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2. Conditions of Permit
3. Date
   Date
5. Construction Site Address:
7. Company/Owner:
9. Contractor/Owner Name:
12. ** 24-HOUR NOTICE PRIOR TO ALL INSPECTIONS IS REQUIRED **
14. Check Each Box*

    By checking each box permit holder acknowledges ALL CONDITIONS listed below will be met. [IF THESE CONDITIONS ARE NOT MET, A $500.00 DEPOSIT WILL BE REQUIRED WITH ALL FUTURE PERMITS.]
    
    

    1. Inspection is REQUIRED before mobilization (i.e. the day you are going to start working)
    2. Inspection is REQUIRED after all the forms are set (i.e. pre-pour)
    3. Inspection is REQUIRED prior to backfilling (sanitary/storm) work only
    4. If the GARAGE FLOOR or PATIO STEPS are being replaced/constructed, a Building Dept Permit is REQUIRED
    5. No dumping/obstructing city streets with any materials and no washing out concrete into City’s storm sewers, it is ILLEGAL
    6. Plywood is required to be laid down on city streets during all work activities, including off loading of equipment
    7. If digging, the contractor must have filled out and passed EPA Water Quality Test
    8. All street and/or sidewalk openings must be repaired within 48 hours and require flowable backfill, see city standard details
    9. Permit, along with this condition sign off must be on site with contractor at ALL times
    10. All applicants are required to maintain the drainage on the above listed property. I acknowledge that per Code 1363.06, Ordinance Number 1979-121, that I will not cause any drainage issues to occur
16. Print Nane
17. Signature
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