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i <br /> � <br /> � <br /> � <br /> PUBLIC WORKS <br /> �'��'�''" IWSPECTION REQUEST <br /> e �- _ __ <br /> Addrnss -- I .J 1-_1 I r���—��� L}� <br /> Contractor <br /> Owner � <br /> Date ���� G� L ime� --------- <br />' TYPE OF INSPECTION R[OUESTED <br /> � ' SIDE SEWER <br /> � ! CURB/GUTTER/SIDEWALK <br /> fiSTREET <br /> ,.; .� J�-�u r.�- <br /> ,,�r,,,., ,_ , --- <br /> ' '47 ''` INSPFCTION REOUESTED ON o�� <br /> '��'o''� � � nm� .. <br /> �,:j,-�;( .� . <br /> �'�',,;'?: f i APPROVAL [ i PARTIAL APPROVAL <br /> �4'i f ] VIOLATION f l CORRECTION REQUIRED <br /> Corrr�r,�ions listed below MUST B[ MADF heloie work can ba ripproved <br /> ' ��`�I�i'>. ,-'�''.� . � Rle�sr contaat insPFclor and arrannn tor aPPan�mont. <br /> i��""��� � � �. Wns not ablP to porform insPection <br /> .. -. ' � CALL 2.59-A231 1 FOR NEINSPCGTION-- 7�1 ho�u no�ice requund <br /> A CERTIFICAT[ OF OCCUPANCY SH�LL E�[ ISSUED AND POSTED ON <br />- TI1E PREMISES PRIOR TO OCCUPANCY. <br />`�i,'` �--- � I <br /> � <br /> .4+�',,.�� . � _ <br /> i`` <br /> 'M' <br /> F. � <br /> 1' <br />:�rt. <br /> p�'e . ' ___- _ _ ..._ <br /> t` � � InsPecbr �- (�_�----- —Date _ <br /> ll/ — <br /> L• . <br />