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ENGINEERING / PUBLIC SERVICES <br />INSPECTION REQUEST <br />Address <br />Contractor <br />Owner <br />Date -lam O Z Permit No. <br />TYPE OF INSPECTION REQUESTED <br />❑ SIDE SEWER <br />❑ CURB/GUTTER/SIDEWALK <br />❑ STREET <br />INSPECTION REQUESTED ON @ <br />DATE TIME <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) 257.8810 FOR REINSPECTION — 24 hour notice required. <br />Inspector �1 ��/�/���� Date �v <br />EPSIR (6/06) DATABAR, INC. <br />