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ENGINEERING / PUBLIC SERVICES <br /> INSPECTION REQUEST <br /> Date: / /(5 _ Permit: _ <br /> Project/Owner: 12/5o4 - oso <br /> Contractor: . <br /> Site Address: -- 17- 11514- - <br /> TYPE OF INSPECTION REQUESTED <br /> 3iSewer Systems Street/Road Base 1V L <br /> Storm Drain Systems Roof/Footing Drains <br /> Water Systems Public Works Final <br /> Curb/Gutter/Sidewalk <br /> Other: <br /> APPROVAL PARTIAL APPROVAL <br /> VIOLATION CORRECTION REQUESTED <br /> Corrections listed below MUST BE MADE before work can be approved. <br /> Please contact inspector and arrange for appointment. <br /> Was not able to perform inspection. <br /> CALL(425) FOR REINSPECTION — 24 hour notice required. <br /> tit eT NG -ZigtfiNS —/4446 <br /> A4_ 0.4n2F)fercw,._ <br /> Inspector * ��+ /� Date 5" <br /> EPSIR(6/09) DATABAR,INC. <br />