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PUBLIC WORKS <br /> �°���«'« INSPECTION REQUEST <br /> � Address � sa3 �f D A.2- — <br /> Contractor -- <br /> Owner /�"?�ay �'O.P «.oE.ri - ars' 3is �- <br /> Dale //' 7 -90 rime _1� � �s� <br /> TYPE OF INSPECTION REOUESTED <br /> ' � SIDE SEWER <br /> ! '�. GURB/GUTTER/SIDEWALF <br /> � ! STREET /�W.�.�� V�r y) <br /> y � � FO/E FuT4�CE !✓/+JNe-� /I KP <br /> INSPECTION REOUESTED ON //' � � �� '�r''— <br /> un�� n��t <br /> ❑ APPROVAL ❑ PARTIAL APPROVAL <br /> ! ] VIOLATION ❑ CORRECTION FtEQUIRED <br /> �1 Correction.listed below MUST BE MADE bclorc work can hr epp�oved. <br /> �1 Please contact inspector and arrange lor appointment. <br /> ❑Wes nol eble to perlorm insper.tion. <br /> ❑ CALL 259•BB10 FOR REINSPECTION — 24 hour notice required. <br /> A CERTIFICATE OF OCCUPANCY SHALL BE ISSUED AND POST[D ON <br /> THE PREMISES PRIOR TO OCCUPANCY. , <br /> v.I—w-.r( L G .y�I'T-a✓ .. <br /> 1NeDA ���/'�f" �Z'•% ��O/G <br /> �/�-NiT/�-�! SL-z� rPEMO(/f= �ir�E TU . <br /> S �1/ C O�/(J�_� !�/b �5 E �?-�l/(��Q�.D <br /> i? CAL /�.t i Ns�t'c no�tJ C aPl�.-�'T" <br /> ,^ <br /> M��L���' s.�rlirh'��y <. -,� �� /l i3C- _ <br /> _r��v�.z v ,��v N ve-�e.��,t -3 s�r v �x�ar <br /> ��l .�'�Gdi��4ArcTlO/�l �D SiDc SG-Z�r_� _ <br /> / <br /> Inspector Date �/-�3- sc� <br />