HomeMy WebLinkAbout1831 E Front St - Engineering
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . . . .
. . .
REQUEST:
Date I ( - z Z - 0 <-I
Time 7 I'\~
Received by VC:i-lI'l/S E. (phone, person)
Location of Work to be inspected ~"'YI.'S S-t. '/.- Fra,,- t ;5 t-. tV E. c"rV\.e r
Name of person requesting inspection De.",-",:-; E'-
Address of person requesting inspection (' ....r() If,,-,--.! I 7 ~ B Phone No. qf1 - '-1'6'1 '1
I
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other
INSPECTION NOTES:
Inspected: Date If -Z'Z. ,... u<-{ Time
Remarks: !Jew WUL+Lr i....sfalta..+,'o",
I ( A ""'" By Ue:", HIS E.
+0" pc...rk.; Dil!. +Cur /';''--,'5'''--+'O,^-
RESTORATION REQUiRED...... YES
NO X
(;.k.It;, Sot-
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-. [)z- <{,
t:''''54
Hy.Lr"'" t-
SURFACE RESTORATION:
SURFACE TYPE: 0 Unimproved DGravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other
Work Order # N7", ~tJE?ro
o COMPLETE
o INCOMPLETE
(Continue on reverse side if nAr.A!=:;~;irv)
01/26/2005 WED 14 05 FAX
~001
PLEASE FORWARD TO TRACY ROOKS
WATER DEPARTMENT METER CHANCE
~
NAME: CI.f... IJ
ADDRESS:
ACCOUNT 11 :
OLD METER 11 :
t:. IT lJ '0 Z. ,-;::1
NEW METER II: ~i'~ 0'2...047'1.../ READING: 000000 ~
REMARKS: 2.. tt Herv;e tur-Jot> me.fer. 1Je.'1J (It.siJ {~+:o,,",--
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DATE: il- 2 Z. -0 c.f
READINC:
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01/26/2005 WED 14 06 FAX
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