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2093 LARGE STORf1A RESf'OfVSE PAPER FORM CHEClCLIST I <br /> � � <br /> � Ins >c�zd E3 ' I/i ' ` <br /> ---._ _ <br /> Date of inspection'_J C� /� _ P- ' 1' <br /> Addres��`r e, �_.�%C•+ :�- �—-( /r.l �`Li1 riil��±i��S'`'q��1Serrice Req�msl Numbac----- ------- , <br /> � <br /> ResidenC�J1rL.I7����'1 Or.ner? �eJ YES [�NO <br /> � <br /> Phone I�umber..------ .[mail:--- ----- <br /> Gencral Buildiny Dotails: <br /> Is Ihis hu Iding e;iihin ihe mmbined se�xcr area? �YES (]IJO Dces Ihe hui�ding have a basemenf7,f�f YES U CJO � <br /> Does Ihz building�ave a backa;a'r.r valve(DlM1J? �.,.]1'ES �'JO � (If yes)1Uas BVYV insla!led hmugh Ciry program ❑Y[5 []NO : <br /> Does Ihe building navc a sump pump7 (]YIiS��f NO Docs Ihz building have 2 grnder pumo? �]YES �NO ! <br /> StormEventDeWils: a�Lp. 2 1 �,� %r'� `r ' <br /> ':1'hem did:��ateren;erirg 6ui!d�g camc from7 �f SURF.ACe FLOVd []GROUP7l)IVATER �S"eIVER B�ChUP-PIXTURES �I UNK�IOIVN <br /> � (L_.2M_r�' - / � / / <br /> Uelails: � �i < G.d�. �i� ' J�_1� , �lv.y�lt�]1c7 %l1.SrG�Q _ _ <br /> i <br /> l'uherr,d�d n�afergo vrlhin Ne building? ❑BtiSES�=PlT PERItdETER ❑BASEFA�NT W[AR FIX7 URES [h]OTHER <br /> a 1 ��._� • <br /> Details�. i; __iYr. _�'i t �'�'1'���' ,.C^, �,,t�.�� . .�r�:�,1,��•n ,T:( �'.'_S/r�; /V. —. <br /> r <br /> Site Observations: <br /> , <br /> �'1�J� � �- �' �:.L�- <br /> Oo+:ns�outlsilegradingissuesnotr.d � v ,;�+�;�.1;f.1�"C. �'�`�r Irc .jT�6 J�'-�Y-1 _ . <br /> / <br /> BuilAing elevalion relative b sewer antl swroundin9 arca issur.s notcd:___ _ _ ._ _— . - <br /> Slla pun,p istiucs coled�—_ - ---— --_- .—- - ------- - --- � -- <br /> Histotieal' `omialionl0lherinformalion: <br /> Pmvious'IloodinQ"i55ue 5erviCe Requcsls a�:iddress�. �,�o. . _ _-_—----- . .. .— -- <br /> Previous'floodin9'issue,noted�yhomenwnec. ___ +1�p_ _ . . --- --- — <br /> Rca�nl s!crmx;dur 1 sewer projecls ampleled in area., _ /�t�_ _ __ProposeA slormv:rter I sew�r projects in a�e.:__Cf�_ __ <br /> � <br /> Pwpertyowne�inD:icslerl in beginnin9 City RacY.water��atve Frogram at adAress:�YES � IJO Uelai!s _ _ <br /> IJoPzs: nr'i_,,.�roi„�( ��f._�i�!'l���<<!/_i.;+_2! n n "�,�---- - --- - — <br /> __'�L�_C��[f- _ `�/ .�'��" „r�Cy7.�� •/��4���..�i.,ri.G±l�;� __'-�' "' - <br /> � V <br /> Rev'sion: 3 TRI�r 1 Thur;day,Supletnber O5, 2013 <br />