HomeMy WebLinkAbout1000 Campbell Ave - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . .
REQUEST
Date ~ - 2 - () '-f
Time 7 ;00 Afl..-l Received by Uell\/II../S E- (phone, person)
Location of Work to be inspected 1000 B (k E - Co..~hell
Name of person requesting inspection l)eV(.vI.l~ E
Address of person requesting inspection L.or () \J6..r& (1iS ctf- '6 Phone No L/t7 - tf S <{ ~
,
Type of Inspection (circle appropriate one) Permit No .~
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Othe@C<..+~ r )
INSPECTION NOTES
Inspected Date &:, - 2- - 6 't
Remarks Z t't P V C- bVLc.. /V\.
Time 3.DD fit-\.
E ,c+e.k S 10 V\..
By De.t\..h' c:;
E
RESTORA TION REQUIRED YES NO X
~
1000 E I
&Mfbel ( AJ~
2" C I- r I 2" Pile.. :s'IJuf
32. Daf
k 2Db ~ 80'
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( II g iatIJ 0<<
IrA 5~1\ p\<i.Sit '-
lM-e+t.r ""g.o \C
SURFACE RESTORATION
SURFACE TYPE ~ Unimproved 0 Gravel
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # Zo330 -06(
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)