HomeMy WebLinkAbout930 Brown Rd - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . .
HiG" v.J P 7 z.. J 2-
REQUEST
Date 7- 28"-0:;
Time
Received by
(phone, person)
Location of Work to be inspected 930 t.5-vou.J1.A.... R.J2
Name of person requesting inspection ])ei-U--1.. (s F.
Address of person requesting inspection &V'0 yJ Phone No
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Type of Inspection (circle appropriate one) Permi~
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav ~er (J~
INSPECTION NOTES
Inspected Date 7 - 2 '!f- 03 Time
Remarks tZ.eIl<=<.:red 5('f't' &L)- {)I(J~ tU(-+l
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RESTORATION REQUIRED YES
NO
SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
D Asphalt D PCC D Othe;( ~-6l (
Work Order # ~ 7z-0C{
o COMPLETE
D INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)