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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST:
Date 9. z. 1:,. c> '-f
Time
711t-v1...
Received by f)e'Ul/5 C
(phone. person)
.,.
Location of Work to be inspected iJd<i:JA.5ll "I- Cckc;.,d :5. E. ~o,vte ,
Name of person requesting inspection DevtVl" s E..
Address of person requesting inspection G>..--p Y""d. /7<i- i3 Phone No. 'f 17 - tf??<f:'7
Type of Inspection (circle appropriate one): Permit No.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other 0c... -re,r
INSPECTION NOTES:
Inspected: Date q.:;.o- O'f Time 3: t9-t) f/"'-'t By {)eYl Y{ f'S F .
Remarks: g X 8' H 0 + -r;., 0<:'. '--;;"111 8 t. A.c a.x.+e",d €" D. r.
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RESTORATION REQUiRED...... YES V"'" NO
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SURFACE RESTORATION: if 'x 25'
SURFACE TYPE: 0 Unimproved 0 Gravel % Asphalt 0 PCC 0 Other
o Repaired by City Work Order # 2-S1 Z.b~ 00 I
o Repaired by Permittee 0 COMPLETE
o No Damage Found 0 INCOMPLETE
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Vertical Datum ~ NA VD 88
lIorizontal Datum ~ NAD 8JI'JI
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Area Map
This map is 1101 intended 10 he II$('d liS a legal description.
This map/drawing is produced ily the City of Port Angeles for its OWII use (lml purposes
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