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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . INSPECTION REPORT. . . . . .
REQUEST:
Date 10 ~'25-6<-{
Time
7 II VV\...
Received by De",,,,-,''', E. (phone, person) I
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Location of Work to be inspected (Z - "f- 6 f\l . . L<J ( VLe r
Name of person requesting inspection Vt"i.-t/.1 /S E.
Address of person requesting inspection ~rf y",,,J /7 "1-13 Phone No. '(lr-L{8'<{'f
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other de<- + t:.. y
INSPECTION NOTES:
Inspected: Date /0 ~ Z5~Ot.( Time.6 PM
Remarks: 7t-ts+a.11 n..elJ 3 /Jor +- "-ydr-c:;.....-t- -ro
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RESTORATION REQUIRED . . . . .. YES
NO X
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SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
o Repaired by City
D Repaired by Permittee
D No Damage Found
D Asphalt 0 PCC 0 Other
Work Order # (<lSIt..( ~ 0 / Z-
D COMPLETE
o INCOMPLETE
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