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Elk River Fire Department <br />Fire & Building Safety Division <br />fR` 13065 Orono Parkway NW • Elk River, MN 55330 <br />763.635.1060 <br />ERFD.FABS@E1kRiverMN.gov <br />Request for Extension of Time to Obtain Compliance with a Notice of <br />Violations anti -Order to Correct <br />Section 1: Owner and Applicant Information <br />Property Name: <br />Address of Property: <br />City: <br />Building Owner: <br />Owner Address: <br />Applicant Name: <br />Applicant Address <br />Section 2: Violation Information <br />Date of Initial Inspection: <br />Code Section: <br />Phoenix ID: <br />Unit Number: <br />SIte: Zip: <br />City: "_1266 <br />State: /11 <br />Violation Number: <br />Original Abate By: <br />Note.- if requesting an extension far more than one violation, submit an application for each individual violation. <br />Premises: Elk River, City of <br />Local-: <br />Address: 13065 Orono Pkwy NW <br />State Reg#: <br />Elk River, MN 55330 <br />Phoenix ID: <br />1 <br />,.Initial Inspected on. <br />4t3107I15 <br />'L--ut Inspected on. <br />08/07/15 <br />Initial Inspector: <br />T. John Cunningham <br />The Violations cited on the above premises ar-.s ow <br />Number ❑ascription Floor <br />Abate <br />By <br />U!A <br />UTA <br />UlA <br />Location: Front Oi%ce!Reception 1st Floor <br />1 <br />Category 1 Nature: <br />49/46/15 <br />Code Section: MSFC, 605.5 <br />Description: Remove permanent extension cords. <br />Version: August 10, 2015 <br />Policy Reference: 8012 (Request for Extension) <br />