BP4086TYPE OF INSPECTION ROUGH FINAL AMOUNT DUE DATE PAID SUB -CONTRACTORS
Terfporary'Service
Footings
Framing
Permanent Service
Plumbing
Electrical
Heating
Air Conditioning
Septic/Sewer Inspection
Water Inspection
Sewer Tap
Water Tap
Remote
Final Inspection G�'�i 13181
COMMENTS:
DATE
Also PxD`-L"S1
Remodeling - replacing windows, doors,:siding, etc.
11 -1 2-dePPLICATION NO.: 3880 AMOUNT PAID: $4700.00 - $15.00 #74413
,PERMIT NO.: Anne ADDRESS: h 21 t' St t
NAME:
JORGENSEN CONT/Melvin Rathjen
255 Nort s ree
LOCATION:
_ot 3 Blk 96 255 North 21st Street
Inspection has been requested for p)65 `)O• d(1J3+ a
Location of Building
ByZ � 'Lo
ame of Company "fYY)0Cb"
On
pe of Inspection
Date
Results of the Inspection are:
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do
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City Representative