HomeMy WebLinkAbout1728 W 6th St - Engineering
CITY OF PORT ANGELES
,
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT . . . . . .
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REQUEST
Date I (- I -- 0'2-
Time
Received by
(phone, person)
Location of Work to be inspected /7 Z g tv
Name of person requesting inspection [Jetl ~II S
Address of person requesting inspection
Type of Inspection (circle appropriate one)
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0-
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Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date
Remarks D~j
Time
U/J J _ / --L-
j-'" Orl ve... tJe-\.y 7 0
By
/ tLS kit tJa i-e ,~
It VCL
RESTORATION REQUIRED
.. YES X NO
.
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved OGravel o Asphalt OPCC OOther uV\..C.ret-e
o Repaired by City Work Order # Z 2. (7
[] Repaired by Permittee r;& COMPLETE f\J'~ -S-e.~\i'~ w~
o No Damage Found 0 INCOMPLETE ~ose\e ~ '\-\~t M\-{
\ I, - JJ- ()')..
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)