HomeMy WebLinkAboutCertificate of Occupancy CITY HALL
Inspection Services Div
215 Church Avenue City of Oshkosh
PO Box 1130
Oshkosh WI
54903 -1130
Of - <O f _ Approved: 8/2/04
ON THE WATER Issued: 8/4/04
Steven /Susan VerHoven
2391 Shore Preserve Drive
Oshkosh, WI 54904
CERTIFICATE OF OCCUPANCY
An Occupancy Permit is hereby granted for the single family residence located at 2391
Shore Preserve Drive, Oshkosh, Wisconsin 54904 as described in Building Permit
Application number(s) 103428.
This building is to be used only as a single family residence and is located in the R -1 PD,
Single Family Residence District with a Planned Development Overlay.
LIMITATIONS:
Maximum persons and /or living units: One living unit
CONDITIONS:
1) Final grading must be done in accordance with the approved subdivision drainage
plan. This plan is on file in the public works office, 3 floor of City Hall.
2) Erosion control measures must be maintained until the lawn is established.
Note: Final grade must be a minimum of 6" below all siding.
NOTE:
1) Copies of inspection results are available upon request in room 205, City Hall.
2) Future permits may be required for additional work to your property.
A new Certificate of Occupancy shall be required prior to occupancy, should additional
building(s) be erected, or should any buildings mentioned above be altered or moved.
The use of land, or buildings, shall not be changed until a Certificate of Occupancy is
issued for that occupancy. All conditions noted above must be complied with in order
for this certificate to be valid.
1
uildi ystems Inspector
cc: Comerstone Homes
City of Oshkosh
Division of Inspection Services
215 Church Avenue
PO Box 1130
Oshkosh WI 54903 -1130
OOH
ON THE WATER
7/20/04
Re: Certificate of Occupancy for 2391 Shore Preserve Drive
A review of the inspection records revealed a Certificate of Occupancy has not been issued. You have
failed to arrange the necessary inspection(s) to verify code compliance. Our records indicate:
A Final Electrical Inspection was not approved.
Without a Certificate of Occupancy there may be delays with any future sale or refinancing of the
property. Please contact this office to make arrangements for the required inspection(s) to be performed.
Your cooperation in complying with the Certificate of Occupancy Ordinance is appreciated. Please call
236 -5050 if you have any questions.
cc: Cornerstone Homes
Building Permit Work Card
Job Address 2391 SHORE PRESERVE DR Permit Number 0103428 Create Date 8/5/03
Owner CORNERSTONE HOMES Contractor CORNERSTONE HOMES
Category 110 - New Single Family
Type • Building 0 Sign 0 Canopy 0 Fence 0 Raze Plan E1- 100 -0803R
Zoning R -1 Class of Const: 8 Size IRR Value $206,000.00
Unfinished /Basement 2414 Sq. Finished /Living 2414 Sq. Ft. Garage 755 Sq. Ft.
Ft.
Rooms 3 Bedrooms 3 Baths 3 ❑ Projection
Stories 1 Height 28 Ft. Canopies 0 Signs 0
Foundation • Poured Concrete 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
Occupany Permit Required Flood Plain No Height Permit Not Required
Park Dedication Required # Dwelling Units 1 # Structures 1
Use /Nature NSFR/ 1 story with a 3 car attached garage, 14'x16' rear patio.
of Work
HVAC Contr BREWER HEATING Plumbing Contr HANSON QUALITY PLUMBING
Electric Contr UNKNOWN ? ? ??
Inspections:
Date 4/28/04 • Type Final Inspector John Zarate not approved
REQUEST LINE / ALSO REQUESTED FINAL FOR HVAC Send Occupancy by Fax. 233 -4185
Date/Time requested: 4/27/04 09:53 AM Notice Type: FC Phone Number: JACK 233 -4342
Access:
KEY KEEPER 5490 JACK WOULD LIKE TO BE PRESENT
Ready Date/Time: 4/28/04 08:00 AM Requested By: CORNERSTONE HOMES
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Date 4/29/04 • Type Re Final Inspector John Zarate approved
REQUEST LINE
Date/Time requested: 4/29/04 08:26 AM Notice Type: Phone Number: JACK 233 -4342
Access:
OPEN
Ready Date/Time: 4/29/04 08:26 AM Requested By: CORNERSTONE HOMES
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Building Permit Work Card
Job Address 2391 SHORE PRESERVE DR Permit Number 0103428 Create Date 8/5/03
Owner CORNERSTONE HOMES Contractor CORNERSTONE HOMES
Category 110 - New Single Family
Type • Building 0 Sign 0 Canopy 0 Fence 0 Raze Plan E1- 100 -0803R
Zoning R -1 Class of Const: 8 Size IRR Value $206,000.00
Unfinished /Basement 2414 Sq. Finished /Living 2414 Sq. Ft. Garage 755 Sq. Ft.
Ft.
Rooms 3 Bedrooms 3 Baths 3 ❑ Projection
Stories 1 Height 28 Ft. Canopies 0 Signs 0
Foundation • Poured Concrete 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
Occupany Permit Required Flood Plain No Height Permit Not Required
Park Dedication Required # Dwelling Units 1 # Structures 1
Use /Nature NSFR/ 1 story with a 3 car attached garage, 14'x16' rear patio.
of Work
HVAC Contr BREWER HEATING Plumbing Contr HANSON QUALITY PLUMBING
Electric Contr UNKNOWN ? ? ??
Inspections:
Date 10/31/03 Type Insulation Inspector Nicole Krahn no time
REQUEST LINE.
Date/Time requested: 10/30/03 01:44 PM Notice Type: Phone Number: 233 -4342
Access:
Open
Ready Date/Time: 10/31/03 10:00 AM Requested By: CORNERSTONE HOMES - Jack Nelson
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Date 11/26/03 Type Rough In Inspector John Zarate
cancelled
REQUEST LINE. Inspect the shower.
It was actually a plbg question. Transferred info to RW.
Date/Time requested: 11/26/03 10:26 AM Notice Type: Phone Number: 233 -4342
Access:
Lockbox 1239.
Ready Datemme: 11/26/03 10:26 AM Requested By: CORNERSTONE HOMES - Jack Nelson
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Building Permit Work Card
Job Address 2391 SHORE PRESERVE DR Permit Number 0103428 Create Date 8/5/03
Owner CORNERSTONE HOMES Contractor CORNERSTONE HOMES
Category 110 - New Single Family
Type • Building 0 Sign 0 Canopy 0 Fence 0 Raze I Plan E1- 100 -0803R
Zoning R -1 Class of Const: 8 Size IRR Value $206,000.00
Unfinished /Basement 2414 Sq. Finished /Living 2414 Sq. Ft. Garage 755 Sq. Ft.
Ft.
Rooms 3 Bedrooms 3 Baths 3 ❑ Projection i
Stories 1 Height 28 Ft. Canopies 0 Signs 0
Foundation • Poured Concrete 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
Occupany Permit Required Flood Plain No Height Permit Not Required
Park Dedication Required # Dwelling Units 1 # Structures 1
Use /Nature NSFR/ 1 story with a 3 car attached garage, 14'x16' rear patio.
of Work
HVAC Contr BREWER HEATING Plumbing Contr HANSON QUALITY PLUMBING
Electric Contr UNKNOWN ? ? ??
Inspections:
Date 10/29/03 11:00 AM Type Re Rough In Inspector Nicole Krahn approved
REQUEST LINE.
Date/Time requested: 10/28/03 01:33 PM Notice Type: Phone Number: 233 -4342
Access:
Open. He'd like to be present. He'd like the inspection conducted on 10/28pm or 10/29am.
Ready Date/Time: 10/29/03 01:33 PM Requested By: CORNERSTONE HOMES - Jack Nelson
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Date 10/29/03 11:00 AM Type Drain Tile Inspector Nicole Krahn approved
REQUEST LINE.
Datemme requested: 10/28/03 03:51 PM Notice Type: Phone Number: 379 -6852
Access:
Go through the basement window.
Ready Date/Time: 10/28/03 03:51 PM Requested By: Brett Resop from Fox Valley Flatwork
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Building Permit Work Card
Job Address 2391 SHORE PRESERVE DR Permit Number 0103428 Create Date 8/5/03
Owner CORNERSTONE HOMES Contractor CORNERSTONE HOMES
Category 110 - New Single Family
Type • Building O Sign Q Canopy O Fence O Raze I Plan E1- 100 -0803R
Zoning R -1 Class of Const: 8 Size IRR Value $206,000.00
Unfinished /Basement 2414 Sq. Finished /Living 2414 Sq. Ft. Garage 755 Sq. Ft.
Ft.
Rooms 3 Bedrooms 3 Baths 3 ❑ Projection
Stories 1 Height 28 Ft. Canopies 0 Signs 0
Foundation • Poured Concrete O Floating Slab O Pier O Other
0 Concrete Block 0 Post 0 Treated Wood
• ccupany Permit Required Flood Plain No Height Permit Not Required
Park Dedication Required # Dwelling Units 1 # Structures 1
Use /Nature NSFR/ 1 story with a 3 car attached garage, 14'x16' rear patio.
of Work
HVAC Contr BREWER HEATING Plumbing Contr HANSON QUALITY PLUMBING
Electric Contr UNKNOWN ? ? ??
Inspections:
Date 9/2/03 • Type Foundation Backfill Inspector John Zarate approved
REQUEST LINE.
Date/Time requested: 9/2/03 11:44 AM Notice Type: Phone Number: 233 -4342
Access:
He'd like to be present.
Ready Date/Time: 9/2/03 11:44 AM Requested By: CORNERSTONE HOMES - Jack Nelson
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Date 10/28/03 Type Rough In Inspector John Zarate not approved
REQUEST LINE.
Date/Time requested: 10/28/03 08:04 AM Notice Type: FC Phone Number: 233 -4342
Access:
Open. Call him when you're on your way.
Ready Date/Time: 10/28/03 08:04 AM Requested By: CORNERSTONE HOMES - Jack nelson
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Building Permit Work Card
Job Address 2391 SHORE PRESERVE DR Permit Number 0103428 Create Date 8/5/03
Owner CORNERSTONE HOMES Contractor CORNERSTONE HOMES
Category 110 - New Single Family
Type • Building 0 Sign 0 Canopy 0 Fence 0 Raze Plan E1- 100 -0803R
Zoning R -1 Class of Const: 8 Size IRR Value $206,000.00
Unfinished /Basement 2414 Sq. Finished /Living 2414 Sq. Ft. Garage 755 Sq. Ft.
Ft.
Rooms 3 Bedrooms 3 Baths 3 ❑ Projection
Stories 1 Height 28 Ft. Canopies 0 Signs 0
Foundation • Poured Concrete 0 Floating Slab 0 Pier 0 Other
0 Concrete Block 0 Post 0 Treated Wood
Occupany Permit Required Flood Plain No Height Permit Not Required
Park Dedication Required # Dwelling Units 1 # Structures 1
Use /Nature NSFR/ 1 story with a 3 car attached garage, 145(16' rear patio.
of Work
HVAC Contr BREWER HEATING Plumbing Contr HANSON QUALITY PLUMBING
Electric Contr UNKNOWN ? ? ??
Inspections:
Date 8/20/03 09:12 AM Type Footings Inspector John Zarate cancelled
FAXED REQUEST. Ready 3:30pm- 4:30pm on 8/20.
Cancelled by J Skotzke.
Date/Time requested: 8/20/03 05:30 AM Notice Type: Phone Number: 231 -1667
Access:
Ready Date/Time: 8/20/03 03:30 PM Requested By: JOHN SKOTZKE CONCRETE CONST
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Date 8/20/03 Type Footings Inspector Nicole Krahn no time
FAXED REQUEST. Ready 1pm -2pm on 8/20.
Date/Time requested: 8/20/03 09:12 AM Notice Type: Phone Number: 231 -1667
Access:
Ready Date/Time: 8/20/03 01:00 PM Requested By: JOHN SKOTZKE CONCRETE CONST
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Electric Permit Work Card
Job Address 2391 SHORE PRESERVE DR Permit Number 104007 Create Date 08/11/2003
Owner JACK NELSON Contractor SCHOMMER ELECTRICAL CONTRACTII
Category 611 - Residential -New Single Family Wiring
Service a New 0 Change 0 Temp 0 N/A Type 0 Overhead • Underground 0 N/A
Volts 120/240 Circuits 0 Fixtures 0
Amps 200 Switches 0 Receptacles 0
Fee $120.00 Value $5,300.00
Appliances Range, Dishwasher, Fan or Blower, Garbage Disposal, Fumace, Dryer & NC.
Use /Nature NSFR/ New home wiring.
of Work
Inspections:
Date 07/29/2004 Type Re Final Inspector Kevin Benner not approved
REQUEST LINE
Reviewed with the General Contractor (Jack) & the Owner (Steve). The G.C. mentioned that the violations
would be corrected on Mon. 8/2/04
Date/Time requested: 07/21/2004 12:11 PM Notice Type: FC Phone Number: 233 -0661 JACK NELSON
Access:
CALL HOMEOWNERS 235 -0661
Ready Date/Time: 07/21/2004 12:11 PM Requested by: CORNERSTONE HOMES
0 Reinspect Fee 0 Fee Wavied 0 Reinspect Fee Paid
Date 08/02/2004 Type Re Final Inspector Kevin Benner approved
Date/Time requested: 08/02/2004 11:23 AM Notice Type: Phone Number:
Access:
Ready Date/Time: 08/02/2004 11:23 AM Requested by: Steve (Owner)
0 Reinspect Fee 0 Fee Wavied Reinspect Fee Paid
Electric Permit Work Card
Job Address 2391 SHORE PRESERVE DR Permit Number 104007 Create Date 08/11/2003
Owner JACK NELSON Contractor SCHOMMER ELECTRICAL CONTRACTIF
Category 611 - Residential -New Single Family Wiring
Service p New 0 Change 0 Temp 0 N/A Type 0 Overhead • Underground 0 N/A
Volts 120/240 Circuits 0 Fixtures 0
Amps 200 Switches 0 Receptacles 0
Fee $120.00 ❑ Value $5,300.00
Appliances Range, Dishwasher, Fan or Blower, Garbage Disposal, Furnace, Dryer & NC.
Use /Nature NSFR/ New home wiring.
of Work
Inspections:
Date 04/27/2004 Type Final Inspector Jon Fischer not approved
FAXED REQUEST / READY AT THE END OF THE DAY
4/27/04 job not complete yet
Date/Time requested: 04/26/2004 11:01 AM Notice Type: Phone Number: BOB 731 -2299
Access:
Ready Date/Time: 04/26/2004 : Requested by: SCHOMMER ELECTRICAL CONTRACTIN
0 Reinspect Fee 0 Fee Wavied ❑ Reinspect Fee Paid
Date 05/20/2004 Type Re Final Inspector Jon Fischer not approved
FAXED REQUEST
5/20/04 I called Jack nelson and left a message to get in
Date/Time requested: 05/19/2004 02:15 PM Notice Type: Phone Number: 731 -2299
Access:
JACK NELSON 233 -4342
Ready Date/Time: 05/19/2004 02:15 PM Requested by: SCHOMMER ELECTRICAL CONTRACTIN
0 Reinspect Fee 0 Fee Wavied ❑ Reinspect Fee Paid
Electric Permit Work Card
Job Address 2391 SHORE PRESERVE DR Permit Number 104007 Create Date 08/11/2003
Owner JACK NELSON Contractor SCHOMMER ELECTRICAL CONTRACTIF
Category 611 - Residential -New Single Family Wiring
Service 0 New O Change° Temp O N/A Type O Overhead • Underground 0 N/A
Volts 120/240 Circuits 0 Fixtures 0
Amps 200 Switches 0 Receptacles 0
Fee $120.00 ❑ Value $5,300.00
Appliances Range, Dishwasher, Fan or Blower, Garbage Disposal, Fumace, Dryer & NC.
Use /Nature NSFR/ New home wiring.
of Work
Inspections:
Date 09/10/2003 Type Service Inspector Jon Fischer approved
FAXED REQUEST. Please inspect at the end of the day on 9/8/03.
9/10/03 called in
9/15/03 mailed in
Date/Time requested: 09/08/2003 11:16 AM Notice Type: Phone Number: 920 - 731 -2299
Access:
Ready Date/Time: 09/08/2003 12:00 PM Requested by: SCHOMMER ELECTRICAL CON - Bob
0 Reinspect Fee O Fee Wavied ❑ Reinspect Fee Paid
Date 10/28/2003 Type Rough In Inspector Jon Fischer approved
FAXED REQUEST. NOTE: Check ground in low voltage cove Tight on final.
Date/Time requested: 10/28/2003 01:06 PM Notice Type: Phone Number: 731 -2299
Access:
Ready Date/Time: 10/28/2003 01:06 PM Requested by: SCHOMMER ELECTRICAL CON
0 Reinspect Fee 0 Fee Wavied ❑ Reinspect Fee Paid
HVAC Permit Work Card
Job Address 2391 SHORE PRESERVE DR Permit Number 104846 Create Date 08/11/2003
Owner JACK NELSON Contractor BREWER HEATING
Category 502 - Residential -Both Plan
Fuel 11 Gas Oil I Electric Solar Solid Value $3,900.00
System 0 New ❑ Replace ❑ Other
u Forced Air u Radiant u Steam U NC _f Vent
Li Electric U Not Water u Suppl. u Con. Burner
Chimney Type 0 Chimney A 0 Chimney B • Direct Vent 0 Not Applicable
Heat Loss 10 As Approved 0 Existing • Not Applicable Value 0
BTU Rate 0 As Per Plan 0 Variable • Other Value
Use /Nature NSFR/ Install HVAC system for new home.
of Work
Inspections:
Date 10/29/03 Type Rough In Inspector Nicole Krahn approved
REQUEST LINE.
Date/Time requested: 10/28/2003 02:49 PM Notice Type: Phone Number: 920 - 748 -6494
Access:
Ready Date/Time: 10/28/2003 02:49 PM Requested By: BREWER HEATING - Mike
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Date 4/28/04 Type Final Inspector John Zarate approved
REQUEST LINE / JACK NELSON CALLED IN FOR FINAL
Date/Time requested: 04/27/2004 09:53 AM Notice Type: Phone Number: JACK NELSON 233 -4342
Access:
Ready DateTme: 04/28/2004 08:00 AM Requested By:
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Plumbing Permit Work Card
Job Address 2391 SHORE PRESERVE DR Permit Number 104789 Create Date 08/11/2003
Owner JACK NELSON Contractor LARRY HANSEN PLBG
Category 410 - Residential- Interior Plan Value $9,180.00
Bathtub 1 Shower 1 Ejector /Grind 1 Dip Well 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 1 Water Softner 0 Drink Ftn 0 Sery Sink 0 Soda Disp 0
Lavatory 6 Lndry Tray 1 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 4 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 FIr/Wst Sink 0 Int Grease Trap 0
Res. Sink 1 Disposal 1 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Bar Sink 0 Dishwasher 1 Beer Tap 0 Sculry Sink 0 Wash Ftn 0
Water Heater 1 Sump Pump 1 Dent. Oper. 0 Hand Sink 0 Urinal 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use /Nature NSFR
of Work
Size Material Type # Conn.Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0
0
Date 4/30/04 Type Final Inspector WJ (Chip) Callies approved
request line / ready at 10:00 am
Datemme requested: 4/28/04 09:32 AM Notice Type: Telephone Number: darlene 757 -6863
Access:
code on garage is 2391
Ready Date/Time: 4/28/04 10:00 AM Requested By: LARRY HANSEN PLBG
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Plumbing Permit Work Card
Job Address 2 SHORE PRESERVE DR Permit Number 104789 Create Date 08/11/2003
Owner ,JACK NELSON Contractor LARRY HANSEN PLBG
Category 410 - Residential- Interior Plan Value $9,180.00
Bathtub 1 Shower 1 Ejector /Grind 1 Dip Well 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 1 Water Softner 0 Drink Ftn 0 Sery Sink 0 Soda Disp 0
Lavatory 6 Lndry Tray 1 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 4 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 Flr/Wst Sink 0 Int Grease Trap 0
Res. Sink 1 Disposal 1 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Bar Sink 0 Dishwasher 1 Beer Tap 0 Sculry Sink 0 Wash Ftn 0
Water Heater 1 Sump Pump 1 Dent. Oper. 0 Hand Sink 0 Urinal 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use /Nature NSFR
of Work
Size Material Type # Conn.Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0
0
Date 11/26/03 Type Rough In Inspector Rich Wood approved w /cond.
SHOWER SAFEING APPROVED - RI COVERED
Date/Time requested: 11/26/03 01:09 PM Notice Type: Telephone Number:
Access:
Ready Date/Time: 11/26/03 01:09 PM Requested By:
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid
Plumbing Permit Work Card
Job Address 2391 SHORE PRESERVE DR Permit Number 104789 Create Date 08/11/2003
Owner JACK NELSON Contractor LARRY HANSEN PLBG
Category 410 - Residential- Interior Plan Value $9,180.00
Bathtub 1 Shower 1 Ejector /Grind 1 Dip Well 0 F Prep Sink 0 Gar Drain 0
Whirlpool 0 Floor Drain 1 Water Softner 0 Drink Ftn 0 Sery Sink 0 Soda Disp 0
Lavatory 6 Lndry Tray 1 Local Waste 0 Wait. St. 0 Shamp Sink 0 Coffee Maker 0
Toilet 4 Lndry Stndp 0 Clothes Wshr 0 Ice Chest 0 Flr/Wst Sink 0 Int Grease Trap 0
Res. Sink 1 Disposal 1 Bidet 0 Exam Sink 0 Catch Basin 0 Ext Grease Trap 0
Bar Sink 0 Dishwasher 1 Beer Tap 0 Sculry Sink 0 Wash Ftn 0
Water Heater 1 Sump Pump 1 Dent. Oper. 0 Hand Sink 0 Urinal 0
Site Drain 0 Classrm Sink 0 Lab Sink 0 Plaster Sink 0 Standp Rec 0
Roof Drain 0 Breakrm Sink 0 Sterilizer 0 Surgeons Sink 0 Ice Maker 0
Use /Nature NSFR
of Work
Size Material Type # Conn.Type
Sanitary Sewer 0
0
0
0
0
Storm Sewer 0
0
0
0
0
Water Service 0
0
0
0
0
Date 10/23/03 Type Underground Inspector Rich Wood approved
FAXED REQUEST.
Date/Time requested: 10/22/03 10:42 AM Notice Type: Telephone Number: 757 -6863
Access:
Ready Date/Time: 10/22/03 03:00 PM Requested By: LARRY HANSEN PLBG
0 Reinspect Fee 0 Fee Waived ❑ Reinspect Fee Paid