HomeMy WebLinkAbout902 E Lauridsen Blvd - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT . . . . . .
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REQUEST
Date
Time
Received by
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(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
~nspection (circle appropriate one)
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INSPECTION NOTES
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Phone No
Permit No N/ A
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Plumbing Final Sewer Excav Othe'f
Inspected
Remarks
Date
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RESTORATION REQUIRED
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NO)(
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
[] Repaired by Permittee
o No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)