HomeMy WebLinkAbout100 Old Joe Rd - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date IZ-L{ -0') Time 9 ;O/V1 Received by OeM/.s E :...(phone'~lnl,
Location of Work to be inspected 0 (~7:!-f!. R J) 'l) Do Y 1 e k!..J ! I/(fer .s~ci{~vt..
Name of person requesting inspection 0<:" "'VI. s E-
Address of person requesting inspection ~ r/Y }i d I .40 Phone No. Lj. t -7 - <I- 8<1 '1
Type of Inspection (circle appropriate one): f Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other ~tA_:+e r
INSPECTION NOTES:
Inspected: Date I Z - "J - 0 5"
Remarks: t<..etJe...,'r 3" PtfL-
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Time -z...:.;. &? A>"\ By D-(.~ "'l / 5 E .
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RESTORATION REQUIRED . . . . .. YES)(' NO
SURFACE RESTORATION: b x8
SURFACE TYPE: 0 Unimproved DGravel)j Asphalt 0 PCC 0 Other
o Repaired by City Work Order # 31)"5 4~o5S-
o Repaired by Permittee /J?J' COMPLETE ka. 3.3 Y2?f _ /
o No Damage Found 0 INCOMPLETE
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(Continue on reverse side if necessarvl
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