HomeMy WebLinkAbout1988-000864 (building- add./remod.) PERMIT
CITY OF ORONO PERMIT TYPE: ���J�.�.��;�ac�
1335 Brown Rd. South • P.O. Box 66 Permit Number: '''`-'�-''='=`�'
Cr stal Ba , Minnesota 55323 �j�=�%����f`�=��=�
Y Y Date Issued:
(612) 473-7357
SITE ADDRESS: =�-����� �::.=�:_�c��; c:��;
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DESCRIPTION:
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CONTRACTOR: OWNER:
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REMARKS:
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APPLICAN E MITEE IGNATURE ISSUE Y: IGNATURE
• \
CITY OF ORONO - BOILDING PERMIT APPLICATION
Total Fee : $_ � � ' 1 � Date Received:
Date Approved:
Permit#:_�_ Project#: "
Building Permit Application Requirements :
1. Building permit application - to be filled out completely and signed
2. 2 sets of construction plans to include the following:
a) Floor plans; �
b) Footing and foundation plan;
c) Elevations (of all sides) ;
d) Wall sections and cross sections;
e) Details - stairs and any special connections.
3. Certificate of survey with location of existing and proposed
structures including hardcover ca2culations and grading and drainage
plans as required.
4. Energy calculations - form provided.
5. Septic report and design if required.
ABOV?" INFORMATYON MUST B$ SQBMITTED IN FIILL BEFORE PLAN REVIEW WILL BE STARTED
------------------------------------ ----- ------ --------------------------
THE APPLICANT IS: (circle one) ,��I�� r ONTRACTO
i,�? �,rta
Jos sz� Ann�ss: �.�� � ��-S�CG -��rc�C', � zzp: 5539 /
PROPffitT3i IDENTIFICATION NO. : (work) Q,3$ �"3 L b
NAME OF OWNER: �Lct,L1�,�e. � �-�u w�H,+1C� �C7����C�Q PHONE: (home) y 7/ - 7 U% 9 .
IKAILING ADDRESS: �7j,�C� ����CC� CITY:� Q�. ZIP: > j��1 � '
CONTRACTOR: �L)� ��r �OYI STYU��•OYl PHONE: � 73 yJ? 7�
�
'�SAILING ADDRESS: y7j � 5 �;��QC.�COI�' CITY: ,�j'��_�I L,� ZIP: s�� � I
�
ARCHITECT: I��O}'L�_ - PHONE: �
MAILING ADDRESS: CITY: ZI�= '
TYPB OF WORR: New Addition Accessory Structure Move
Demo Remodel/Alteration � Renovate Land Alteration
PROPOSED US$ (describe in detail) : l.t) � �� � � Q � � �-�-ne-i�
, sam � ace �- � �
� ��;�ch ��o_c ` � ,� ��o o - ._� P e � -� .�, � ,
STORI$S: � SQ. FEBT OF EACH FLOOR: �� T C /� � � �� .s c r e e n e� �I C�
w� � wat wo,,� cr� ort� �, ,
NO. OF BBDROOMS: G�G$ STALLS: ATT. DET.
�I i
ESTIMAT$D CONSTRDCTIOII VALOATIOP (excluding land) : $ �L 7 .��• �
I hereby apply for a building permit and I acknowledge that the information
above is complete and accurate; that the work will be in conformance with the
ordinances and codes of the City and with the State Building Code; that I
understand this is not a it and work is not to start without a permit; and
that the work will be i acco dance with t a d plan.
APPLICANT'S S IGNATUR$: �'�_ ��4.G'"����-�� � �i��,�i� DATE: � !�� ��
(Please fil out the � se side of this form)
Y
��� �s�. . ��;�
�. �� b�f�r�' �� r . ��
� C ITY of ORONO
'a"�,�,°��,��'� ,_ _�'
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'F r,y� q �r,(' 1
,!�a.'.� '� Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
� ��� �
� - � ���� On the North Shore of Lake Minnetonka
DATA_,PRIVACY__.ADVI SORY
In accordance with M.S. 15.165, "Rights of subjects of data", we
would like to inform you that your request for a permit or license
from the City of Orono or any of its departments may require you to
furnish certain private or confidential information.
You are notified that:
1. The information you furnish will be used to determine your
qualification for the permit or license reguested.
2. You may refuse to supply data, but refusal may require that
the City deny the permit or license.
3. The information may be shared with other local , state or
federal agencies to the extent necessary to process the permit or
license.
4. If your requested permit or license requires Council action
to approve, some information may become public.
5. You have certain rights under M.S. 15.165 to review private
data on yourself.
6. Your full name, and date of birth are required to process
this application or permit.
J��11� 11-e ��c��- -- �r����S_�c�
First Middle Last
���.�. ���.S�o _ _ C�.rc-�_..._--.. ._. .. . _ _ . � _ . _ _
Address
`` �. __ _. _ - - �r� �_ _ ._ _._. .. _. _ ..3._�__l _. - -__ -
City State Zip
,� a �8
. .
`� � � - ^7 d � . . _.. ._ _ ___.___.. _ _-
Phone C-��0 � 7
I understand my rights as stated above.
_ _. _ . . .. . _ ��:�_-� -- -. ._. .. . _ ______________. ...__. . . . ___ _
Si e
BUILDING&ZONIN —473-7357 ADMINISTRATION&FINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
` � L5 � L5QVL5
CHECR OFF LIST FOR ISSOANCE OF PERMITS D �
FOR OFFICE USE ONLY
ADDRBSS OR LEGAL DESCRIPTION: J� C�-� �-� � � �'�� �� � � 4 (g�g
,�/ ct ���
a C� r �� �
TYPE OF WORR: � � ' '/ ' �� '-� � 7- � � C
ZONING RLVYEW BY: ��, DATE APPROVBD: �j "T� ` ��'' I
Zonin District: � �� � Lot Area: 2� 2 St�� ` (
� ,
�
� � i
Fi re Dept. : �' r""' � � �'-- Width: .:�� � Depth: �`�� �= I
Post Of f ice: ��=`'�`"� G Proposed Setbacks: �
Front: � � � � � R.Side: ��
� �.
Zoning File: # Rear: � ' '' L.Side: ' '�` ;
Council Approvai Date: �'""" Adjacent Structures: �
i
Resolution # : ��' Lake: `� =�°"�r '�� Wetland: — i
�
f , '
Hardcover: Existing� : �:' ' Proposed$ : ��- �`/ �
Gradin : Staff A roval Date:����'1'� Council Approval Date: � 4
g PP I
Septic: Staff Approval Date: "— By: �" �
1
BUYLDING REVIEW BY: � -- DATE APPROVED s Cs�- 3� $�S' �
IIBC: S CONSTROCTION TYPE: � I
!
BLDG SIZE: H. L. W. ,
SAC CHARGE REQOIRED: Yes No f
�
Sq. Footage: Esti.mated Construction Value 3�'�t�0 "-�' s
�
lst Floor x = �
2nd Floor x =
i
x = E
x =
Garage X = �
TOTAL X =
Inspections Required: Work Requiring Separate Permits:
Site Plumbing Grading/Filling
�( Footing Mechanical Fire
��Framing Well Water Connection
Insulation �eptic Sewer Connection
Wall Board �Fireplace Other '
�Final
Fireplace
REVI$W BY OTHBI2S: DATE:
Access: Existing New
Access Approval: Date BY�
REMARRS TO BS NOTSD ON PERMIT:
_�
CITY of ORONO
.- � G' �� Post Office Box 66•Crystal Bay, Minnesota 55323•Municipal Offices
f�� a
.. �� ���� ��J ���� � ����
��� �� ;,,�n the North Shore of Lake Minnetonka
����1� � �� ��,
, � �M 1� w 1�,; ,:� �--o rt--�.�
May 2 7 , 19 8 8 C�/� E✓'YV `'''"�
��, �-,� 1 /�a.�,, a� _ �-�...
�� -t�, � � � �r ��,
Jeanette & Lawrence Brustad �G' .-.�... �.._
3309 Casco Circle " ^ "
Wa y z a t a, MN 5 5 3 91 ` . �f" �7�,u,Q_�X.(,,�,�� ,_.��-,�, ��,y�.;
s..
_� "'�' ��
� .t��, �,(��r�.-},..7 n '»'4r Q� �..�.�.� ,
Dear Mr. and Mrs. Brustad: - -�O ti ��
� G � �� � + -
,.j ��'"r �.
The Building & Zoning Department is in receipt of your application for
a building permit, which was received by this office on 5/24/88. A review
of the application finds that the following information needed for review
is missing:
,e;� ,'r.....�1. Certificate of Survey. Have surveyor update survey to show
, "'�� actual as built house location. (Copy attached; his phone number is
473-4141 . )
2. Site Improvement Plan (driveways/landscaping/sidewalks/decks/etc.).
Also show location of proposed porch. This can be done on the survey.
3. Hardcover Calculations (500-1000' zone - worksheet attached).
Review of your application will not continue until the noted items are
received. Failure to submit required items immediately may result in
delays in issuance of permits.
Please contact the Building & Zoning Department at 473-7357 if you
have any questions.
Sincerely,
,� �G�� ` ����'
ichael P. Gaf �
Assistant Zoning Administrator
J� '! �? C L f�J
�if/��L�l��' l`� �ri.�p �s
J !
Thomas J. Jacobs,
Building Official
lh
Enclosures
BUILDING&ZONING—473-7357 • ADMINISTRATION&EINANCE—473-7358 • PUBLIC WORKS—473-7359
ASSESSING
HARDCOVER R�GOLATIO1�iS AND wotus��r
� A. HARDCOVER ORDINANCE - In 1975, the Orono City Council adopted an ordinance limiting
the percentage of lot area that can be covered with impervious surfaces ("hardcover")
such as roofs, driveways, sidewalks, etc. on properties located within 1,000 feet of
a lake. Studies have shown that sediments, oils, and debris carried into the lake
from highly urbanized areas have a detrimental impact on the quality of water in the
lake. The intent of Orono's ordinance is to ensure that rainfall run-off will be
cleansed by filtering through grassed or vegetated yard areas before entering the
lake.
B. IiARDCOVER SETBACR ZONES - PERCENTAGE ALLOWED
I. 0-�5': in the area within 75' of the lakeshore, No Hardcover is allowed
(0$). -- --
II. 75--250': in the portion of the lot located between 75' and Z50' from the
lake, 25a of that portion of the lot may be hardcovered.
III. 250--500': in the portion of the lot located between 250' and 500' feet
from the lake 30$ of that portion of the lot may be hardcovered.
IV. 500-1,000': in the portion of the lot located between 500' and 1,000' feet
from the lake 358 of that portion of the lot may be hardcovered.
NOTE: These regulations apply even if you have a lot that does not abut the lake but is
within a lakeshore zoning district.
C. HOW TO DETERMZNE LOT AREA WITHIN EACH SETBACR ZONE (To be used as denominator in all
hardcover percentage calculations)
I. 0-75' Zone
Area = 75' x �Average width of lot in 0-75' zone\
measure parallel to shoreline �
75' x ft. = s.f. (1)
(Avg width) Area of 0-75' zone
II. 75-250' Zone
Area = (175'or avg lot depth in zone) x(Avg width of lot in 75-250' zone\
� measure parallel to shoreline �
175' x ft. = s.f. (2)
(Avg widthD Area of 75-250' zone
III. 250-500' Zone
Area = (250' or avg lot depth in zone) x�Avg width of lot in 250-500' zonel
measure parallel to shoreline �
250' x ft. = s.f. (3)
fAvg width) Area of 250-500' zone
IV. 500-1,000' Zone
� Area = (500' or avg Iot depth in zone) x Avg width of lot in 500-1000' zone
�` ___ � measure parallel to shoreline )
500' x ft. = s.f. (4)
(Avg width) Area of 500--1,000' zone
D. HARDCOVER CALCULATION SUMMARY
A. B. C. D. E. F. '
........._.�........�..............._...._..............._..........._........_........_...._..__......�............_.._......_........�.........
Existing Final
Lakeshore Existing Hardcover Proposed Hardcover Allowed
Setback Lot Area Aardcover Percentage Hardcover Percentaqe Hardcover
Zone In Zone In Zone (B/A)x100 In Zone (D/A)x100 Percentage
.._......�....�..... ...................�.. ..........��...... ..............�...... .................... ............_......_. _._................_.�........
0-75' sf sf 8 sf $ 0 8
75-250' sf sf 8 sf 8 25 8
250-500' sf sf 8 sf 8 30 8
500-1000' sf sf � � 8 sf 8 35 8
HARDCOVER LIMITATIONS HARDCOVER INCLUDES:
�F �, E - Structures with roofs
coE,`��q`;��'`�� LA� -- Decks, even if slatted
��`'�µ �% 0��� - Sidewalks
/� %�,� - i� P�`9 - Driveways (paved or gravel)
�5� �:'� -� -- Decorative landscaping areas underlain by
' \ , plastic sheeting
�� - Tops of retaining walls, rock walls
� � ' .— 25`�' � - Any other surface that does not al low direct
2'�--- P��°`� absorption of rainfall into the ground
PJ�t� - - -
o - '
�a� _ �,-`
, - ���\\�\
� ,\ \\ � 3°�,
.\ \ �c°
\.��� \�\� A�'��
ROA D
E. OTHER LARESHORE REGULATIONS
S$C. 10.22, RBGOL�i4IOHS FOR 'LA-lA', 'LR--2A-1•, 'LR--1H', 'LR-lC' AND 'LR�1C--1• OH$
FAMILY LARBSHORB RSSIDEH?IAL DISTRICT. With�II any "LR-lA"� LR-lA-1"� "LR-1B"� "LR-1C"� Or
"LR-1C-1" One Family Lakeshore Residential District the following regulations shall apply:
Subd. 1. Lakeshore Set Back Regulations. The set back from the shoreline for
lakeshore lots shall be at least 75 feet and no building may be located closer to the
shoreline than the average distance from the shoreline of existing residence
buildings on adjacent and nearby lots.
Subd. 2. Lakeshore Hard Cover Regulations. Within 75 feet of shoreline there
shall be no excavating, filling, hard cover, temporary or permanent structures.
Within 75 to 250 feet of the shoreline there shall be no greater than 258 hard cover.
Within 250 to 500 feet of the shoreline there shall be no greater than 308 hard
cover. Within 500 to 1,000 feet of the shoreline there shall be no greater than 358
hard cover.
Subd. 3. Tree Removal Regulations. No trees within 75 feet of the shoreline
with the diameter of six (6) inches or more shall be removed withouC first obtaining
a permit from the Council.
HARDCOVER CALCULATION WORKSHEET � � .
.,-�`___..� �
5etback Zone: (circle one) 0-75' 75-250' 250-500' S00-1000'
Existing Flardcover g = Total Existinq Hardcover x I00
Existinq Hardcover in 2one Lot Area W' �
a. House `� �1 X � a S.f. = S'f' x 100 � g
s.f.
length width _
' r � Additional Hardcover to be add in zone: �F
x � ' s.f.
X , ` a Item Lenqth x Width = TOTAL s.f.
s.f.
X a s.f. ' ` ;1.� X a s.f. '
L�
x a s.f. X = s.f.
b. Garage x = s.f. X a s.f.
� � / L✓.''
�, �, ,-
c. Driveway ; x ? f a�_� s,g, X = s.f.
X m � s.f. � TOTAL S.F. TO BE ADDED (2)
�.��
d. Sidewalk x a S.f. Existing Hardcover to be Removed, if any:
X a g.f. Item Lenqth x Width = TOTAL s.f.
X = s.f. X = s.f.
,
e. Patio/ x � c = � y ._` s.f. X = s.f.
Deck
x a s.f. X = s.f.
f. Landscape ;n � x �" = C s.f. X = s.f.
areas
. underlain x .,, S.f. � TOTAL S.F. TO BE REMOVED �3�
by plastic
`�/
sheeting X Q s.f. Final Hardcover Proposal: '
� X a s.f. [�ine (1) + Line (2) �Line (3) ) _
� �
� f. Other x = s.f. [ .�'�, '� + .` _ ) a -�.-=` - s.f. (4)
. Existing To be Added To be Removed Final
x � s.f.
Proposed Hardcover 9 =
x � s.f. .
`�� TOTAL EXISTING HARDCOVER IN 20NE = Line (4) x 100 = S'f' x 10 - � g
/ � s.f. (1) ��_., s.f.
, Fl/ZF/i , , . ;i:r� i ��; � :
HARDCOVER CALCULATION WORKSHEET
Setback Zone: (circle one) 0-75' 75-250' 250�500' 500�1000'
Existing Flardcover 8 = Total Existinq Hardcover x I00
Existinq Hardcover in Zone Lot Area Within Zone
s.f. $
8. HOuse X a s�f� � x 100 a
s.f.
length width
x o Additional Hardcover to be added in zone:
s.f.
x a s.f. Item Lenqth x Width Q TOTAL s.f.
x m s.f. X a s.f. '
X = S.f. X � 3.f.
b. Garage x = s.f. X = s,f,
c. Driveway x = s.f. X = s.f.
x a � S,g, � TOTAL S.F. TO BE ADDED (2�
�_�/
d. Sidewalk x a S.f_ Existing Hardcover to be Removed, if any:
x a 9�f. Item Lenqth x Width = TOTAL s.f.
x = s.f. X � s.f.
e. Patio/ x = s.f. X � s.f.
Deck
x a s.f. X = s.f.
f. Landscape x = s.f. X = s.f.
, areas �
underlain x + s.f. TOTAL S.F. TO BE REMOVED �3�
by plastic
sheeting X Q g.f. Final Hardcover Proposal: '
• X Q S.f. [Line (1) + Line (2) -Line (3) ] _
� f. Other x a S.f. � + ` ) a S.f. (4)
. Existing To be Added To be Removed Final
x � s.f.
Proposed Hardcover $ _
x � s.f.
� TOTAL EXISTING HARDCOVER IN ZONE � Line (4) x I00 = - S'f' x 100 = g�
��� s.f. (1) s.f.
�) �
/ , .1- ,•� .t:�r , . .
� �r �R��� T�i�S IT�M NAS BEEN
. .
- , r.�.oP '�
. n�t of su���y �CROFII�ED �
� for Rer,r.i�k Constr��ct�on, Inc.
�' of Lots 151, 152, and 153, �C� � P-
Wir.shi^'s Subdivisi�n of Sprin� ?ark Lots \ / �c,� y���- �p`�
Henn�pin County, Mznnescta �.. ./.5' r� �� \�
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BY
----_�_-
DATE �.•/— �8 - ----_�_._�
Certificate of Survey:
I hereby certif'�r that th�s is a true and correct representation of a survey
of the b011Y1�AP�CS of Lots 151, 152, and 153, Winship's Subdivision of Spring
Park Lots, the locatian of all existing buildings, if any, thereon, and thc
proposed location of a proposed buil�ing. It does not purport to show other
im�rovements or encroachnents.
.
� �'7'Y
� s�el�: 1n = 4�� •
' Date : 2-26-76 Gordon R. Coffin Re�. o. 60bk
` � . Iron �r,arker fclmd Land Surveyor and P]..anner
o . Ircr. m�rker set I.on� Lake, Aiinnesota
_ . k
y�Qjt}� �,vlv J! /1�/C�L/� �.. o"r��arr r� .mm vd►Y�"'�t iVro -� �
/
3as �v ��� No.
,>
�;5�`/L� ���yQ��L:r/ � " b/` Date
�jL�� ���j ` y�7� Sheet No.
Proposal Submitted To: Work To Be Performed At:
Name � U�� �
Street ,� �� ��� Street -�/��r�
City �nA Na City SGate
State //`��" n q Date of Plans
Phone !'j��j ' /��! Architect
We hereby propose ta furnish the materials and perfor the labor necessary for the completion of "
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All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and
specifications submitted for above work and completed in a substantial workmanlike manner for the sum of
Dollars ($ C�(��..� 1.
with payments to made as follows:
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My a:teration or deviation from ebove specificetions involving extra �
cests,vr�il be executed cnly upon written orders,end will become an ReSpeCtfUlly SUbmttted �ws���� /•�%'
extre charge over and above the estimate.All egreements contingent
upon st,ikes,eccidents or delays beyond our control.Owner ta carry
fire,tarnaCo and o:her necessary insurence upon above work.Work- Pe�
men's Compenseuo�end Public Liability Insurance on abave work to be
�k"'�"� --� Note—This proposai may be withdrawn by us if not accepted
y ���-�� ��Jf o within days.
RCCEPTANCE OF PROPOSAt
The abovt- prices, specifications�nd cr , � , .,�;� s„.� ;z,.�����r•y �anr� ��r� G���reb� �cr,F=�,r;�d. o ar �u h r;JAc� to do the work as sRF�c+�ied.
Payment wilf be r�ade es outlined abo� �. �
S.c�nature
Dace _ � Signature
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� 0�0 COPY
� � BUILDING PERMIT PLAN REViEW
INS?ECTOR T!'1►+�M� �W�+QV�" �.����
• f DATE �'� 'gr PERMIT NO. �,��
� `'� ��''.�I APPROVED AS SUSP✓IITfED . �,1 .
j �.. � , j .k APPROVED WITH CORRECTlONS AS NOTED I
; �,. ' , �j �OT APPROVED — CORRECT & RESUBMIT �,, j
i These comments are for your information. All work shell be done
+ `' ' ire tuli compliance with ali appliCable buitding & zoning COde Ie- i
Alrbrements including items not specificaliy noted in this revtav�4 i i
I . KEEP THIS PLAN SET ON SITE AT ALL TIrnES. , !
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I����IFI���'IqH OF P�E�I�S�S REQU���D
Apprdv�d Addresses S �II �� Displayed�
plainl� Visibie And legible From The _ - - -
Street �ror�ti�,� '�he Proper�y --- _ _�:�.���
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Wood Of Natural Resi�tance To Decay Or �
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' ' ' CtTY OF ORONO
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� BUTLDING PERMIT PL�kN REVIEW
itNSPECIOR �A7AA ��A �►.O
17ATE �•3•��_ PERMIT NO.
❑ APPROV;_D AS S�BMiTTED I
�APPROVED 4'VITH CORRtCTI0N5 AS NOTED
� NO�f APPROVED - COP,RECT & RESUBMIT
------- ___ _ _____.
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7hese comments are_for your information_lYII work shali be done
, � in full campliance with all applicable building & zoning code r9-
� Autrements including items not specifically noted in this revlew.
, j KEEP THIS PL,qN SET ON SITE AT ALL TIMES.
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D� � TIME
CITY OF ORONO CALLED IN ��J
INSPECTION N(�'y'I�� SCHEDULED
PERMIT NO. �� COMPLETED �D"��� I ,�
ADDRESS ��-��� C�S� ���
OWNER ru�f CONTR. �a�¢r
TELEPHONE NO. y 1 - 0/%
,�1 FOOTING O PLUMBING RI O SITE INSPECTION
d FRAMING ❑ PLUMBING FINAL O EXCAV./GRADING/FILLING
� � INSULATION ❑ MECHANICAL ❑ LAKESHORE/WETLANDS
� ❑ WALL BD. ❑ WATER HOOKUP ❑ LICENSING
� ❑ FINAL ❑ METER SET/TURN ON ❑ COMPLAINT
Q O PROGRESS ❑ SEWER HOOKUP ❑ FOLLOWUP
� ❑ DEMOL. ❑ SEPTIC INSTALL. ❑ SEPTIC FINAL
Q ❑ FIRE PREV. ❑ SEPTIC MAINT. ❑ FIREPLACE/WOOD BURNER
� ❑ WEIL TEST PUMP O
i COMMENTS:
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W WORK SATISFACTORY:PROCEED ❑ PHOTO TAKEN
❑ CORRECT WORK 8 PROCEED
❑ CORRECT WORK,CALL FOR REINSPECTION BEFORE COVERING
� CORRECT UNSAFE CONDITION WITHIN HOUFS INSPECTOR WILL RETURN.
❑ STOP ORDER POSTED.CALL INSPECTOR.
D INSPECTION REQUIRED.CALL TO ARRANGE ACCESS.
call for the next inspection 24 hours in advance.
Owner/Contr. site
I nspector 413'1357
White/Inspector's File Canary/Site Notice
D TE ' TIME
CITY OF ORONO � CALLED IN �v�� �_
INSPECTION NO i E SCHEDULED -����� ('�/'�,,�J
PERMIT NO. ��`� COMPLETED �'��`� v�l�
ADDRESS �V�� � �� (�'►'�•
OWNER CONTR. P�c'�tr ���+
TELEPHONE NO. > � - `/ � ` �
❑ FOOTING ❑ PLUMBING RI ❑ SITE INSPECTION
❑ FRAMING ❑ PLUMBING fINA� ❑ EXCAV./GRADING/FILLING
� ❑ INSULATION ❑ MECHANICAL ❑ LAKESHORE/WETI.ANDS
� O WALI BD. O WATER HOOKUP ❑ LICENSING
� � FINAL O METER SET/TURN ON ❑ COMPLAINT
� ❑ PROGRESS O SEWER HOOKUP ❑ FOLLOWUP
� O DEMOL. ❑ SEPTIC INSTALL. ❑ SEPTIC FINAL
Q O FIRE PREV. � SEPTIC MAINT. ❑ FIREPIACE/WOOD BURNER
� ❑ WELL TEST PUMP ❑
= COMMENTS:
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�❑ CORRECT WORK 8 PROCEED
C.1 ❑ CORRECT WORK.CA�L FOR REINSPECTION BEFORE COVERING
� CORRECT UNSAFE CONDITION WITHIN HOURS.INSPECTOR WILL RETURN.
❑ STOP ORDEA POSTED.CALL INSPECTOR.
❑ INSPECTION REOUIRED.CALL TO ARRANGE ACCESS.
call for the next inspection 24 hours in advance.
Owner/Contr. on site
I nspector 473-7357
White/Inspector's File Canary/Site Notice