HomeMy WebLinkAbout717 E 11th St - Engineering
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CITY OF PORT ANGELES 1~[/
DEPARTMENT OF PUBLIC WORKS 17
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST' .t6-
Date ~ - ~ 0 I
Time
Received by
(phone, person)
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_~00 \ \ CD 7-
1 I t-h +13 Phone No
Permit No
Final Sewer Excav Other [)Jet .t-e Y
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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
INSPECTION NOTES
Inspected Date
Remarks
By
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Time
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RESTORATION REQUI ED. .. YES f/NO
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SURFACE RESTORATION:
SURFACETYPE 0 Unimproved DGravel ~alt OPCC
o Repaired by City
o Repaired by Permittee
o 0 Damage Found
Work Order #
~ COMPLETE
o INCOMPLE
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(Continue on rev~r~e side if necessary)
STREET SUPERINTENDENT
(DATE)