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; ENGINEERING / PUBLIC SERVICES <br /> � INSPEC� RE(�UEST <br /> c-.2�'- � <br /> Address �Q0�.3 _ /3 T�r/��Z_ <br /> Contractor _��'9��`� —._ __. —___ <br /> Owner ��4�i�%� _--_-- <br /> Date � -l3 —� �7` Permit No. �,Q�7G�-(7`l.�-�-- - <br /> TYPE OF INSPECTION REOUESTED <br /> U SIDE SEWER <br /> ❑ CURB/GUlTER/SIDEWALK <br /> U STREET <br /> o �OOT//-�i�. �- ��'"�� �T�/�//t/S <br /> INSPECTION REQUESTED ON Q <br /> DATL TIM[ <br /> ❑ APPROVAL � PARTIAL APPROVAL <br /> �� VIO ION !� CORRECTION REQUESTEC <br /> ❑ Corrections listed below MUST BE MADE be(ore work can be approved. <br /> O Plcase conlacl inspector and arrange br appointment. <br /> U Was not able to per(orm inspection. <br /> � CALL �425� 257-8810 FOR REINSPECTION — 24 hour notice required. <br /> — /� - - ' —/ — — -- — - <br /> —/�-���4�.� --�,��— —. ... _ _ <br /> Inspeclor . . . -- -- __�� _ �_Dat�� —��---. .- <br /> � <br /> I I"�i��(G/U6) DP.fAOAR INC <br />