HomeMy WebLinkAbout1766 Mt Pleasant Rd - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT . . . . . . . . . . .
REQUEST
Date ~- ~D - 0 I Time
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
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Received by
(phone, person)
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Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other! U('1~~
INSPECTION NOTES
Inspected
Remarks
Date
Time
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By
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RESTORATION REQUIRED .
. YES
NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC 0 Other
o Repaired by City Work Order # ~ 6 {; -, / 7? 7'
o Repaired by Permittee ~PLETE
o No Damage Found 0 INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)