HomeMy WebLinkAbout1026 Caroline St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
,
. . . . ; . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST /'?
Date 1 - 1-- D )
,
Time
Received by
(phone, person)
Sewer Foundation Framing
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1'1117 6- l?-;, Phone No
Permit No
Chimney Plumbing Final Sewer Excav Other LLJ(~ /"'--
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
INSPECTION NOTES
~ Time
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By
S -e n/I?~
Inspected Date
Remarks
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RESTORATION REQUIRED
YES
/.
NO V
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
D Repaired by City
Cl Repaired by Permittee
D No Damage Found
Work Order #
~MPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)