HomeMy WebLinkAbout903 S K St - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . INSPECTION REPORT. . . . . . . . . . .
DtU - 20d (- I ~6G
REQUEST
Date C - 2 fc - 0 I
/Df/
Time 8 . ~ A UV\ Received by ~.'l "'- (<? E. (phone, person)
Location of Work to be inspected Cj 0 :3 :;.;"
Name of person requesting inspection De. ~'t. "t r S
Address of person requesting inspection c::..or~
,
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney Plumbing Final
~
K
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Phone No
Permit No II" e;
Sewer Excav Other ~o....+e. r
INSPECTION NOTES
Inspected Date C ~- Z' - 0 I
Remarks 7& 8 rf f! l/.C
~ II" "X S /'Iu..efer..
By Ue.'("t t"~ 1:=
IN;?E ~v6,1-V,
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~O 'f 0
G II '3CJ
C V1 2.,/37 /
.
RESTORATION REQUIRED , , , , ., YES
NO X
{ .... '703 So . 51
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~ ~ 'J 13' offset
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SURFACE RESTORATION'
SURFACE TYPE gr Unimproved 0 Gravel
D Repaired by City
D Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC
Work Order # I ggz
~ COMPLETE
o INCOMPLETE
D Other
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)