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ENGINEERING / PUBLIC SERVICES <br /> INSPECTION REQUEST <br /> (� Da :�U � /��Pe�rmit�:�_v�1�_o�_O� <br /> Project/Owner�l� �����' I_�JJ <br /> Contractor: (�/�� � <br /> Site Address:=1—l. �� � "�S� � J� <br /> TYPE OF INSPECTION REQUESTED <br /> ❑ Sewer Systems ❑ Street/Road Base <br /> ❑ Storm Drain Systems ❑ oof/Footing Orains <br /> ❑ Water Systems Public Works Final <br /> ❑ Curb/Gutler/Sidewalk <br /> ❑ Other: <br /> APPROVAL � PARTIAL APPROVAL <br /> � IOLATION � CORRECTION RE�UESTED <br /> ❑ Correclions lisled below MUST BE MADE betore work can be approved. <br /> ❑ Please contact inspeclor and arrange for appoinlment. <br /> ❑ Was not a61e to per(orm inspection. <br /> ❑ CALL(425)_ FOR HEINSPECTION — 24 hour notice required. <br /> ���2���`f��r.�..S�'�L^7� . <br /> Inspector�� � ate � — � <br /> EPSIR(E/09) DATAPAR.INC. <br />