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ENGINEERING / PIlBLIC SERVICES <br />INSPECTION REQUEST <br />Date:? 30 -ip Permit: <br />Project / Owner: <br />[t <br />Contractor:____ <br />Site Address <br />TYPE OF INSPECTION REQUESTED <br />❑ Sewer Systems ❑ Street / Road Base <br />n Storm Drain Systems n Rool / ak r gi <br />❑ Water Systems Public Works Final <br />❑ Curb / Gutter / Sidewalk <br />❑ Other:.. <br />APPROVAL i`I PARTIAL APPROVAL <br />J CORRECTION REQUESTED <br />❑ Corrections listed below MUST BE MADE before work can be approved. <br />❑ Please contact inspector and arrange for appointment. <br />L Was not able to perform inspection. <br />❑ CALL (425) _ _.__ FOR REINSPECTION — 24 hour notice required. <br />Inspector <br />tPSIR W09) DATA/R. INC. <br />