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2019-09-18_PERMIT FILE - C1981035 (10)
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2019-09-18_PERMIT FILE - C1981035 (10)
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Last modified
10/8/2019 9:09:43 AM
Creation date
10/8/2019 9:01:35 AM
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Template:
DRMS Permit Index
Permit No
C1981035
IBM Index Class Name
PERMIT FILE
Doc Date
9/18/2019
Doc Name
Reclamation Bond Information/Estimates
Section_Exhibit Name
KI Appendix 12
Media Type
D
Archive
No
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PROPERTY INSPECTION REPORT <br />�1 /X /-7 � <br />CLIENT: <br />RESS: Zj I Z� <br />v ERATION/PERMIT NO: <br />PROPERTY INSPECTED: �irZlvT��'��4 <br />-?o o Co <br />Street Cy <br />5 r►t/-"U C' <br />City State ip Code <br />Phone Number <br />Alzt�L <br />OWNER'S NAME: 4;z <br />Frame Construction: <br />Wood Frame ✓ <br />Concrete Block <br />Other <br />�v .c <br />(Describe) <br />0 <br />ment Construction: <br />Walls: Cncrt. Blk. <br />Stone <br />Tile <br />OtherFloor: Concrete <br />Concrete <br />Dirt <br />Main Beam: Steel <br />Wood <br />Wall Suprt <br />City <br />Softener <br />Spring <br />Gravity Fed <br />Pump Type <br />Age of Spring <br />O-MMENTS: <br />Exterior Finish: <br />Brick <br />Stone <br />Wood <br />Alum. Or Vinyl <br />Concrete Block <br />Other Lo19 <br />Describe) <br />Garage: Size, Construction <br />Attached <br />Detached <br />Integra <br />A—; W <br />WATER SUPPLY <br />(Information from owner/tenant) <br />Well <br />Drilled Hand Dug <br />Pump <br />Submersible <br />Jet/Shallow <br />Piston <br />Age Depth <br />SW Level <br />page Of -5, <br />Date of Inspection: J l 2 Z �ZOyz <br />10 <br />Type of Inspection: <br />Pre -Blast <br />Pre -Construction <br />Post -Blast ( ) <br />Other Of9� <br />Inspector, <br />(Signature) <br />Structure Type: <br />Residential V� <br />Commercial <br />Architectural Description: <br />Story (# of floors) S - <br />Ranch <br />Mobile <br />Split Entry <br />Other <br />Age of Building 2')(z T_M <br />Location of Property if above address is not <br />specific or owner's address is different: <br />Roof: <br />Shingle <br />Tile/Slate <br />Tar/Chip <br />Tar Paper <br />Metal <br />Water Samples Taken: <br />Yes No <br />Water - Gal./Mii <br />Observable Water <br />Conditions: <br />Iron Sulfur. <br />l-� <br />Property Owner or Occupant Signature: <br />
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