SLCDPU Dog Inspection Form

• Audit Title

• Client / Site

• Prepared by

• Location
  Address

Inspection Details

• Inspector name

• Inspection Date/Time

  Date

• Pre-application site visit?

  Yes

  No

  N/A

Applicant Information

• Applicant Name

• Address of permit applicant (in protected watershed)
  Address

• Canyon Community?

  Select Maxfield Mill D Pinetree Mount Haven Silver Fork Cardiff Silver Fork Solitude Brighton Forest Glen Evergreen Lady of the Lake Silver Lake Estates Wasatch Resort Snowbird Forest Homes Lost Acres Primitive Pines Other

  • Maxfield
  • Mill D
  • Pinetree
  • Mount Haven
  • Silver Fork
  • Cardiff
  • Silver Fork
  • Solitude
  • Brighton
  • Forest Glen
  • Evergreen
  • Lady of the Lake
  • Silver Lake Estates
  • Wasatch Resort
  • Snowbird
  • Forest Homes
  • Lost Acres
  • Primitive Pines
  • Other

• Application Address Primary Residence?

  Yes

  No

  N/A

• Is the address a business?

  Yes

  No

  N/A

• Applicant have an old tag?

  Yes

  No

  N/A

• Did the tag get turned in?

  Yes

  No

  N/A

• Images of the structure & site

  Media

Dog Information

• Dog Name

• Dog breed

• Weight of dog

• Age of dog

• Color of dog?

• Images of dog (if on site)

  Media

Enclosure Information

• Enclosure description

• Enclosure Images

  Media

• Method of waste dispoal

Proximity to Wetlands and/or Ephemeral Streams

• Distance of inhabited structure to wetlands and/or ephemeral stream in feet

• Images of proximity (if necessary)

  Media

NOTES

• Notes?