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ASSET PROTECTION BOND INSPECTION FORM

Building Consent ID: 19942 1 Building Consent Issued Date: 21 NOV 2005 Property File Number: P/0410/40 Site Address 40A ANNE ROAD Ward: Otumoetai/Bethlehem Property Owner Details: KELLY, SHONA MARY

P O BOX 8063 TAURANGA 3030

Project Description: ADD GARAGE, CREATE BATHROOM AND INSTALL SINK IN RUMPUS ROOM OF DWELLING

Receipt Numbers: Receipt Paid By: Receipt Amount: 1 2006 182295 2006 228796

SM KELLY KELLY, SHONA MARY 2,118.03 1

Refund Details I Payment of Fees Made by: OWNER Refund Due to: Fee Type: Fee Amount: Amount to Refund: 1 IBC $110.00 IPI $120.00 CCC $40.00 BIN $318.93 BEX $900.00 PIM $215.00 VCB $500.00 ADIF $125.00 BIA $59.10 103 $30.00

INSPECTIONS RESULTS DATE: ry'^/i^loh ^ Vehicle Crossing: Footpath: Berm: Water Toby: Box: Backflow: Meter Type: Meter Serial Number:

Meter Reading:

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Meter Location:

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