HomeMy WebLinkAbout2000-P02039 - new structure ✓
.� � PERMIT
CITY OF ORONO
2750 Keiley Parkway - PO Box 66 Permit Number: �'e2e�Po�o3Q
Crystal Bay, Minnesota 55323
(612) 249-4600 Date Issued: 1�s/oo
SITE ADDRESS: 34s Lea�st
LONG LAKE,MN 55356
P��: OS-117-23-14-0003
DESCRIPTION:
Proposed Use: Residential UBC Occupancy: R3
Permit Class: Building Construction Type: �7O
Permit Type: New Structure Census Code: 101
Permit Sub-type: Single Family
DETAILS:
Resolution#: 4,207.00
Separate pernuts requirrd : j
p�urnbin;; Mrcc_hc�n,t�c�� Fif'��Jl�c'� �M�.�I ljcYV�'r (�,��nt(�t'�c�1,� �C.ctw'.� -�rr��tntc,��, 1A�tf! �`7fic��c�.
cTlc�.fr;c41 (5+�1��.
Separate inspections require
NOTICES:
F E E S U M MA RY: Permit Fee: $ 3,��8•75 Valuation:$ �00,000.OD
Plan Review Fee: $ 2,410.73
c�o
State Surcharge Fee: $ , .
_�,r�iee.r °'���,
TOTAL FEE: $ 6,419.48
A P P L I CA N T: Ke�tn waters�asso� O W N E R: C C DEVOR&J W DEVOR
6216 Baker Rd, Suite 110 345 LEAF ST
Eden Prairie, MN 55456 LONG LAKE MN 55356
THE UNDERSIGNED HEREBY REQUESTS PERMISSION TO MAKE THE REAL IMPROVEMENTS SPECIFIED
/�ND AGREES TO DO ALL WORK IN STRICT COMPLIANCE WITH ALL CITY OF ORONO ORDINANCES AND
STATE F NIINNESOT UII,DING CODE REQUIREMENTS.
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APPLICANT PERMITEE SIGNATURE r„��'L �
Today's Date: 1/5/00 Page 1
�� Total Fee: $ Date Received: �� "�-�-�`�1���
Entered By: Permit#: '� �.� �
CITY OF ORONO - BUILDING PERNIIT APPLICATION
All information must be submitted in full before plan review will be started.
(please print all information)
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THE APPLICANT IS: (circle one) OWNER OR CONTRACTOR
.�- � ZIP: �.� �.� ��;
JOB SITE ADDRESS: ��{ .J ���- �•
NANIE OF OWNER: ���u�5 � �,���T ����(�PHONE: (home) /�� -� •� �'�,�
(work) (� � � (a T� - � 3 I�
MAILING ADDRESS:�;.lDS�� �vN�P.� Sia� j�, CITY: ��p fU�, ZIP: ' ,3 V
l.��S 1�
CONTRACTOR: K.�i.!�� I��A��� � �S s��r PHONE: � � � �L�-�;��
CONTACT PERSON: �7 u b Y ��p�'iy�S MOBILE/PAGER:
MAILING ADDRESS:���l�o '�k�Ze�'-�'`1> S��r�"a �lu CITY: ��,��tU�r.�;����r t'� ZIP: ��(�
STATE LICENSE: # �,U� j� ��
ARCHITECT/ENGINEER: ��� ���`G1L) �� � S`�_PHONE:
MAILING ADDRESS: CITY: ZIP:
NAME; REGISTRATION#
TYPE OF WORK: New � Addition Accessory Structure
Move Remodel/Alteration Land Alteration
PROPOSED WORK(describe in detai�: ��'�(�,� '�-���l�l�
STORIES: _�_ SQ. FEET OF EACH FLOOR: � l 1�G� fi .:-�� � �
NO. OF BEDROOMS: � GARAGE STALLS: ATT. ,�� DET.
ESTIMATED CONSTRUCTION VALUATION (excluding land): $ . �, ���`��
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 permit and work is not to start without a
pernut; and that the work will be in accordance with the approved plan.
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� APPLICANT'S SIGNATURE: �� � � � ��- � DATE: q
NOTE! Parade of Homes events require separate permit approval by Police Department and
City Council 60 days prior to the event. Non pernzitted events will not be allowed.
9
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Sec.13.04 RIGHTS OF SUB,TECTS OF DATA
Subd. 1. Type of data. The rights of individual on whom the data is stored or to be stored shall be as set forth in this section. '
Subd.2. Information required to be given individual. An individual asked to supply private or confidential data concerning hunself shall
be informed of: (a)the purpose and intended use of the requested data within the collecdng state agency, political subdivision, or statewide system; (b)
whether he may refuse or is legally required to supply the requested data; (c)any known consequence arising from his supplying or refusing to supply
private or confidenaal data; and(d)the identiry of other persons or enddes authorized by state or federal law to receive the data. This requirement shall
not apply when an individual is asked to supply invesrigative data, pursuant to section 13.82, subdivision 5, to a law enforcement officer.
The commissioner of revenue mav place the noace reauired under this Subdivision in the individual income tax or propertv tax refund instrucdons
instead of on those forms.
Subd.3. Access to data by individual. Upon request to a responsible authority, an individual shall be informed whether he is the subject of
stored dah on individuals,and whether it is classified as public,private or confidendal. Upon his further request, an individual who is the subject of stored
private or public data on individuals shall be shown the dara without any charge to him and, if he desires, shall be infortned of the content and meaning
of that data. After an individual has been shown the private data and informed of iu meaning, the data need not be disclosed to him for siz months
thereafter unless a dispute or acUon pursuant to this section is pending or additioual data on the individual has been collected or created. The responsible
authority shall provide copies of the private or public data upon request by the individual subject of the data. The responsible authoriry may require the
requesring person to pay rhe actual costs of making, certifying, and compiling the copies.
The�esponsible authoriry shall comply immediately, if possible, with any request made pursuant to this subdivision, or within five days of the
date of the request,excluding Satutdays,S�ndays and legal holidays, if immediate compliance is not possible. If he cannot comply with the request within
that time,he shall so inform the individual,and may have an additional five days within which to comply with the request, ezcluding Saturdays, Sundays
and legai holidays.
Subd.4. Procedure when data is not accurate or complete. An individual may contest the accuracy or completeness of public or private data
concerning himself. To exercise this right, an individual shall notify in wricing the responsible authoriry describing the nanire of the disagreement. The
responsible authority shall within 30 days either: (a)correct the data found to be inaccurate or incomplete and attempt to notify past recipienu of inaccurate
or incomplete daa,including recipients named by the individual; or(b)notify the individual that he believes the data to be correct. Data in dispute shall
be disclosed only if the individuaPs statement of disagreement is included with the disclosed data.
The determinaaon of rhe responsible authority may be appealed pucsuant w the provisions of the administrative procedure act relating to contested
cases.
DATA PRIVACY ADVISORY
In accordance with M.S. 13.04, Subd. 2, "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 fumish certain private or
confidential information.
You are notified that:
1. T'he information you fumish will be used to determine your qualification for the permit or license requested.
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 pernut 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. 13.04 (available upon request) to review private data on yourself.
6. Your full name is required to process this application or permit.
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Firs� � —'Mi dl Last
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Address ' y�
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City State ip Phone
I understand my rights as stated abo�v -.
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Signatu
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,j • CHECK OFF LIST FOR ISSUANCE OF PER�'IITS
FOR OFFICE USE ONLY -
ADDRESSORLEGAL: '��t5 tx�lA� s�r- , .
PID:
DESCRIPTION OF WORK: (U�� t'?x`� -
ZO�'G RE`'IEW BY: DAT'E APPROVED: t- s•ao
BUII.DPs iG REVIEW BY: � DATE APPROVED: r-5-o 0
FEES TO BE CHARGED: Misc. Fees Calculated By:
PERNIIT Yes ✓' No
pL?,ri REV�W Yes �/' No SEtiVER CO�fNECTION
STATE SURCHARGE Yes � No tiVATERCONNECTTON
INVESTIGATION FEE Yes No � Pt1RK FEE
SAC Yes �_ No_�/ STTEINSPECTION
Number of SAC-Units OTHER (specify)
________--- --- --
ZO�Zti'G CHE.CK LIST Zoning Dis�ict: �ra•r� .
Fire Department: (e n,c, (A iC,� Post O�ce: (,�o�� School District: ot�N D
Lot Area: Sq.fc. 7?�,b 3?.7 Acres 1•��O � Width 2'i'3.t _ �4✓L Depth z 1�
Survey Submitted: Yes�_ No Date of Survey: I Z-�d�9 S
Proposed Setbacks: �
Front(�e): l 35 Right Side: � 7 2 3 �
Rear(Street): �1•"t.' Left Side: 5�1�`3
Adjacent Structures: ��P� Wetland: �.!/�4
Buildin;Height: Def. Hgc. Z5•S Pea�:Hgt. T7. �
Lot Coveraae: o'k '
Grading: Staff Approval Date: 1 - 5 • c9 � By: � Council Approval Date: '"
Septic: Staff Approval Date: 5�e.,-.�� By:
Zoning File: # 2�f�1 Z `. Resolution: # Z a? Resolution Date: /��3•O�S
Shoreland District: 11�b
Avg. Setback: Bluff Setback: L,fltCoverage:
� Existing Proposed
Hardcover: 0-75'
75-250'
250-500'
500-1000'
Hazdcover Variance Required: Yes No Date of Council Approval:
RED�ARKS ('in house):
7
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BUII�DING REV�W CI�Cg LIST
UBC: R•3 . � CONSTRUCTION TYPE: V�
Sq Footage $Per Sq Ftg
� Basement . . , x . _
�. lst Floor . x _ �
2nd Floor x _ .
Gara;e x =
x =
TOTAL
Fstimated Construction Value: $ lono,ndo�'''
Inspections Required: tiYork Requiring Separate Permits:
Site � _�Plumbiag Fire
Hazdcover Removal � Mechanical Water Connection
. _�F��g � Septic o�Sewer Connectioa �
� a Frazaing . a Fireplace ��i _Lawn Irriaatioa
�_Insulation (Masonry) Other
�Wall Board �. (Iy�gg;� _�Well (State Permit)
'` F�� Grading/Filling _g.Electrical(State Permit)
Other
REitiZARKS(IN IiOUSE): . .
REV�tiV BY OTHERS: DAT'E: ~ -
Access: Existing New .
Access Approval: Date gy; �
REI�IARKS (TO BE NOTED ON PERivII1�: � �N�
8
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Devor Heatloss.xls Heat loss
Client Name: Charles&Janet Devor
Site Address: 345 Leaf Street
Orono,MN
KEITH WATERS & ASSOCIATES, INC.
6216 Baker Road Eden Prairie,MN 55346License#0001508
Phone(612)974-0004 Fax(612)974-0005
Permitted Heat Loss
Area(Sq. Ft.)x U Value = Heat Loss
1 Total exposed wall area: 2537.73 0.11 279.15
2 Total roof/ceiling area: 2053.76 0.03 53.40
Total permitted heat loss: 332.55
Heat Loss Through Wall Segments
Wall Windows 441.33 0.34 150.26
Doors 44.75 0.19 8.50
Rim Joist 250.83 0.04 9.56
Wall Framing(Average 10%) 180.08 0.10 18.64
Net Insulated Wall 1620.74 0.04 65.38
Foundation Windows 0.00 0.00 0.00
Foundation Wall Above Grade 0.00 0.06 0.00
3 Total heat loss through walls: 252.35
(If item#3 is the same as or less than item#1,
then you have met the intent of SBC(c)2.
Heat Loss Through Roof
Skylight 0.00 0.34 0.00
Roof/Ceiling Framing(Average 10%) 205.38 0.03 5.85
Net Insulated Roof/Ceiling 1848.38 0.02 35.70
4 Total heat loss through roof: 41.54
(If item#4 is the same as or less than item#2,
then you have met the intent of SBC(c)2.
Alternate Building Envelope Design
To utilize the total envelope system method,the values established by the sum of items#3 and#4
shall not be greater than the sum of items#1 and#2.
Permitted Loss Item 1 +Item 2: 279.15 53.40 332.55
Actual Loss Item 3+Item 4: 252.35 41.54 293.89
Heat loss is acceptable
12/22/99 1
Devor Heatloss.xis Wall Sections
Ceiling
Rim Joist Foundation Framing
Section Wall Section Section
Material R-Value Material R-Value Material R-Value
1 Interior air film 0.68 1 Interior air film 0.68 1 Interior air film 0.61
2 R-22 Insulation 22.00 2 R-14 Insulation 14.00 2 5/8"Gypsum board 0.56
3 1 1/2"Soft wood 1.90 3 10"Poured Conc. 1.28 3 R-29 Insul. 29.00
4 1/2"CDX plywood 0.62 4 Cedar Shingles 0.87 4 3 1/2"Soft wood 4.35
5 cedar shingles 0.87 5 5
6 Exterior air film 0.17 6 6
7 7 Exterior air film 0.17 7 Exterior air film(still) 0.61
Total R= 26.24 Total R= 17.00 Total R= 35.13
U=1/R= 0.04 U=1/R= 0.06 U=1/R= 0.03
Wall Framing Ceiling
Section Section
Material R-Value Material R-Value
1 Interior air film 0.68 1 Interior air film 0.61
2 1/2"Gypsum board 0.45 2 5/8"Gypsum board 0.56
3 5 1/2"Softwood 6.87 3 R-50 Insulation 50.00
4 1/2"CDX plywood 0.62 4
5 Cedar shingles 0.87 5
6 Exterior air film 0.17 6
7 7 Exterior air film(still) 0.61
Total R= 9.66 Total R= 51.78
U=1/R= 0.10 U=1/R= 0.02
Insulated
Wall Section
Material R-Value
1 Interior air film 0.68
2 1/2"Gypsum board 0.45
3 R-221nsulation 22.00
4 1/2"CDX plywood 0.62
5 Cedar shingles 0.87
6
7 Exterior air film 0.17
Total R= 24.79
U=1/R= 0.04
Keith Waters and Associates, Inc.6216 Baker Road,Suite 110 Eden Prairie, MN 55346 License#0001508 Page 1
�' � .
Dc�vor Heatloss.xls Heat loss
Client Name: Charles&Janet Devor
Site Address: 345 Leaf Street
Orono,MN
KEITH WATERS & ASSOCIATES, INC.
6216 Baker Road Eden Prairie,MN 55346License#0001508
. Phone(612)974-0004 Fax(612)974-0005
Permitted Heat Loss
Area(Sq.Ft.)x U Value = Heat Loss
1 Total exposed wall area: 2537.73 0.11 279.15
2 Total roof/ceiling area: 2053.76 0.03 53.40
Total permitted heat loss: 332.55
Heat Loss Through Wall Segments
Wall Windows 441.33 0.34 150.26
Doors 44.75 0.19 8.50
Rim Joist 250.83 0.04 9.56
Wall Framing(Average 10%) 180.08 0.10 18.64
Net Insulated Wall 1620.74 0.04 65.38
Foundation Windows 0.00 0.00 0.00
Foundation Wall Above Grade 0.00 0.06 0.00
3 Total heat loss through walis: 252.35
(If item#3 is the same as or less than item#1,
then you have met the intent of SBC(c)2.
Heat Loss Through Roof
Skylight 0.00 0.34 0.00
Roof/Ceiling Framing(Average 10%) 205.38 0.03 5.85
Net Insulated Roof/Ceiling 1848.38 0.02 35.70
4 Total heat loss through roof: 41.54
(If item#4 is the same as or less than item#2,
then you have met the intent of SBC(c)2.
Alternate Building Envelope Design
To utilize the total envelope system method,the values established by the sum of items#3 and#4
shall not be greater than the sum of items#1 and#2.
Permitted Loss Item 1 +Item 2: 279.15 53.40 332.55
Actual Loss Item 3+Item 4: 252.35 41.54 293.89
Heat loss is acceptable
12/22/99 1
� •
Devor Heatloss.xls Wall Sections
Ceiling
Rim Joist Foundation Framing
Section Wall Section Section
Material R-Value Material R-Value Material R-Value
1 Interior air film 0.68 1 Interior air film 0.68 1 Interior air film 0.61
2 R-22 Insulation 22.00 2 R-14 Insulation 14.00 2 5/8"Gypsum board 0.56
3 1 1/2"Soft wood 1.90 3 10"Poured Conc. 1.28 3 R-29 Insul. 29.00
4 1/2"CDX plywood 0.62 4 Cedar Shingles 0.87 4 3 1/2"Soft wood 4.35
5 cedar shingles 0.87 5 5
6 Exterior air film 0.17 6 6
7 7 Exterior air film 0.17 7 Exterior air film(still) 0.61
Total R= 26.24 Total R= 17.00 Total R= 35.13
U=1/R= 0.04 U=1/R= 0.06 U=1/R= 0.03
Wall Framing Ceiling
Section Section
Material R-Value Material R-Value
1 Interior air film 0.68 1 Interior air film 0.61
2 1/2"Gypsum board 0.45 2 5/8"Gypsum board 0.56
3 5 1/2"Softwood 6.87 3 R-50 Insulation 50.00
4 1/2"CDX plywood 0.62 4
5 Cedar shingles 0.87 5
6 Exterior air film 0.17 6
7 7 Exterior air film(still) 0.61
Total R= 9.66 Total R= 51.78
U=1/R= 0.10 U=1/R= 0.02
Insulated
Wall Section
Material R-Value
1 Interior air film 0.68
2 1/2"Gypsum board 0.45
3 R-221nsulation 22.00
4 1/2"CDX plywood 0.62
5 Cedar shingles 0.87
6
7 Exterior air film 0.17
Total R= 24.79
U=1/R= 0.04
Keith Waters and Associates, Inc.6216 Baker Road,Suite 110 Eden Prairie,MN 55346 License#0001508 Page 1
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION N, IC SCHEDULED � y— �
PERMIT NO. COMPLETED � �� ���
ADDRESS ���5 �-�'� S1
OWNER CONTR. tl._�l�l� ?���C�'s
TELEPHONENO. �� �— � � S�I�7D
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� DESCRIPTION
1 FO G 11 MECHANICAL RI 18 EXCAV/GRADING/FILLiNG
Q 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
y 03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
� 04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Z
Q O5 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEET YOU:_YES_NO
� COMMENTS:
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� �CORRECT WORK,CALL FOR REINSPECTION TEMPORARY
� BEFORE COVERING
PERMANENT
[7 CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN
INSPECTOFi WILL RETURN
Ci STOP ORDER POSTED.CALL INSPECTOR CITATION ISSUED
G INSPECTION REQUIRED.CALLTO ARfiANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-46��
OwnerlContractor on site:
Inspector.���� `Z�C'✓--�l.f
White Copylinspector's File Canary CopylSite Notice
DATE TIME
CITY OF ORONO CALLED IN
INSPECTION;NOT�CE SCHEDULED _�_
PERMIT NO.;' __..' �-G�� coMP�ETE� �v -����
ADDRESS � ��S L� � J
OWNER CONTR. t�.l�1 (�V��S
TELEPHONE NO. �f 3S- I cS� 7G
� ��S�RIPTION ��G�I'��C� C-,���..�
u�-.Q1 FOOTING � 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
� 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
� 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR TO MEEf YOU:_YES_NO
� CQMMENTS:
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V BEFORECOVERING PERMANENT
[1 CORRECT UNSAFE CONDITION WITHIN HOURS. pHOTO TAKEN
INSPECTOR WILL RETURN
I,STOP ORDER POSTED.CALL INSPECTOR GTATION ISSUED
C INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlContractor on site: ��/���
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Inspector. ,�' "���.��:.����
White Copyllnspector's File Canary CopylSite Notice
c� DATE TIM
CITY OF ORONO PD2b�j IcALLED IN � 9��
INSPECTION TICE SCHEDULED �7"��- +a ' ��
PERMIT NO. COMPLETED � r� ���
ADDRESS ��� �—T�'P �'•
OWNER CONTR. �t� w�5
TELEPHONE NO. � �� �I �O�j
� DESCRIPTION �' ��) P�S
ly 01 FOOTING 11 MECHANICAL RI 18 EXCAV/GRADING/FILLING
� 02 FRAMING 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
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Q 03 IN/ SULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z 4 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q�OS FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
v 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
J 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
� OWNERICONTRACTOR T�MEEf YOU:_YES_NO
� COMMENTS: �C�/� � �
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V BEFORECOVERING PERMANENT
❑CORRECTUNSAFECONDITIONWITHIN HOURS. c pHOTOTAKEN
INSPECTOR WILL RETURN CI CITATION ISSUED
❑STOP ORDER POSTED.CALL INSPECTOR
❑ INSPECTION REQUIRED.CALLTO ARRANGE ACCESS.
Call for the next inspection 24 hours in advance. 249-460�
OwnerlCont a tor on site:
Inspector.��/(�_�,�J�
White Copyllnspector's File Canary CopylSite Notice
r�'� DATE TIME
CITY OF ORONO (��� CALLED IN �('�
INSPECTION TICE '� SCHEDULED ��� � '✓ —
PERMIT NO. coMP ETEo '>'� ��
ADDRESS ��� L���"' �'
OWNER CONTR. ��-l'� �-'a�s
TELEPHONENO. �?J�^� ��3
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Ly 01 FOOTING 11 fv1ECHANICAL RI 18 EXCAV/GRADING/FILLING
�FRAM— lt�l� 13 MECHANICAL FINAL 19 LAKESHORE/WETLANDS
03 INSULATION 24/25 WOOD BURNER/FIREPLACE 34 TREE REMOVAL
Z04 WALL BD. 12 WATER HOOK-UP 17 SITE INSPECTION
Q 05 FINAL 14 SEWER HOOK-UP 06 PROGRESS
� 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPLAINT
J 07 DEMO-FINAL 15 SEPTIC INSTALL. 22 FOLLOW-UP
= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
� 10 PLUMBING FINAL 36 FOUNDATION/REMOVAL
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White Copyllnspector's File Canary CopylSite Notice
� D TE TIME
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? 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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White Copy/lnspector's File Canary Copy/Site Notice
DATE TIME
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INSPECTION NO CE�`j � SCHEDULED �� �� `6 �
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= 09 PLUMBING RI 23 SEPTIC FINAL 35 HARD COVER REMOVAL
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Call for the next inspection 24 hours in advance. 249-460�
OwnerlContractor on site:
Inspector.�/����.r�i�
White Copyllnspector's File Canary CopylSite Notice