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Home My WebLink About2014-01071 - plumbing . � CITY OF ORONO * 2 0 1 4 - 0 1 0 7 1 * 2750 KELLEY PARKWAY DATE ISSUED: 09/23/2014 ORONO, MN 55356- 952) 249-4600 FAX: 952) 249-4616 ADDRESS : 3655 NORTH SHORE DR PIIv : 08-117-23-34-0050 LEGAL DESC : CRYSTAL BEACH : LOT 000 BLOCK 000 PERMIT TYPE : PLUMBING(>$500) PROPERTY TYPE : RESIDENTIAL CONSTRUCTION TYPE : FIXTURES-MULTIPLE NOTE: WATER CLOSET 3, 4 LAV,3 SHOWER MUTLITPLE FIXTURES VALUATION OF PLUMBING 8000 APPLICANT PLUMBING FIXTURE FEE 100.00 STATE SURCHARGE PLBG(VALUATION) 4.00 PREFERRED PLUMBING INC MAIL-IN FEE 2.00 6400 HIGH POINT TRAIL TOTAL 106.00 PRIOR LAKE,MN 55372- (952)447-5761 Payment(s) CREDIT CARD 7189 106.00 OWNER HAGEN,AL&DONNA 3655 NORTH SHORE DR WAYZATA,MN 55391- AGREEMENT AND SWORN STATEMENT The work for which this permit is issued shall be performed according to the approved plans and specifications,applicable City approvals,and the State Building Code. This permit is for only the work described and does not grant permission for additional or related work which requires separate permits. All provisions of laws and ordinances goveming this type of work shall be compied with whether or not specified herein.This permit will expire and become null and void if construction authorized is not commenced within 180 days of the date of issuance,or if construction is suspended for a period of 180 days at any time after work has commenced. The applicant is responsible for assuring all required inspections are requested in conformance with the State Building Code.This permit may be revoked at any time for due cause. ��c�-� �-'--} � �—.a r---- � ,�--�..3 , t Applicant Permitee Signature Date Issued By Signature Dat Sep 22 1408:23,a Preferred Plumbing, Inc. 952-447-5764 p.4 l___� FpR CI'£Y CSE OYLY � ( I Z� �� /�a�T� City of Orona � � ; �yO P.O.Box 66 Date Received: Permrt i� I U� % 2750 Keilcy Parkway � ; Crystal Bay,P.fN�5323 �pproved B}': Amount$: � � � 195�)249-4r00-:�(�in � (952)2d9-4C�16-Fax 1�F `� CITY OF Olt4N0-PLUMBING PERMIT y ��kEsrtoF�'�J (All Comrnercial Permits blust be Approved b3�the State Prior to City Approval) E�l'L ://ovr4-�v.dli.mn.Qo��/CCi ULPDF/ c lu�nb�lan�•e�'a �. df j GENERAL INFORMATION 1. You may apply for phunbinb permits by mail or in person at the City offices. Applicacions will bc reviewed and a pern�it wi�]be issued wathin tu�o working days. 2, Pecmit cards will be sent by return mail after a re��iew is completed. PERMITS r1RE NOT VALID LNT7L YOU RECER'E A PEIZl�fIT. WURK MIjST`'OT BEGIL�UNTIL TPE PERMIT CARD IS POSTED ON THE JOB SITE. 3. Plumbing permits may be issued ONLY to licensed plumbing contractors and to property owners residing in the dweliing_ �. VJhen any nev�.�construction or remodelin�is involvcd,a separate building pennit must be ob[ained. 5. Al!woi-k must 6e done in accordance with Sta'e Code reyuirements. 6. A'.[wor_c must be inspected and air tested before it is covered. Call(952)249-4b00. (24-48 hour natice required) TYPE OF PERMiT � _ (Check All Tha�Apply} �esidential ❑Commercial(Approva)Rcquired� �New ❑ Additiona'. ❑Repairs ❑Replacc ❑ ln Accessory Structurc? *You will need urior approval and ma��need CUP. (Per Orono City Codc,Chapter 78,.Article IV) Job Site i Owner information: _ � 5ite Address: _ �b S S 1��fi�^ ��n�� c'� Owner:��c,�cl�,� �n,� 1��S Mailing Address: City: --- Zip: —.. Home Ybone: Alternate Phane: Contractor Information: Contractar: Q�� r� P I��b��-�� Contact Person: �_ o,, � .Adciress: (,� ;� � �o;,�Y �,- t State Bond#: C_ y -7 p�l City: 4��-.o� L�� Zip: �537�Expiration Date: �Z J Z t____ f�� d i s� 1'hone: (a� z-yg 3- �i�t� Alternate Ph�ne: ,� Insurauce-Current: �«��.-��-�a, 1 � \�. \ Sep 22,1408:23a Preferred Plumbing, Inc. 952-447-5764 p.3 PLUMBING�IXTURBS BEING:IN3TALLED .>. . FIXTURE BSMT 1'' 2N OTHER. FIXTLtRE BSMi' 1 2 ° O'�'NFR TYPE FL FL ! TYPE FL FL Water Closet � ' Floor Drains I.avatory 3 Se��er Ejector � Bathtub i � Laundry Tray � Sho�ver ; Washer � Kitchen Sznk Water Heater DisposaE I 11Jater Softener pish�i�asher � VJet Bar Sil(cocks � Miscel laneous , . PER�IT FEE CALCLTL�TZQN(�)�' . : BASED OFF-2002 STATE STt1TUE Q Yes,this section applies The replacem�t of only ane Residexrial fixture or annliance that meets ail tfiree of the following requirements: 1. Does not require modificanon to electrical or gas service. 2, Has a toral cost of$500.00 or Less;excludzn¢the cost of the fixture or appliancc: and 3. Is improved,instafled or replaced by the liomeownex or licensed plumbing contractor. Skip next seccion,if this applies; Cost of.Pertnit $ 15.00 State Surcharge $ �.00 Mail-In Fee(If Applicable) $ 2.00 Total Permit Fcc $ (Permit Fees Continued On Next Page) � Sep 22 1408:2�.a Preferred Plumbing, Inc. 952-447-5764 p.5 ' �MIHNRSOTA�EPAR761EN70F � � _ �� .� �LU�Y�BI„� CONTRAGTQR � �� . �. r�►BOR&�n�nusr� Construction Codes and Lice�sing Oivfsion licensing and CerGTicaGon 5e�ices a43 lafayeqe Road N SL Paul.MN 55155 , WebsiOe: www.dli.mrt govlccld.asn Email: dli.ik:ense[�statemn.us Phone: 651.284.5034 This is to certify that the certificate holder is liceRsed as a PLUMB[NG CONTRACTOR in the stabe of Mi�nesota and is in compliance with Minnesota Statutes 3266.46,and may perform or offer to perform plumbing wark in all areas of the state during ihe]icense period; provided ihe responsble individual is at ail times a MASTER PLUMBER and the certificate holder�naintains compli�nce with the required bond,generaE liabilih�insurance,a��d workers'compensation laws. license : PWN€BWG C�NT�IACTOR 4 Lic Number : PC645709 PREFERRED PLUMBIRlG ING � Effeciive Date : 01/13/20i4 6400 HIGH POINT TRAIL B Expiration Date : y?.13112015 PR](3R LAKE, MN 55372 � r V�RIFY UP TO-DATE STATUS,BOND;AND INSURANCE fNFO AT www.dli.mn.qovlccld/LicVerifv.aso (ENTER NUM86�1). . MINNESOTA dEP7.OF LAB�R AND INOUS7RY CONSTRUCT]ON CODES AND UCENSENG PLEASE CHECK YOUR CARQS FOR ACCURACY. 443 Lafayette Road!V IF YOU FIN�AN ERROR,PLEASE CALL 651.284.3037 ST. PAUL,MN 55155 lMMEDIATE�Y. GIVE THIS CARD TO EMPLOYER WALLET DISPLAY COPY STATE OF MINN�SOTA STATE OF MINNESOTA �. z,, : ��we. ��. �u� MASTER PWPlBER �=:`:"r ,. . MAS7ER PLUMBE•R `''• g 6�� ,�� ' �� '•,�� License# PMU61287 - License# PM061287 Expiration�ate 12l3I/2D14 �-:��; ExpirationDafe 12/33/2014 �••, Effective DaSe Ol/Ol/2�13 .�.;�:,.rb Effective Date O1/Ol/20�3 ��»,,,��,�� Originaf Issue�ate 11/10/1999 �►iginai Issue Date lI/10/1999 DANIELJ CLOUGH DANIELJ GLOtJGH 64Q0 HIGH POINT TRL 6400 H1GH POI�IT TRL PRiOR LAKE,MN 55372 PRIOR LAKE,MN 55372 �""""�Q''^°�P""r'y'E^'T°F MECHANlCAL CONTRACTOR BOND � LABOR&lNDUSTRY Cnnsnuctioo Codes and Liceiuing Divi��n Uoensing and CertiNcatien Services 443 iafayette Road N SL Paul,i�iN 56t 55 VYebsite: www.dli.mn.oar�cid.asp Email: Ni_6censeC�state.mn.us Phane: 651.284.5034 .1'his is to certify that the certificate holder is registered as a MBCk1ANICAL CONTRACTOR BOND in the state of R�linnesota and is in cornpliance with h4innesota Statutes 326B.197,and has filed a$25,000 mechanical bond to perfocm gas,heating,ventitation,cooling,air conditioning, fueE buming,or refrigcration work in all areas ofthe state during the registtation period;provided the work performeci complies with the State Ivtechanical Code and[hc cestifiaate liolder maintxins compliancc with the required bond and wotkers Compensation laws. Registration : MECHAI�lCAL CONTRACTOR 80ND � RegNumber : MB005368 PREFERRED PLIJMBIhIG INC � Effective Date : 07/26/2014 � 6400 HIGH POINTTRL � Expiration Date : 07126/2fltB pRIOR LA�tE,MN 55372 � VERIFY 11P TO-DATE STATUS, BOND,AND lNSURANCE INFp AT wuvw.dli.mn.aov/ccldlLieVerifv.asa (ENTEF�i�UMBER}. Sep 22 1408:23,a Preferred Plumbing, Inc. 952-447-5764 p.6 �"'1 A��'�� CERTIFICATE 4F LIABILITY INSURANCE ��v�'�' 'I 112?J2013 THIS �RTIFICATE IS ISSUED RS A MATTER � INFORMATION ONLY AMD CONFERS NO RIGHTS UPON TME CERTIRCA7E HOLDER. THIS CERTIFlCATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE A�ORpED BY THE POLlGES BELOW_ THIS CERTIFICATE OF INSURANCE DOES NOT C�NSTITUTE A CON7RACT BETWEEN THE ISSUING INSURER(S), AUTHORI2ED REPRESENTATIVE OR PRODUCER,AND THE CERTIFlCATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policyt�es�must be endorsed. If SUBROGATION IS WAIVED,s�ject to the t�rns and conditians of tne policy,certain policies may require an erxiorsement.A statemerrt o�this certificate does not canfer rights to the certfficate holder in lieu of such endarsement s . PRODUCER GONTACI' FEDE�ATED MUTUAL INSURANCE COMPANY n ME: ENT T CT C 3 PNONE HOME OFFICE: P.O.90X 32B arc No e:�:888-333-4949 aic No:507-446-4664 ONIATONNA, MN 550&0 AooREss:CLIEN7CONTACTCENTER FEDINS.COM INSURER�S)AFFOROING COVERAGE ryq��( iNsueEe a:FEDERATED MUTUAL INSURANCE COAAPANY 13935 INSUqED 3$6-896-1 INSURER 8: PREFERRED PLUMBING INC INSURERC: 0400 HIGH PCIN'TRL PRIOR LAKE, MN 55372 INSURER D: INSURER E: INSURER F: COVER/1GES CERTIFICATE NUMBER:22 REVISION NUMBER:0 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE IVSURED NAMED ABOVE FOR THE POLICY PERIOD IN6ICATEO. .VOTWITkSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCU6qEN7 WITH RESPECT TO WHICH THIS CERTIFIGATE MAY HE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY 7HE POLICIES DESCRIBED HEREIN IS SUB.FECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIldITS SHO'NN MAY HAVE BEEN REOUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE DL SU9R POL�CY EFF POLICY EXP �Tp NSR Wlro POUCY NUMBER NM/DOIVVV FdM10DJYVYV lIM1T5 GENERAL LfABILITY EACH OCCURRENCE $��OOO�OOO COMMERCIALGENSRALUA&LITV P��ES�RE�WTE�Cc $1��0 CLAIMS•MADE a OCCUR MED EXP(twy one Derson) $$,a�0 A X BUSINE55OWNER'SLIABILI7Y N N 93D6754 'I2/�l/2�13 12/311ZO'I4 PERSONALSADVINJURV $��fl� CENERAL AGGREGATE $2�p Q� GEN'L AGGREGATE LIMIT APPClES PER: PRODUCTS-CQMPlOP AGC ��OOO,OOO X POUCY PRO- JECT �� AVTOMOBILE LIABILRV X AfVY AU70 EaM81'1ED sINGLE LIMIT $;�QQD,ODO BODILY INJURY;Por pwsonl A a�uros�E� AUTOSU`ED N N 9306755 12l31/2013 i2131/2014 BOD11V INJURY(Per actidenU HIRED QUTOS �N-OWNE� AUTOS PROPERTY DAMAGE Pe cdden X UMBRELLA LIAB X OCCUR El�CH OCCUPRENCE $1��QQ�QQQ A EXCESSLIAB cuvks-r�o.oe N N 9885831 12l3'I/2013 12/3112014 l.6CpEGATE $1,000,000 pEp RETENTIOFJ WORKERS COMPEHSATI�N V!C ST47J- OTH- ANO Eb1VlOYERS'LIABIUTY y�N x TOfiY LIMITS . ER A1iY PROPRIETORIPARTNERIEXECt1iIVE E.L.EACN ACCIDEhT $$�O,OOO A OFFICERlMEMBEi E%CLUDED? N�a N 9306756 12/31/2013 � i2;3112014 �6landatory in NH) EL DISEASE-EA EMPLOYEE $�� It yes,descrihe�ndef DESCRIPIICN OF OPERATIONS helow E.L qSEASE•POUCY LIMIT $��Q� DESCRIPiION OF OPERATIONS 1 LOCqiIONS 1 VEHICLES(At�di ACORD 101,Addificnal Rernarks SehetlWe,if more space is requred� CERTIFICATf HOLDER CANCELLATlON 356-893-1 22 p CITY OF OR�NO SHOULD ANY OF TkE ABOIJE DESCRIBED POLICIES BE CANCELLED BEFORE 2750 KELLEY P!(�VY 7HE EXPIRATION DATE THEREOF, NOTICE VJILL BE DEUVERED EN ORONO, MN 55356-9387 ACCORDANCE WITH THE POUCY PROVISIONS. AUTHCRIZED REPRESENTATVE O 19�8-2010 ACORD CORPORATION_All ri�ts reserved ACORD 25(2010l0� The ACORD name anu Iogo are regislered marks of ACORD Sep 22 1408;22a Preferred Plumbing, Inc. 952-447-5764 p.2 PE12M1T FE�CAL;CULATION.S -;JOBS O�ER$SOO:�a If above does not apply;follow guidelines below: 1. CONTRACT PRiCE *is 125"/0 ofcontractprice with a(Minimum Fee of$50.00) ��OOO , °a s.Ol2S�__� IOO, Oa (contract price) (miuimam SSOA�) 2. STATE SURCHARGE � $OC�b ,o v x.0005 � '-� . °o (contracl pricc) 3. POST.�GE&HANDLING(Only on Mail-In Applications) $ 2.00 4. TOTAL PERI4IIT FEE(Add Lines 1-3 Abovc) s ■ * CONTRACT FRICE or JOB COST mcans the actual or estimated dollar amount charged for the pern►itted work including materials,]abor,profit,and other fixed costs. R is the amount to be charged to the customer for the work done. If any material,equipment, labor or installations are fumished by the owner, tenant or any otFier party,the reasonable market value of such items must be added to the estimated cost or contract price for permit fee purposes_ in fhe event that there is a dispute on the amount of the job cos� the City may request the submission of a signed copy of the actual con�act. PLLTMBTNG PERMIT APPLICATIOI�T AGREEME]��T The undersigned hereby applies to the City for issuance of a Phunbing Perrrut, agrees to do all work irz strict accordance with the ordinances of the City and the regulations o€the State of Minnesota, and certifies that all statements made on this appticarion are complete, true and correct. Applicant's Signature: �- Date: `'1� Z-t� I i-} 3 Sep 22 1408:2?,a Preferred Plumbing, Inc. 952-447-5764 p.1 � � � � S � C � t \ � �� j ll!,� - � � 3 — � �. � � .-� o ,� o-. L ,�` �� T L�v--c� � ��cJ T c� S ��" V� �`^ c��1 �� r—o � ✓�c� , � � � ( ` 1� S � �t_�tiC�✓\ . (1 �- (� o � � c\ ` � 1�- L � � � � �---L 1 v1 S � C—��L�� S S o O�!1 � S � V.1 � C� _- � _ � ' i� � .�,� � � � ,I 23 � �. �� _ � � �� _ (�� I <�i�`� ' D E TIME �' CITY OF OR CALLED IN ,D INSPECTION NOTICE SCHEDULED � PERMIT NO. � 'COMPLETED ADDRESS OWNER TELEPHONE NO. " CONTRACTOR r � � DESCRIPTION �" h � ❑ FOOTING ❑ PLUMBING FINAL EXCAV/GRADING/FIWNG Q p POURED WALL ❑ MECHANICAL RI ❑ LAKESHORE/WEfLANDS vj ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNEFl/FIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATEH HOOK-UP ❑ PROGRESS � ❑ FINAL � SEWER HOOK-UP ❑ COMPLAINT v ❑ DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER HEMOVAL J �PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDA710N/REMOVAL 2 OWNERlCONTRACTOR TO MEET YOU:_YES_NO � COMMENTS:d• � ' � t�rti v - �RS sc�. U - o �� U rr �cg� - /5 flo��iK� � �. o� n "�� C�y/D r/t4 G /1��L .Al��s �ar ��p !/c�rtTi � �l•L� � Q �- rh-� . 6.��t .�»,- 3 «� � .. z �La�d�! r�.Qa.t on aQ��i ��a! � �/'Uv � e �•�e�rel� t�c� � .c:.-s �ar � � C G�� !ao✓ ��c� s .L. �(�� 6 r�ct W� .b Gl• L. �[ov r f.�4ff � ❑WORKSATISFACTORY:PR EED ❑PROJECTCOMPLEfE � ❑CORRECT WORK&PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORE C0IIERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑pHOTOTAKEN INSPECTOR WFLL RETURN ❑CITATION ISSUED O STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (952) 249-4600 OwnerlCartractor on site: Inspector: Q� � White CopYllnspector's Ffle Canary CopYlSite Notiee ✓ DATE TIME � CITY OF ORONO CALLED IN INSPECTION NOTICE SCHEDULED PERMIT NO. Z-014•b�7� anP ED . ADDRESS OWNER TELEPHONE NO. CONTRACTOR / � DESCRIPTION � � ❑ FOOTING PLUMBING FINAL 0 EXCAV/GRADING/FIWNG Q ❑ POURED WALL ❑ MECHANICAL RI p LAKESHORFJWEfLANDS y ❑ FRAMING ❑ MECHANICAL FINAL � TREE REMOVAL 2 ❑ INSULATION ❑ WOOD BURNERIFIREPLACE O SITE INSPECTION Q p RADON SLAB ❑ WATER HOOK-UP O PROGRESS � � FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v O DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL v ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL 2 OWNEWCONTiiACTOR TO MEET YOU:_YES_NO y COMMENTS: � W � � J O �. a� O � W � Q � W � � � i j W � WORKSATISFACTORY:PROCEED ❑PROJECTCOMPLEfE � ❑ RRECT VI�RK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY W O ❑CORRECT WORK,CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑pHOTO TAKEN INSPECTOR WILL RETURN ❑CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in a ance. (952) 2 9-4600 OwnerlContractor on site: Inspector. White CopyAnspectoPs File anary CopylSfte Notke ��,� DATE TIME � CITY OF ORONO ( CALLED IN �� INSPECTION NOTICE b�r}� SCHEDULED � PERMIT NO. � ��` � COMPLETED ADDRESS �� OWNER TELEPHO NO. ��'��3�� CONTRACTOR � �� DESCRIPTION � �� O FOOTING ❑ PLUMBING FINAL ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANICALRI ❑ LAKESHORENVETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL p TREE REMOVAL Z ❑ INSULATION ❑ WOOD BURNERJFIREPLACE ❑ SITE INSPECTION Q ❑ RADON SLAB ❑ WATER HOOK-UP ❑ PROGRESS � ❑ FINAL ❑ SEWER HOOK-UP ❑ COMPLAINT v � DEMO-SITE ❑ SEPTIC MAINT. ❑ FOLLOW-UP _ ❑ DEMO-FINAL 0 SEPTIC JNSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI O SE FINAL ❑ FOUNDATION/REMOVAL 2 OWNERICONTRACTOR TO M YES_NO y COMMENTS: � l,/.(. - �w✓ - I�85 ,s��►• S�D � - o f1'i� � �s� �fe�//��.�� /� 6 es�• �. � ° b!C �r� c4'�v� ✓ W � Q � 2 W � W � J � �VORKSATISFACTOHY:PROCEED ❑ PROJECT COMPLETE W ❑CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY O ❑CORRECT WORK CALL FOR REINSPECTION TEMPORARY V BEFORECONERING PERMANENT ❑CORRECT UNSAFE CONDITION WITHIN HOURS. ❑ PHOTO TAKEN INSPECTOR WFLL RETURN O CITATION ISSUED ❑STOP ORDER POSTED.CALL INSPECTOR O INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call forthe n xt inspection 24 hours in advance. (952) 249-46�� Ow oMractoro '! .�o��y inspector. w White Copyllnspector's File Cenary CopylSite Notke �C/'r�� DATE TIMF� 1 CITY OF ORONO CALLED IN ��L� INSPECTION NOT�_CE _O`� SCHEDULED /- 7�S �/.',3� PERMIT NO. ��'�� COMPLETED ADDRESS ��_�S`� /�,J�'L l�Y�- �� L (l`�� OWNER TEL��ONE NO - � �- CONTRACTOR ��'l � DESCRIPTION �� ❑ FOOTING �PLUMBING F L ❑ EXCAV/GRADING/FILLING Q ❑ POURED WALL ❑ MECHANI RI ❑ LAKESHORE/WETLANDS y ❑ FRAMING ❑ MECHANICAL FINAL ❑ TREE REMOVAL 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 ? ❑ DEMO-FINAL ❑ SEPTIC INSTALL ❑ HARD COVER REMOVAL J ❑ PLUMBING RI ❑ SEPTIC FINAL ❑ FOUNDATION/REMOVAL � OWNERICONTRACTOR TO MEET YOU:_YES_NO � COMMENTS: � a i�J'�b n� �s �o��ws ' � J O � �i,�ce✓e� — S tt .� Se�l�� — o _ Q � �/�d(/�G C[1wtLJ�sL�lo�i, G�r 8� z k!�r �t.o�'2/� !n� �'o w�� S�- r.�.�' � ��Gs w � � rer�Gv2 �'vo� von fT a � ctG .rc e.r Co�,�.� ��o.z a�r ��v�w�o �— W� ❑WORKSATISFACTORY:PROCEED n�� ❑ PROJECTCOMPLETE W �'CORRECT WORK 8 PROCEED �GS ❑ ISSUE CERTIFICATE OF OCCUPANCY �O CORRECT WORK,CALL FOR REINSPECTION / TEMPORARY V BEFORECWERING PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. ❑ pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR �CITATION ISSUED ❑INSPECTION REQUIRED.CALL TO ARRANGE ACCESS. Call for the next inspection 24 hours in advance. (J52� 249-4600 OwnerlContractor on site: Inspector. '� r,� � i% White Copyllnspector's File Canary CopylSite Notice