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CORRECTION NOTICE / FIELD INSPECTION REPORT
JOBLOCATION:1:IOD-llto6 \..0 So ~C"'"~
CONTRACTOR:-1k\.\...\\ac- 8.-e.c::~..:,=.c-\ "-
PROJECT TO BE INSPECTED: i t.t ~
TYPE OF INSPECTION: 1=;~\ 'G.\e~\ t.-
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r-ity of Oshkosh
spection Services Division
215 Church Avenue, PO Box 1130
Oshkosh, WI 54903-1130
Phone: (920) 236-5050
Fax (920) 236-5084
Violations must be corrected and approved within 30 days unless otherwise noted. Call for re-inspections prior to concealment
and/or occupancy. Upon completing the corrections, the owner/contractor/agent must sign and date at the bottom of this notice
and return it to the Inspection Services Division by the Compliance Date of
.;l'~MftOO])E INSPECTION RESULT
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)!.j Not Approved! Insp. Report left on site 0 Not Approved! Insp. Report given to
S;gned Q~es';;;;Sion :310 ~1 ?rInspocnon
o Mailed/Faxed
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Phone #
Print Name
Company
Signature:
Date
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