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TY OF OSHKOSH, CO�E ENFORCIIIENT DIVISION, 215 CHt1RCH AVENUE, OSNKOSH, WISCONSIN 54901
VIOLATION/CORRECT/ON NOTICE
DATE INSPECiED:
;CUPANCY LIJSP6CSED
10RE55
iNEAS NAME ANU ADORESS �
)TICE DELIVERED/EXPLAINED S0:
c<:
rQ� ! OADER FINDINGS OF INSPECTION
ILHR
5C.1u CGMPLeTION STATENiENT. Upon compietion of the construction, t e super-
vising architect, engineer or designe�os{helbest of histornheraknownt
with the department certifying that,
ledge and beiief, construction has been performed in substantial
compiiance with the approveG pians and specifications.
LNSPECTOR:
IeWCE DAiE: