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� � . <br /> p�5 <br /> C H <br /> 9Hy <br /> H �� PUBLIC WORKS <br /> o xo ����'��'" INSPECTION REQUEST <br /> � yH 7 <br /> �� �, � -3 ��J (�. • � � <br /> Addrr_ss __ 4' . ._ . --- ._��..�-��-�' <br /> � Zp <br /> H C Contractor ��"�•���-- ��• •�� r `� `'" ' I <br /> H �/ �� <br /> H �1 Owner l�D ��:-�. q � <br /> 4'�� C) �� <br /> � ~ Date /� Timc —-- <br /> H <br /> rJ [~iiH TYPE OF IN£PECTION FEO�IESTED <br /> � Gy X SIDE SEWER '� <br /> �:�t+ /\ <br /> �� . � CURB/GU7TER/SIDEWALK <br /> y STAEET , <br /> � � l�' �5- 7/�.Z <br /> INSPECTION REOUESTED ON__>��! ,Il_— °' �'�� ' <br /> (� PPROVAL i l PARTIAL APPROVAL <br /> �� �' [:! VIOLATION C1 CORRECTION REQUIRED <br /> i � � �. � Conections Ii�teA below MUST BE MADE belore werk can be opprovod � <br /> �. Please conlac� inspeclor and arrani�e foi apPointinent <br /> ❑ Was not able to perform inspeclion. <br /> � �' C CALL 259�bB10 FOR REINSPECTION — 24 houi notice required. <br /> �' � i.CERTIFICATE OF OCCUPANCY SHALL BE ISSUED AND POSTED ON <br /> TH[ PREMISES PRIOR TO OCCUPANCY. <br /> � -- <br /> � � � �� ` � � � ; <br /> ��. --�- <br /> I' �� 6 � r L'C 5 /7� - 3/�s- � on..n.� ; <br /> ��� �j�-) � �� C'/.... r�P.Q r �� K � � l'A�'•wv � <br /> � <br /> �� � I <br /> — i <br /> I <br /> !'� I <br /> I <br /> � -- <br /> 5 3� � <br /> Ir,sPcr.lur _ _ _—Da�e ��_ <br /> �w'�'<_ <br />