HomeMy WebLinkAbout912 E 8th St - Engineering
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APPLICATION FOR WATER
City Water Department
Port Ang~les, Wash. ~ - 8
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I hereby apply for water to be furnished in accordance with rates and rules of the City
for the following premises
Name of Applicant Oc.o-H- ~ L~ Jl )~
Address tj/;b E ff/l ~/O'1 So. ;ndfld~ s:t
Renewal 0 New Service [ff" BI~ Lot~ Add~7 tj r? C.JiSU
/"X ~ II Meter Number I r?:2 3 g~ 3 V Fa-cI-
Se<vke Left 00 0 Se<vke Left Off []2( S;go~d ~dO~
Installed by TW ~ OOG) WD
p~ )-.2.017 ci &4D~ ~ IOZE,tH)
Remarks ~
1<e~-# q~o~_ W 'D 2/ qS
Size of Service
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST
Date 1--/?- -- D-d-.
Time
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
1/;1- E Q*h
T t.D \\ (~'f
/(~ -+ B Phone No
Permit No / ~o 7
Plumbing Final Sewer Excav Other <l.i~/A ,tcr
Sewer Foundation Framing
Chimney
INSPECTION NOTES
Inspected Date
Remarks
Ti~~,~;~~ I~~
LJ..-1:J::r . ,- . - - --l? u;~ n hI"1
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RESTORATION REQUIRED
YES
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NO~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC _ 0 Other
o Repaired by City Work Order # _ c:2.1 9 S
[] Repaired by Permittee ~MPLETE
[] No Damage Found 0 INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)