED AS PROPOSED
WILL BE ACCEPTED
"['HG ESCROW W[LL NOT BE REFUNDED UNTIL THE ABOVE LETTER FROM THE SURVEYOR IS RECEIVED AND APPROVED.
APPWCANT PERMIT FEE SCHEDULE 206.50
ALLSTAR CONSTRUCTION STATE SURCHARGE(VALUAT[ON) 5.10
5145 INDUSTRIAL ST
SU(TE 103 TOTAL 211.60
MAPLE PLAIN, MN 55359
(763)479-8700
Minnesota State License#: 20631574
OWNER
STEELE,THAD& DANIELLE
4050 BAYSIDE RD
MAPLE PLAIN, MN 55359-
AGREEMENT AND SWORN STATEMENT
l'he work for which this permit is issued shall be performed according to
the approved plans and specifications,applicable City approvais,and [he
S[ate Building Code. This permit is Yor only the work described and does
not grant pemiission for additional or related work which requires separate
permi[s. All provisions of laws and ordinances governing this type of work
shall be compied with whether or not specified herein.This permit will
expim and become null and void if construction authorized is not
commenced within 180 days of the date ot�issuance,or if construction is
suspended for a period of 180 days a[any time after work has commenced.
The applicant is responsible for assuring all required inspections aze
requested in conformance with the State Building Code.This permit may be
revoked a y tim for due use.
� 2�( � �Z / � /
Apptic�an ermitee Signature Date Issue B ignature Date
SEPARATE PERMITS REQUIRED FOR WORK OTHER THAN DESCRIBED ABOVE.
C��y -: �� �
� ���
City of Orono a l 1 . �o
Building Permit Application
for New Structures or Additions ao� - 0003
,—=_=_-; Mailing Address: Permit number:
O�,0,j�.\\ PO Box 66
\ Crystal Bay, MN 55323-0066 Date received: ! /
a � ? �,1�I� Street Address:' Received by:
'�' � �` ti`�' 2750 Kelley Parkway Plan review fee: �� . 3 ` 5/�
�1.�' � gw� Orono, MN 55356 _D
itEsxo,. �!'l/ l
�-_—_�' Total Fee:
Main: 952-249-4600 Fax: 952-249-4616 www.ci.orono.mn.us
This application form must be completed in full and all required information must be submitted.
Incomplete applications will be returned. (P/ease print)
GENERAL INFORMATION: �, � � �
Job Site Address: �,�U /�
Will this be a Parade of Homes, Rem delers Showcase Home or other Display Home? ❑ Yes No
If yes,a special event permit is required with Police Department and City Council approval 60 days prior to the event. Shuttle bus service will be
required unless applicant demonstrates sufficient on-site parking is available. Non-permitted events will not be allowed.
CONTRACTOR/APPLIC�4NT INFORMAT ON:
Name: � ., -
State License# �QC �!�/,s�� Expiration Date: ,
Phone: ���- � . office cell
Mailing Address: ,S'jy � C' � ZIP:
Contact Person: � Applicant is: / Homeowner (Circle One)
Email and/or Fax: � � - '
PROPERTY OWNER INFORMATION: ��" � al���r �� ��
Name: ��,� ' ��o ��
Phone (day): - - �
Address: o o � Cit : ZIP:
Email and/or Fax
ARCHITECT/ENGINEER INFORMATION:
Name: ti'�,/�Q'
Phone (day):
Address: City: ZIP:
Email and/or Fax:
PROJECT INFORMATION:
1.Type of Project 2. Proposed Use 3.Structure Type 4.Sewage Disposal&
Water Supply
❑ New Construction ❑Single Family with �Residence
�Addition attached garage ❑ Garage/Accessory Bldg. ❑ Public Sewer
❑Accessory Building � Single Family with ❑ Deck
❑ Relocation detached garage ❑ Office/Commercial ❑ Private Sewer
❑ Other: (specify) ❑ Multiple Family/Condo ❑Warehouse
❑ Public ❑ Storage ❑ Public Water
**Any earth movement may require ❑ Commercial ❑ Other(specify)
MCWD review&permits. ❑ Industrial ❑ Private Well
Minnehaha Creek Watershed District(MCWD) ❑ Other:(speCify)
18202 Minnetonka Blvd
Deephaven,MN 55391
Phone: 952-471-0590
Fax: 952-471-0682
www.minnehahacreek.or
Estimated Construction Valuation (excluding land) $ / �do,, —
i
Packet Last Updated: 10-20-2011
-20-
STRUCTURE INFORMATION:
1. Structure Dimensions 1.Structure Dimensions(continued) 2.Type of Construction
a. Length(ft.)= 1_� Number of bedrooms=S� �Wood/Frame
Masonry
b.Width (ft.)= %3 Number of garage stalls: ❑ Metal
Attached= c� ❑ Pole Bldg.
Areas in square feet Detached=�_ ❑ ICF
❑ On-site Prefab
c. Basement= ❑ Off-site Prefab
d. 1S`Story = /�� ❑ Other(please specify):
e.2nd Story=
f. '/z Story =
g.Total Area= �
�
.- i;��� �
REQUIRED SUBMITTALS:
All of the information must be submitted in order for your application to be processed:
Not
Enclosed A licable
❑ Permit A lication
❑ Pro osed Buildin Plans
❑ MN State Ener Code Calculations and Mechanical Code Re uirements Form
❑ � Surve meetin all re uirements
❑ Stormwater Pollution Prevention Plan
❑ Hardcover Calculation s
❑ I� Se tic S stem Site Evaluation Re ort
❑ � Access Permit
❑ � Wetland Buffer Im rovement Plan
❑ En ineered Plans for Retainin Walls 4 feet or above
� ❑ Plan Review Fee
�SI ❑ Other �n c � �
APPLICANT ACKNOWLEDGEMENT:
• Agrees to provide all information required or requested by the Building Department;
• Agrees to pay the City of Orono for engineering consultant review costs in excess of$500;
• Certifies that the information supplied is true and correct to the best of his/her knowledge. The applicant recognizes that they
are solely responsible for submitting a complete application being aware that upon failure to do so, the staff has no alternative
but to reject it until it is complete;
• Acknowledges the Escrow Agreement is completed and signed;
• Understands some or all of the information that you are asked to provide on this application is classified by State law as either
private or confidential. Private data is information which generally cannot be given to the public but can be given to the subject
of the data. Confidential data is information which generally cannot be given to either the public or the subject of the data. Our
purpose and intended use of this information is to annually update our records and records of other governmental agencies
required by law. If you refuse to supply the information,the application may not be issued.
. Agrees that in the event that weather or other conditions prevent the completion of an as-built survey at the time the
Certificate of Occupancy is requested, a temporary Certificate of Occupancy may be issued upon receipt of a $10,000
escrow to ensure completion of the as-built survey and all site improvements.
_� // /.z
ApplicanYs Signature: /�� Date: �
Packet Last Updated: 10-20-2011
-21 -
Plan Review Checklist for New Structures / Additions
f Address/PID/ Legal: ' I� C�
.rl � � � � � � C� �
Description of work: .
Septic review by: V"� Date Approved: � �""� � �-' 1 1
Zoning review by: i Date Approved: � —���( �
Building review by: -�.� ` ` r Date Approved: / - / cr - Z�i� 2
Grading review by: Date Approved:
Zoning File#: Resolution#: Resolution Date:
Zonin District Fire De artment Post(lffice School District
R�.- �
Zoning: LotArea: �2��� * SF/ C Width: J� � �" Depth: 1��� � �
Surve Submitted: es � ������ —1�---
y � No Date of Survey: I�t Z
Pro osed Setbacks:
Front( e) Rear et) ( N S E� ( N S E W ) Other Buildings Wetland
Side Si�
2-- ' c�2.` 330 ' ��
Building Defined Height: Building Peak Height: #of Stories Ok?: ❑ YES
FOR A BUILDING WITH A BASEMENT OR CRAWL 8PACE: FOR A BUILDING AN A SLAB FOUNDATION:
START WITH the distance between the basement floor/crawl START the distance between the slab and the highest
space floor and the highest roof peak,the top of WITH roof peak,the top of the cornice Qf a flat roof,
the cornice of a flat roof,the deck fine of a the deck lir�s of a mansard roof, or the
mansard roof,or the uppermost point on a round uppermos#point on a round or other arch-type
or other arch-t e roof roof
SUBTf2ACT half the distance between the highest window and SUBTRACT half the distance between the highest window
hi hest roof eak of a itched roof and hi hest roof eak of a itched roof
SUBTRACT the distance befween the basement floor/crawl ADD the distance between the stab and the highest
space floor and the highest existing grade within existin rade within the foundation
the foundation or 10 feet,whichever is less. EQUALS [3efined buildin hei ht
EGlUALS Defined buildin hei ht
� Lot Coverage: N t� gF o�o
Shoreland District MCWD Permit Received Avera e Lakeshore Setback Bluff
/ � Yes � No � N/A � Yes �� No
0 Yes D�No � Yes � No �N/A �
t Permit Number: Setback:
Hardcover Zones Existin Pro osed Variance Re uired CUP Re uired
0-75' 0 Yes o ❑ Yes No
75-250' Type(s): Type(s):
250-500'
500-1000'
REMARKS (in-house):
- Updated: 09/11/2Q09
z:lforms�ptan review checklist.docx
Fees to be Char ed YES NO
Permit �
Plan Review
State Surcharge �,r'
Investigation Fee �
SAC—Number of SAC Units
Q
Sewer Connection
Water Connection
Park Fee �
Site Inspection
Other(specify)
Misceltaneous Fees
Calculated By:
Square Foota e $ er Square Foota e
Basement X = $
1 S' Floor X = $
2nd Floor X = $
Garage X = $
Estimated Construction Value: $ =d� �� u'"
Orono Inspections Required Work Requiring Separate Permits Required State Permits
❑ Site ❑ Plumbing � Grading / Filling 0 Well
y 0 Hardcover Removal ,0" Mechanical � Fire Electrical
�Footing ❑ Septic � Water Connection
� Poured Wall ❑ Fireplace � Sewer Connection
0 Foundation Survey � Masonry � Lawn Irrigation
; 0 Radon Rock Bed ❑ Mfg.
�Framing 0 Other(specify)
� sulation
�s-Built Survey
�inal
0 Other (specify)
REMARKS (in-house):
=s
Other Review: Reviewed by: Date Approved:
Access:Existing: � YES � NO New: � YES � NO
REMARKS (TO BE NOTED ON PERMIT AND INITIALLED BY PERSON PULLING PERMIT)
: � '' 1�eu ar1 c� bu� ��- �v � m ��t� or �err `
� v�O�S w�I 1
�1 t I �e.,
5u t�e� '�s �ec e�� �o�ro�.
Updated: 09/11l2009
z:\formslplan review checklist.docx
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AG=500
Lyle Oman
From: Kate Jerke (kate@allstartoday.com]
Sent: Thursday, January 19, 2012 8:06 AM
To: Lyle Oman
Subject: RE: 4050 bayside
Hi Lyle,
Please see responses below...
Stud size :The suds will be 2x6
Window and door header size: ( front ) 2-11 7/8" LVL 9-9 3/8" with 4%" bearing on each side, ( dbl wide enrty door) 2-
2x10 78" with 3" bearing on each side, ( side window ) 2-2x10 7-5 7/8" with 3" bearing on each side.
Wall floor and roof sheathing type and size: %2" OSB for wall and roof sheathing, 3/4 "t&g cdx for floor sheathing
Rafter size and spacing: 2x8 rafters 16" OC
Wall, floor and roof insulation type and R-values: Floor will be insulated to R38, walls to a R19, and roof to be foamed
with closed cell foam
Siding, roofing and below joist sheathing type: Walls and below joist to be sheathed with 5/8" t-1114x8 sheets with 1x4
cedar trim, roof to be 16" medium hand split blue lable.
Heat source: Forced airc
Please let me know if you have any other questions. Thank you!
KateJerke
763-479-8700
Allstar Construction
Residential Division
�
Fax: 1-763-479-6600
www.Al IstarTodav.com
From: Lyle Oman [mailto:LOmanCa�ci.orono.mn.usl
Sent: Wednesday, January 18, 2012 3:53 PM
1
. • .
� •
emo
To: Finance Department
From: Christine Mattson, Planning Assistant�J` ,
CC: Street File
Date: 5/8/2012
G/L: 101-22205
Re: Building Permit Escrow Refund
Building Permit#2012-00038 pertaining to 4050 Bayside Road is complete. The Applicants,
Thad & Danielle Steele, request a refund of their$600 escrow.
The following is attached:
• Escrow Refund Request
• Email from Bonestroo indicating no unbilled WIP on this project
• Email from Campbell Knutson indicating no unbilled WIP on this project
• Original signed escrow agreement
• Copy of cash register receipt showing escrow amount received
Mail to: Thad & Danielle Steele
4050 Bayside Road
Maple Plain, MN 55359
w:�,street files�bayside road�4050\escrow refund memo 2012-00038.doc
RECElVED
APR 12 2012
�� �
� CtTY OF ORONO
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Christine Mattson
From: Schlegel, Kellie [Kellie.Schlegel@stantec.com]
Sent: Monday, May 07, 2012 3:54 PM
To: Christine Mattson
Subject: RE: Unbilled WIP
We do not have any WIP on the projects listed below.
Kellie Schlegel
Engineer
Stantec
2335 Highway 36 West
St. Paul MN 55113
Ph: (651)604-4734
Kellie.Schleqel c(�.stantec.com
stantec.com
The content of this emaii is the confidential property of Stantec and should not be copied, modified, retransmitted, or used for any
purpose except with Stantec's written authorization. If you are not the intended recipient, please delete al�copies and notify us
immediately.
� Please consider the environment before printing this email.
From: Christine Mattson Lmailto:CMattson@ci.orono.mn.usl
Sent: Monday, May 07, 2012 11:35 AM
To: Schlegel, Kellie
Subject: RE: Unbilled WIP
Yes, that would work. Tomorrow at the latest please. O
Thanks so much!
From: Schlegel, Kellie jmailto:Kellie.Schlegel@stantec.coml
Sent: Monday, May 07, 2012 11:21 AM
To: Christine Mattson
Subject: RE: Unbilled WIP
I should be able to get this info to you soon (hopefully today or tomorrow). Does this work?
Kellie Schlegel
Engineer
Stantec
2335 Highway 36 West
St. Paul MN 55113
Ph: (651)604-4734
Kellie.Schleqe�(a�stantec.com
stantec.com
The content of this email is the confidential property of Stantec and should not be copied, modified, retransmitted, or used for any
purpose except with Stantec's written authorization. If you are not the intended recipient, please delete all copies and notify us
immediately.
� Please consider the environment before printing this email.
1
From: Christine Mattson jmailto:CMattson@ci.orono.mn.usl
Sent: Monday, May 07, 2012 8:55 AM
To: Schiegel, Kellie
Subject: FW: Unbilled WIP
Hi Kellie,
I received Darren's out of office replay. I unfortunately need to know if there is any unbilled WIP on the below
projects before Darren returns. Are you able to research? Or can you direct me to who can do this in Darren's
absence?
Thanks!
From: Christine Mattson
Sent: Monday, May 07, 2012 8:42 AM
To: Darren Amundsen (darren.AmundsenCa>bonestroo.com); 'Sherry Charboneau'
Subject: Unbilled WIP
Good Morning,
Any unbilled WIP forthe following?
Buildin Permit# Address
2011-00318 115 Creek Rid e Pass And 8� Marnie Pfeifer/ Charles Cudd
2011-00075 3215 Graham Hill Rd Kei h &Am Korsi / Charles Cudd
2012-00038 4050 Ba side Road Danielle Steele
2012-00205 1390 Cher Place Ter & Gretchen Blount
2011-01586 1200 Loma Linda Ave Donald & Carol n Udell
Thank you!
Christine Mattson
Planning Assistant
City of Orono
2750 Kelly Parkway Orono ` MN 55356 (physical addressJ
PO Box 66 Crystal Bay ! MN ' 55323-0066 (mailing addressJ
�° 952.249.4620 � 952.249.4616
� cmattson@ci.orono.mn.us ' � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
Summer Office Hours begin Monday, May 21,2012
Monday-Thursday: 7:30 am to 5 pm/ Friday 7:30 am to 11:30 am
OUR OFFICE WILL BE CLOSED: Monday, May 28, 2012 (Memorial Day)
2
Christine Mattson
From: Sherry Charboneau [SCharboneau@ck-law.com]
Sent: Monday, May 07, 2012 12:23 PM
To: Christine Mattson
Subject: RE: Unbilled WIP
Christine:
Nothing for Campbell Knutson.
Sherry
Sherry L. Charboneau
Legal Assistant
CAMPBELL KNUTSON P.A.
1380 Corporate Center Curve.Suite 317• Eagan,MN 55121
�' (651)234-6230• Fax: (651)452-5550
�scharboneauCalck-law.com•www.ck-law.com
From: Christine Mattson Lmailto:CMattsonCa�ci.orono.mn.usl
Sent: Monday, May 07, 2012 8:42 AM
To: Darren Amundsen (darren.AmundsenCa�bonestroo.com); Sherry Charboneau
Subject: Unbilled WIP
Good Morning,
Any unbilled WIP for the following?
Buildin Permit# Address
2011-00318 115 Creek Rid e Pass And 8� Marnie Pfeifer/ Charles Cudd
2011-00075 3215 Graham Hill Rd Kei h & Am Korsi / Charles Cudd
2012-00038 4050 Ba side Road Danielle Steele
2012-00205 1390 Cher Place Ter & Gretchen Blount
2011-01586 1200 Loma Linda Ave Donald & Carolyn Udell
Thank youl
Christine Mattson
Planning Assistant
City of Orono
2750 Kelly Parkway 3 Orono MN 55356 (physical address)
PO Box 66 ' Crystal Bay '' MN 55323-0066 (mailing addressJ
`�' 952.249.4620 � 952.249.4616
� cmattson@ci.orono.mn.us � www.ci.orono.mn.us
Office Hours: Monday- Friday 8 am to 4:30 pm
Summer Office Hours begin Monday, May 21,2012
Monday-Thursday: 7:30 am to 5 pm/Friday 7:30 am to 11:30 am
1
� BUILDING PERMIT ESCROW AGREEMEN'f
Orono Building Permit#2012-00038
�
AGREEMENT made this ��day of -� �►Vl�' , 20� by and between the ClTY OF ORONO,
a Minnesota municipal caporation("City")and Thad & Danieile eele ("Owners").
Recitals
1. A building perrnit application has been filed for an addi�ion located at 4050 Bayside Road the
("Subject Property'}, legally described as Lot 2, Block 1, Popov Addition, Hennepin County Minnesota.
2. Owners request Ehe City to review this application.
3. The City will commence its revisw of the application and incur casts associated with said review
only if the Ou�mer establishes an escrow to ensure reimbursement to the City of its costs.
NOW THEREF�RE,THE PARTIES AGREE AS FOLLOWS:
1. DEPOSIT OF ESCROW FUNDS. Contemporaneously with the execution of this Escrow
Agreement, the Owners shall deposit $600 with the City. All accrued interest, if any, shall be paid to the City to
reimburse the City for its cost in administering the escrow account.
2. PURPOSE OF ESCROW. The purpose of the escrow is to guarantee reimbursement to the City
for all out-of-pocket costs the City has incurred (including planning, engineering, in excess of $500, or iegal
consultant review) or rnrill incx�r in reviewing the plan. Eligible expenses shall be consistent with expenses the
Owners would be responsible for under a building permit application_ The escrow will also guarantee
reimbursemerrt to the City for all out-of-pocket costs the City has incurred to assure that the work is completed 'm
accordance with the Stormwater Patlution Prevention Ptan and the provisions of Orono City Code Chapter 79.
The finanaal security may also be used by the City to eliminate any hazardaus conditions assoaated with ths
work and to repair any damage to pubiic property or infrastructure that is caused by the work(including planning,
engineering, or legal consultant review) associated with building permit #2012-00038 if c�mpliance with the
approved building permit is not accornplished.
3. MONTiiLY BILLING. As the City receives consultarrt bills for incurred costs, the City will in tum
send a bill to the Ow�ers. Ovmers shal{ be responsible for payment to the City within 30 days of the Owners'
receipt of bill.
4. DISBURSEMENT FROM ESCROW ACCOUNT. In the event that the Owners do not make payment
to the City within the timeframe outlined in#3 above, shatf issue a Stap Work Order until the Owners pay all expenses
invoiced pursuant to #3. The City may draw from the escrow account without further approval of the Owners to
reimburse the City for eligible e�enses the City has incurred.
5. CLOSING ESCROW. The Balance on deposit in the escrow, if any, shall be retumed to the
Owmers when the�eview has been completed and written notification is received from the Owners requesting the
funds.
6. CERTIFY UNPAID CHARGES. If the projec�is abandoned by Owners,or if the eligibfe expenses
incurred by the City exceed the amount in escrow, the City shall have the rigt►t to certifiy the unpaid balance to the
subject property pursuant to Minn. Stat.§§415.01 and 366.012.
CtTY: CITY OF ORONO OWNER:
By:_� C�- �/--�- �'�� ( „ �� -
�-
i�: � G2��-�c-� --�n��.:�"��,�
�����!�`" , '�9,����-�'�riie„r;��t�t�'��lie
Checklist for Refunding Building Permit Escrows
Building Permit # ��Z"�30
Street Address:
Appficant Name: (�1 �
Escrow request received Date: ��Z���
Permit Type: �� X 15r IJ�V�IJu�����
Are all inspections compfeted? es No
If not, list what is outstanding:
Was there a Temporary Certificate of Occupancy issued? Yes No Date:
Was there a Final Certificate of Occupancy issued? Yes No Date:
v�J ��ril. C-��on �-�acid�
��:�•, r� ` NO NA
As-built survey required? Yes, approved on
4�CP`�Z-
❑ Email CK & Bonestroo to see if there is any unbilled WIP. Date email sent:
❑ Prepare memo for Finance Department
z:\fortnslzoning standard forms\checklist for refunding building permit escrows.doc
Last Updated: 10-31-2011
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GRONBERG&ASSOCIATES,INC. /')/ ,,....����
SURVEYING�ENGINCFRING AND LAND PLANNING �/'►�� �(�'
665 N.WILLOW ORIVE
LONG LAKC,MINNCSOTA SS386
952•473•4141
F4%: 832-673-6435
Apri16,2012
City of Orono
2750 Kelley Parkway
Orono,MN 55356
Attn: Chris Mattson
RE: 4050 Bayside Road As-built
Today we measured the 13' X 15' addition that was recently constructed by Thad and
Danielle Steele at the above address and found it to be the same size and location as
shown on our survey dated 1/12/12 showing the proposed addition.
Sincerely,
Gronberg&Associates,Inc.
i/.��-'��
Mark S. Gronberg,P.E. &L.S.
CC: Danielle Steele
.�- �� - /
�-- D E TIME �%
CITY O O NO CALLED IN --7L�
INSPECTION NOTICE SCHEDULED
PERMIT NO COMPLETED
ADDRESS �
OWNER EPH E NO. '
CONTRACTOR J�L WL
>; DESCRIPTION ��� ' � �G�-�Vl�v�
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Z ❑ INSULATION ❑ WOOD BURNER/FIREPLACE ❑ SITE INSPECTION
Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS
� ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT
� ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP
i ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL
� ❑ PLUMBING RI ❑ SEPT G FINAL ❑ FOUNDATION/REMOVAL
��ONTRACTOR TO MEET YOU�YES_NO
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
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❑STOP ORDER POSTED.CALL INSPECTOR � CITATION ISSUED
❑ INSPECTION REQUtRED.CALLTO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (952� 249-4600
OwnerlContractor on s te-
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W ❑CORRECT WORK 8 PROCEED ❑ ISSUE CERTIFICATE OF OCCUPANCY
O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. � pHOTOTAKEN
INSPECTOR WILL RETURN
❑STOP ORDER POSTED.CALL INSPECTOR '�CITATION ISSUED
❑ INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
Ca11 for the next inspection 24 hours in advance. (J52� 249-4600
OwnerlContractor on site:
Inspector. ,�!�
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