Laserfiche WebLink
2013 LARGE STORM RESPONSE PAPER FORM CHECKLIST <br />G <br />Dale ol insoecGon: � � � <br />Insperted By: �r� ^k MU �s, �(� e I OJ.y S <br />Rd(�ff?55: I\ O� Li . �J ����eU lS I VJ� ' Service RPquesl �nmber. <br />ResidenC Q 11` ��W`p " Owner? �YES 0 NO <br />Phone Number: Z.0 � � % `1 �V y u Finail: _ �l�-L1'�(.1(,t ^+f C� �o % i1�fJ // . �',LJ1�'j <br />General Building Detaiis: <br />Is lhis buildinq wilhln Ihe combined sewar area7 � YES �NO <br />�oes the builtling have a backvialer vaive (BN9�)? ❑ YES �NO <br />Does the Guilding have a sump pump? ❑ YES j�NO <br />Does lhe building have a basem?nl^ [� YES NO <br />(Ityzs) N'as BVdV installed lhrough City program ❑ YES �`jNO <br />Does the building have a gnnder pump? 0 YGS [gd0 <br />Starm Evenl Details: <br />P,'here did water entenng huilding crome trom? ❑ SURFACE FLOW � GROU�DINATER U SEV7ER aACKUP - FIXTURES �U�:ICNON'N <br />Details:.�h1_P-i,\J�C) O1 �..i.�P1��1 �.U.,��� OJ� GT '`'`� l���e�, <br />Vdhere di� weter go within Ihe b�ilding? � BASEMENT PERIAIEI ER [� BASEMENT NEAR FIXTURES ❑ OTHER <br />� Details:�lu,•�`� �`fei.Cn} h^�+` (�U('���� <br />J d <br />; <br />Site Observalions: <br />Dov:nspoul f sile grading issues noted _ <br />,+�o.,�ti r���;, �� p�pe I� ���1�.. o� �.s-t }a <br />Ouilding eleva6on relative to sewer and surmunding area issues noted: <br />Sde pump issues noted: � <br />Histarical Information I Other Information: <br />�U^, � I�U� "� �l—�s� <br />� s��ce �=�dh ��„ � <br />Previous'floc�ding'issueServi:eRequeslsataddress: N�^� p <br />Previous "Ilo��ding' issues no(ed by homeowncr v� "P^� � rt��,.!-,.I S� ^« ��1��� r,�.3� �Q�li h� <br />Recenl slom�water 1 sewer projects oompleted in area: Proposed slormwater 1 sewer projects in area: _ <br />Property owrer inlcrested in be�inning Cily BacAwaler Value Program at address �] YES ❑ NO Delails <br />Noles' �� � IU��"� ` S(`�f J p r 0( 2 l ��/� I/ln <br />�s� �, �a��le�, r�..�C, u, ���1�1' ��. ,��ti�f �^ ��"'-s`� %lour. <br />Revision: 3 TRW 1 Thursday, September O5, 2013 <br />IOJ <br />�SJUf <br />