HomeMy WebLinkAbout1416 Fairchild Airport Rd - Engineering
Dw' 2011-/1.11
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
.
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUES~ I
Date "1 ?-- q .- 0 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)
Sewer Foundation Framing Chimney Plumbing Final
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I 7 -t- Phone No
Permit No
Sewer Excav Other
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INSPECTION NOTES'
Inspected
Remarks
Date
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RESTORATION REQUIRED. .... YES
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SURFACE RESTORATION.
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
D Repaired by City
D Repaired by Permittee
o No Damage Found
Work Order #
S-CO-MPLETE
o INCOMPLETE
o Other
/13'7
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)