Permit Foundation 1844 Sea Oats Dr 2012 f CITY OF ATLANTIC BEACH
j 800 SEMINOLE ROAD
ATLANTIC BEACH, FL 32233
INSPECTION PHONE LINE 247-5814
Application Number . . . . . 12-00001712 Date 11/27/12
Property Address . . . . . . 1844 SEA OATS DR
Application type description FOUNDATION ONLY
Property Zoning . . . . . . . TO BE UPDATED
Application valuation . . . . 8400
----------------------------------------------------------------------------
Application desc
FOUNDATION ONLY FOR FUTURE SCREENED PORCH
----------------------------------------------------------------------------
Owner Contractor
------------------------ ------------------------
LAGOY, EDWARD HOMEOWNER BLDG SVCS, INC (RC)
1844 SEA OATS DRIVE 739 BROOKMONT AVE E
ATLANTIC BEACH FL 32233 JACKSONVILLE FL 32211
(904) 322-1054
----------------------------------------------------------------------------
Permit . . . . . . FOUNDATION ONLY
Additional desc . . FOUNDATION ONLY
Permit Fee . . . . 95 . 00 Plan Check Fee 42 . 50
Issue Date . . . . Valuation . . . . 8400
Expiration Date . . 11/27/12
----------------------------------------------------------------------------
Special Notes and Comments
If on-site storage is required, a post construction
topographic survey documenting proper construction will be
required.
Roll off container company must be on City approved list
and container cannot be placed on City Right-of-Way.
(Approved: Advanced Disposal, Realco, Shappelle ' s and Waste
Management . )
2010 FLORIDA BUILDING CODE, 2008 NATIONAL ELECTRIC CODE
*SUBMIT "CERTIFICATE OF COMPLIANCE" BY A LICENSED PEST
CONTROL COMPANY PRIOR TO C.O.
----------------------------------------------------------------------------
Other Fees . . . . . . . . . STATE DCA SURCHARGE 2 . 00
ENG REV BLDG MOD OR ROW 25 . 00
STATE DBPR SURCHARGE 2 . 00
----------------------------------------------------------------------------
Fee summary Charged Paid Credited Due
----------------- ---------- ---------- ---------- ----------
Permit Fee Total 95 . 00 95 . 00 . 00 . 00
Plan Check Total 42 . 50 42 . 50 . 00 . 00
Other Fee Total 29 . 00 29 . 00 . 00 . 00
Grand Total 166 . 50 166 . 50 . 00 . 00
PERMIT IS APPROVED ONLY IN ACCORDANCE WITH ALL CITY OF ATLANTIC BEACH ORDINANCES AND THE FLORIDA
BUILDING CODES.
City of Atlantic Beach APPLICATION NUMBERBulldhtg D_eryp,�a�rlmetrt (To be asspd by the&&ft Deparlh h iap
Atlaratc Beach,Fiorfde 32133$445 I!'
PhM{904)247,5M • Fax(9 9)2474984S '-011
ua Dat�arot�ert
Cftywebeft Ixtp:fA~.coaXus
APPLICATION REVIEW ANDIRACKING FORM
ProPedy Address: f. QLar-sk- rte a' ,►
es
Appikant: 46 a ZcN,i
Project: "0/A is works
eeff ,�c dpil l PUNIC
Fire Services
Review fee S -- Dept Signature
IQther Agency Review or Permit Required �VeritMd� Daft
Florfda Dept.of EnvlrormerProtwbw
Florida Dept.of Trarapoitax w
SL Johns Fdi w Wsler went Ofatrtrt
Army Carps of Engineers
Di &km of Hotels arrd Reetiimrft
OWSIM ofAtooklic Ben*Vft and Tobacco
04hw.
APPLICATION STATUS
Ravi"vft Department First Review: ❑Denied.
(Clyde one) Comments:
BUILDING
PLANNING &ZONING Reviewed by:
TREE ADMIN Second Review: []Approved as revised. ❑Denied.
KS Comments:
UTILITIES
PUBLIC SAFETY Renrtcn+ed by: DOW
FIRE SERVICES Third Review: QAppmved as Wised. QDenied.
Comments:
Reviewed by: Uabe:
F'rM db7rsrna
1% r City of Atlantic Beach APPLICATION NUMBER
Building Department
800 Seminole Road (To be assigned by the Bolding Deparftherit)
Atlantic Beach. Florida 32233-5445 �r`G /712--
Phone(904)247-5826 • Fax(904)247-5845 lI
oraso�' E-mail: building-deptecoab.us Date routed:
City web-site: Mtpl/www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: #Y41 �fCL � % . Department review re uired Y N
0
Applicant: e Planning HB Zoning
�> T in
Project: -_& A /-Yj (e- blicworks
Public Safety
Fire Services
Review fee $ Dept Signature
Other Agency Review or Permit Required Review or Receipt Date
of Permit VerifiedBy
Florida Dept.of Environmental Protection
Florida Dept.of Transportation
St Johns River Water Management District
Army Corps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
4
APPLICATION STATUS
Reviewing Department First Review: Approved. ❑Denied,
(Cirtde one.) Comments:
BUILDING
PLANNING&ZONING -/ �z-
Reviewed by: Date:
TREE ADMIN_ Second Review-
. Approved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: 0APProved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07127/10
r r,, City of Atlantic Beach EDate
PPLICATION NUMBER
Building Department signed by the Bti Wft Depa hft)
800 Seminole Road
"s Atlantic Beach, Florida 32233-5445 - - /�/L
Phone(904)247-526 • Fax(904)247-5845 /�
.►;sl>�' E-mail: building-deptQcoab_us ted: �U 1
Cityweb-site: httpJ/www.coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: rJ �f l� a(uS �� D
epartment review re wired Yes No
Applicant: l T - ... .
/ cf ., 4 G &Zoning
T m
Project: li�1-2761tJ'Yj ,s' i f ubtic Works'
C Public Safety
Fire Services
Review fee $ Dept Signature
r
r Agency Review or Permit Required Revrew or Receipt Date
of Permita Dept.of Environmental Protectiona Dept.of Transportation
ns River Water Management District
Corps of Engineers
n of Hotels and Restaurants
n of Alcoholic Beverages and Tobacco
Other:
APPLICATION STATUS
Reviewing Department First Review: 19ApProved. ElDenied.
(Circle oneComments:
8
PLANNING&ZOAI
Reviewed by: OILd. Date: r'
TREE ADMIN. Second Review:
❑Appr+oved as revised. ❑Denied.
PUBLIC WORKS Comments:
PUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: DApproved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07127/10
BUILDING PERMIT APPLICATION
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: FL �/nx S -To u it Permit Number: 1!�,2 -/7/ Z
Legal Description SO-Zc) �-ZS=2�! Parcel#
c� ooF�rArea o q. t. q f"t
Valuation of Work$ C.�G Proposed Work heated/cooled non-heated/cooled eye
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structure(s)(circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval#
For multiple products use product approval form
Describe in detail the type of work to be performed:
b_Ae :
Property Owner Information:
Name:UA44U. +r L#16nev Address: 14 qt SUs onws 1paue
City 1-t kj State' ( Zip Phone
E-Mail or Fax# (Optional)
ContractorInformation:
Company Name: " rzjz ec'r t gy[t l+ r 4r 5L.yit" :- Qualifying Agent: ,e! A
Address:7," BQ oick-4,A ALX- City 4'Adi4y llu.t s- State 1:-L,-Ln Zip :'Z zt j
Office Phonei'"pq-32 Ztc^;*V Job Site/Contact Number - . Fax#
State Certification/Registration# C_ C_6"&,ZA C-cc E9 2 9!51 z
Architect Name & Phone#VWj m-FEFcc c-.LA t �'cJ-S !13.( "
Engineer's Name& Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the
issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for a period of sixth)months at any time after
work is commenced. 1 understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, urnaces, Boilers,Heaters,
Tanks and Air Conditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
1 hereb certify that I have read and examined this a plication and know the same to be true and correct. All provisions of laws and ordinances governing this
type o7Mrk Will be complied with whether speci ted herein or not. The granting of a permit does not presume to giv authority to violate or cancel the
provisions of atty other federal,stat , or loc l l regulating construction or the performance of construction.
Signature of Owner Signature of Contractor
hl (( .
Print Name ` .�1.1.�.. Print Name %%. ��A... .......... :X7:�Q�'fC_ ._ .......
e Befor '
t of 20 this Day of 20
Notary,PuTplic
DEBO AMANDAWHITE
�' 8TEPHANIEPARSONg �' Revised 01.26.10
MY COMMISSION#EE 057349
$~ NOtary Public,State of Fbft : EXPIRES:May 21, nder
Commission#EE 174709 ',aE; Bonded Thru Notary Public Underwriters
My OOmm.ayNrae Fdk on en.
2187SThird St
J Y
Jacksonville Bch, FL 32250
904-372-9351
beach@rod-law.com s9tu„hal,^ , t
PROPERTYES : 1844 SEA OATS DRIVE ATLANTIC BEACH,Florida 32233 SURVEY 1
{ ADDRSY NUMBER: FL1204. 984984
FIELDWORK DATE:4/25✓2012 REVISION DATE(S):(rev.o 4✓25 �� �
izolz)
'T �{; y�y�lMypK+�efiMLJwww�Mi/4Myi
FL'1204.1984 A OPY
BOUNpARY SURVEY
FILEIV”
DUVAL COUNTY
N 89'57'19"E I 17.37(M)
tN
'FIR N 89'5719"E 1 17.14'(P) lie'FR I �{
ID B.R. (PER PLAT) #4144
0.8'Off
b 0
r v✓CJ%
19.7 O
'
o
STY. N w
O RE5#1844
2001
Y� No
N 'iC n ° ROOD O O t ti
to to 1 3
V
ch CV 20.0
0 0 � ,}
Z Z
o GONG.DMI
45.9' SIT-- 40 3' _.,.....� 6
. _ _
In }
0.5'0-'-
112
.5'OFF I/2"FIR 6'W.F.(M'.l
NO ID z 5 89°5719"W I I G.55'(P) u2°FIR s
O z N 89°51'23"W I I G.31'fM) No iD k
p ( ¢.'
in 30.0'•--+� P,:
-�—24
C9
c6 ED ,
in to
Lr) in
ON
O
J hereby certify that this Sketch of Survey of the o o 12 MR
hereon described as been made under Z Z No ro
my direction, aK e0 of my knowledge and @ BLC.GOP.
belief, it is a and ac representation of a
survey that ets ttg89ninim technical 30 o tS
standards s t favtby 1 to i o Board Of30
Professional L W __ , escribed in Chapter
_...
5J-«17 of fh sr�oP ive Code. GRAPHIC SCALE (In Feet)
State of Fl rofees�onoP
Sur
and Mapper
s Ft.0 DA 1 inch — 30' ft.
Nq se o.,off
SURVt:
Use of This Survey for Purposes other than intended,Without Written Verification,will beat the User's Sole Risk and Without Liability to the Surveyor. "
Nothing hereon shall be Construed to Give ANY Rights or Benefits to Anyone Other than those Certified.
FLOOD INFORMATION:Z. ,
_e•tcrmmg a search with the local governing municipality or www.
:^-�a g0v,the property appears to be located in zone X.This Property was ,a a�
CITY OF ATLANTIC BEACH,community number 120075,dated
•s- r City of Atlantic Beach .
Building Department
APPLICATION NUMBER
... .. � f ��r�=:� E
Tobe
800 Seminole Road /!� �UM Dw
)
Atlantic Beach. Florida 32233-544 0 f a 20 f� ;G 1712—
Phone
7/L-
Phone(904)247-526 Fax(90I`5845
'lshr
-E-mail: builds
n9-depteooab.us Date routed 2
City web-site: http://www coab.us
APPLICATION REVIEW AND TRACKING FORM
Property Address: J�7 / f �f �L / -S �Q De artment review ulred Yes No
Applicant: 1 �` ' l' c� ,�6�/� Planning&Zonin
in
Project: tdA ,d' � ublicWorks
ubiic Utilities.....
C Public Safety
Fire Services
Review fee $__ __ Dept Signature —
LF11orida
r Agency Review or Permit Required Review or Receipt Date
Of Permit Verified
a Dept.of Environmental Protection
Dept.of Transportation
hns River Water Management DistrictCorps of Engineers
Division of Hotels and Restaurants
Division of Alcoholic Beverages and Tobacco
Other:
AP
PLICATION STATUS
Reviewing Department First Review: ❑Denied.
(Circle one.) Comments:
BUILDING
PLANNING&ZONING
Reviewed by: Date: q Z
TREE ADMIN. Second Review.
' ElApproved as revised. ❑Denied.
PUBLIC WORKS Comments:
IPUBLIC UTILITIES
PUBLIC SAFETY Reviewed by: Date:
FIRE SERVICES Third Review: []Approved as revised. ❑Denied.
Comments:
Reviewed by: Date:
Revised 07/27/10
l�U11bV111ki 1 Irinivi11 tlrrLil.t111V1\
CITY OF ATLANTIC BEACH
800 Seminole Road, Atlantic Beach, FL 32233
Office (904) 247-5826 Fax (904) 247-5845
Job Address: is >:: Permit Number:
Legal Description M r' Parcel #
caw' oor Area of q. t. q. t
Valuation of Work$ ' ,�% .r ,cx Proposed Work heated/cooled non-heated/cooled ,;_,'X
Class of Work(circle one): New Addition Alteration Repair Move Demolition pool/spa window/door
Use of existing/proposed structures) (circle one): Commercial Residential
If an existing structure,is a fire sprinkler system installed? (Circle one): Yes No N/A
Florida Product Approval #
For multiple products use product approvalorm
M r.
Describe in detail the type of work to be performed:
..� e fw •,�t§� tit R ;J 5�. Y':
Property Owner Information:
Name: 0' Address: R �4-�l ,A r ea-
City ' r. 44 State'"_Zip. ,? !r7 Phone
E-Mail or Fax#(Optional)
Contractor Information:
Company Name: .�
p y a a t �.,m� �� r�� � =`.��,. �°.� ����` Qualifying Agent: �� -0V&."'
Address:-1 City State `-
Zip 1
�Z. '
._ a
Office Phone ; t w.x .p.. Job Site/Contact Number Fax#
State Certification/Registration# .__
Architect Name&Phone# 7 '
Engineer's Name&Phone#
Fee Simple Title Holder Name and Address
Bonding Company Name and Address
Mortgage Lender Name and Address
Application is hereby made to obtain a permit to do the work and installations as indicated. 1 certify that no work or installation has commenced prior to the
issuance of a permit and that a0 work will be performed to meet the standards of all laws regulating construction in this jurisdiction. This permit becomes null
and void if work is not commenced within six(6)months, or if construction or work is suspended or abandoned for aperiod of siXP6)months at any time after
work is commenced. I understand that separate permits must be secured for Electrical Work, Plumbing, Signs, Wells, Pools, urnaces, Boilers, Heaters,
Tanks and AirConditioners,etc.
WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF
COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS
TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH
YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF
COMMENCEMENT.
I hereby certify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this
tvpe of work will be complied with whether sppect ted herein or not. The granting of a permit does not presume to gry authority to violate or cancel the
provisions of any other federal,stat , or loc 1 la regulating construction or the performance of construction.
Signature of Owner �'
g Signature of Contracto
Print Name ..................... ..�(.,.�. -......... ... ... . ..�,��........................... Pant Namey 1L ..........��x .:� '! -............
eft e t. t` Befo�T_6,ay
f 20 "�?this of �� ,._/ k 20/
Notaryc
pEgp pMANDAiWHffE
.*' �' Revised 01.26.10
,,: MY MISSION#EE 057349
~ STEPHAMEPAR$QNg "' EXPIRES:May 21,2015
p Notary Public,State 01 Florida V Bon dod Thnt Notary Public Under~Comrnlssion#EE 174709
My oomm.expires Feb.29,2016
Comp. By: RLC
y Date: 11/19/2012
s
w
Public Works Department
City of Atlantic Beach
Permit No: 12-1712
Address: 1844 Sea Oats Dr.
Rgguired Storage Volume
Criteria'
Section 24-66 of the City of Atlantic Beach's Zoning, Subdivsion, and Land Development Regulations
requires that the difference between the pre-and postdevelopment volume of stormwawter runoff be
stored on site. Volume of Runoff is defined as follows:
V= CAR/12
Where: V=Volume of Runoff
C= Coefficient of Runoff
A=Area of lot in square feet
R=25-yr/24-hr rainfall depth(9.3-inches for Atlantic Beach)
Predevelocment Runoff Volume:
Lot Area(A) = 10,647 ft2
Runoff Coefficient
Area Lot Area
Description (ft) (ft) "C" Md "C"
Impervious 3,141 10,647 1.00 0.30
Pervious 7,506 10,647 0.20 0.14
Runoff Coefficient(C)= 0.44
Runoff Volume
V= 0.44 x 10,647 x 9.3 / 12
V= 3,598 ft3
Postdevelopment Runoff Volume:
Lot Area(A) = 10,647 ft'
Runoff Coefficient
Area Lot Area
Description (ft) (ft) "C" Md "C"
Impervious 3,949 10,647 1.00 0.37
Pervious 6,698 10,647 0.20 0.13
Runoff Coefficient(C)= 0.50
Runoff Volume
V= 0.50 x 10,647 x 9.3 / 12
V= 4,099 ft3
Reauired Storage Volume
DV= Postdevelopment Runoff Volume- Predevelopment Runoff Volume
DV= 4,099 - 3,598
DV= 501 ft3
Retention 1844 Sea Oats-onsite Retention w-gmd.xlsx 11/19/2012
r Comp. By: RLC
a
Date: 11/19/2012
Public Works Department
City of Atlantic Beach
Permit No: 12-1712
Address: 1844 Sea Oats Dr.
Prpvided Storage:
Elevation Area Storage
(ft) (ft) (ft)
0.0 113 0 BOTTOM
0.5 707 205 TOB
Elevation Area Storage
(ft) (ft) (ft)
0.0 75 0 BOTTOM
0.5 300 94 TOB
Elevation Area Storage
(ft) (ft) (ft)
0.0 0 0 BOTTOM
0.5 0 0 TOB
Inground storage=Wd"pf
A=Area= 1007.0
d=depth to ESHWT= 3.0
pf= pore factor= 0.3
Inground Storage= 906.3 ft3
Required Treatment Volume= 501 ft3
Supplied Treatment Volume= 1,205 ft3
Retention 1844 Sea Oats-onsite Retention w-gmd.xlsx 11/19/2012
2187 S Third St = r
1 � _
Jacksonville Bch, FL 32250
944-372-9351
beach(--;orod-law.com '
P.. S,7runh�Ur lam.
s,
PROPERTY ADDRESS: 1844 SEA OATS DRIVE ATLANTIC BEACH,Florida 32233 SURVEY NUMBER: FL7204.1984
,r ,a rte:• .. `r'r,,: s' ` "toes
FIELD WORK DATE:4/25/2012 REVISION DATE(S):(rev.o 4/25/2012)
FL 1204,1984
BOUNOARYSURVEY
DUVAL COUNTY
N 89'57'19"E 117.37'(M) I I
112 FIR N 89°571 9"E I 17.14'(P) 112 rX
NO iD B.R. (PER PLAT) #4144 ?'
0.81 OF
N I
i
10.2. 30.3' cp
197 0 0 10.5'
Z p o t�
5rr. N 1
g { RF5#1844 w 3
m
{� ,p 20.0' _ o0
N to
AIC t,n WOOD ( ❑
Ln II : DECK to
Cf)0 1 { 20.0.
00 {
0CONC.DhV
45.9' 40.3'
�.
0.5'0--
:/2
-
NO;D S 59'5719"W I 16.55'(P) /neo o I E
O o N 89°51'23"W I 1 G.31'(M)
d o
N 240'
lD 0? I
N u,
L
�D m r:
00
I hereby certify that this Sketch of Survey of the p o
FIR
hereon described as been mode under Z Z i/2
No!DD
my direction, d� _ et, of my knowledge and @ eix.Col.
belief, it is a `and act representation of a
survey that ets It8� ninim technical
_ -.. - .as _.. . ib 30 0 t 5 30
Professional Lffi><v�thrS� as ese Flo a �bed oard �f Chapter GRADSme
k
5J 17 of th LA&W ive Code.
s ,I F GRAPHIC SCALE (In Feet)
State of Fl rofess�onOD Surve and Mapper
s rto on 1 inch 30 ft.
se �o. 4
SURVt3'40�
'i
;Q
Use of This Survey for Purposes other than Intended,Without written Verification,will beat the User's Sole Risk and Without Uability to the Surveyor.
Nothing hereon shall be Construed to Give ANY Rights or Benefits to Anyone Other than those Certified
-"-COD INFORMATION:
� .;
ce-
EA
�,rm,ing a search with the local governing municipality or www
oc the property appears to be located in zone X.This Property was .
Cl Y OF ATLANTIC BEACH,community number 120075,dated
5951 Arlington Expressway
BUG UT
v Jacksonville, Florida 32211
SER VICE Phone 904-743-8272
bugoutservice.com Toll Free 1-877-BUG-U-OUT
TERMITE TREATMENT RECORD
Bug Out Service,Inc. verifies to the Builder,Building Inspector,Homeowner,and Lending Institution,in compliance
with Florida State Law (Chapter 482-226),this building has received a complete treatment for the prevention of
subterranean termites.Treatment is in accordance with the rules and laws established by the Florida Department of
Agriculture and Consumer Services.An annual inspection and renewal of the annual termite protection contract is
necessary for continued protection.
l Y I L I 5 ,- 6"1 .5 733
Location of Property(Street Address,City and State Lot Block
If termite infestation should occur within one year from the date of treatment in this building,Bug Out will retreat the
structure using the standards in effect at the time of retreatment.The property owner shall have the option of extending
the limited warranty beyond the first year for no less than four additional years.If during the term of this guarantee,
additions or alterations are made which affect the structure and create new termite hazards,or interfere with the
treatment method used,this guarantee will become null and void.
Soil Treatment: Technician Treatment Treatment
' / Record Date Record Time
Chemical Used: t/ Premise Pre Other Concentration:0.5% A rl jZj,J)z /S�
Gallons applied: 135 Method of application: Pressure sprayed _Soil rodded y rZ �'S!
Square footage of soil area treated: SSP �r.-tiiaeff ft.of Masonry Voids treated: 6 121 1Z
Tubs and Traps
Final Soil Treatment:
Wood Treatment:
Chemical Used: Bora-Care Concentration 1:1 Solution
Framing area treated: 24 inch barrier treatment
Method of Application: Pressure sprayed Gallons Applied
Baiting System: Ck Sentricon•
Product Used: Sentricon Colony Elimination System Linear Feet: Colony Elt.Inaeon System
Monitoring System:
Product Used: Linear Feet:
Builder:
By(Signature): Date: 11 IM 117 _Title:
Reorder from Rush to Excellence White-Job Site Canary-Job Site Pink-Bug Out
904-367-0100 Form#4045 Rev 02/17/12