HomeMy WebLinkAbout507 Black Diamond Rd - Engineering
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date ) -- ~ ~ - "6 I
,
(
Time
Received by
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
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11 fi I -f- f) Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other V) A t-e Y
INSPECTION NOTES
Inspected Date Time By
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RESTORATION REQ~IRED Y S NO L/
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel D Asphalt D PCC
D Repaired by City
CJ Repaired by Permittee
o No Damage Found
Work Order #
~PLETE
D INCOMPLETE
J D Other
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(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)