HomeMy WebLinkAbout1013 Hazel St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
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534
REQUEST
Date ~ -/ 0 - Q 1-
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)
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Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other L,-UL+-e,s.--
INSPECTION NOTES
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Inspected
Remarks
Date
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RESTORATION REQUIRED
YES
/"
NO L../'
SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
D Asphalt D PCC D Other
Wo~rder # ;)..// (
~ COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)