HomeMy WebLinkAbout520 Golf Course Rd - Engineering
REQUEST
Date 0 5" -.I \ -OD
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS l}.J VJ /009, I~O~
. INSPECTION REPORT. .
7:66 ~
Time -'.;",-=" _Received by ft-. ~""> (phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection Phone No
Type of Inspection (circle appropriate one) Permit No
~ Foundation Framing Chimney Plumbing Final Sewer Excav Other
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INSPECTION NOTES ;/ ~
Inspected Date 0,5'-1"2--00 Time (00 flu- By sz'l,. ~~ ~
Remarks ~'A ~ ~ 4- Lf\ J~ ~ ~ d, Lfu CtK'. ~ 7. 5" '-;i:,/ . ~--~
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D
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5
IS
12-
D
RESTORATION REQUIRED
YES
NO
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SURFACE RESTORATION 1J A
SURFACE TYPE D Unimproved D D Asphalt D PCC
D Other
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)