HomeMy WebLinkAbout1722 W Lauridsen Blvd - Engineering
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CITY OF PORT ANGELES ~
DEPARTMENT OF PUBLIC WORKS Cff3'V
. . . . . . . INSPECTION REPORT . . . . . . . . . :/..
. . . .
REQUEST'
Date g - 3> - 0 (
Time I PM
Received by Ueltl(lS ~ (phone, person)
Location of Work to be inspected 1722 Lo..vrtdselA.... Z5llld
Name of person requesting inspection t>e", I-t I S E.
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Address of person requesting inspection / 7 - <y.. D
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing
Co rf Y AV"'d. Phone No
Permit No
Final Sewer Excav Other W",--fe r
INSPECTION NOTES'
Inspected Date ~~ffjJt/ifJt
Remarks ("Ad e
8 3-01 Time ~
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D € "'\<\..~ ~ E
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RESTORATION REQUIRED . ... YES
NO x:
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tJes f ltW(~dsell\. ~,of
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IN
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SURFACE RESTORATION.
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
D Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order # /CJro
C&l COMPLETE
o INCOMPLETE
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STREET SUPERINTENDENT
(DATE)