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PROPERTY INSPECTION REPORT <br />CLIENT: ~/-1 ~ ~(~~~,~ <br />RESS: ~{yZy ~ . ~ ~Z~ <br />v ERATION/PERMIT NO: <br />PROPERTY INSPECTED: ~ir'Zlv~T~~ ~~',~~~~ <br />Street ~y <br />5 r-t/-"U C' <br />City State ip Code <br />Phone Number <br />~~~~ L <br />OWNER'S NAME: ~'~,~ ~ll-~`!`~~ <br />Frame Construction: <br />Wood Frame / <br />Concrete Block <br />Other ~~ ~--~;., ! ~ <br />~~ ~v ~~ .~ <br />(Describe) <br />• ment Construction: <br />Walls: Cncrt. Blk: <br />Stone <br />Tile <br />Other r^s k~~~:~~' ~~-~~- <br />Floor: Concrete <br />Dirt <br />Main Beam: Steel <br />Wood~- <br />Wall Suprt <br />Exterior Finish: <br />Brick <br />Stone <br />Wood <br />Alum. Or Vinyl <br />Concrete Block <br />Other Low <br />Describe) <br />Garage: Size, Construction <br />Attached <br />Detached <br />Integra <br />~~. . <br />WATER SUPPLY <br />(Information from owner/tenant) <br />City <br />Softener <br />Spring <br />Gravity Fed <br />Pump Type <br />Age of Spring <br />~MMENTS: <br />Well <br />Drilled Hand Dug <br />Pump <br />Submersible <br />Jet/Shallow <br />Piston <br />Age Depth <br />SW Level <br />page ~ of,~ <br />Date of Inspection: J l ,Z Z ~ZOyz <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) _ 5--~ <br />Ranch <br />Mobile <br />Split Entry <br />Other <br />Age of Building ~s~-b-T_~ <br />Location of Property if above address is not <br />specific or owners 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 />