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EI�GIIoIEERING / Pll�L1� SER\/ICE� <br /> INSPECTION REQUIEST <br /> � Address _T"b_J_�_� __���__��✓"��3t9� <br /> Contractor <br /> - - - - -- ------ ---- -- --- <br /> - <br /> Owner _��� ��i�T _ _ ��/�------ <br /> Date � l�_�� _________ __ Permit No. <br /> TYPE OF INSPECTION REQUESTED <br /> ❑ SIDE SEWER <br /> ❑ CURB/GUTTER/SIDEWALK <br /> ❑ STREET <br /> � <br /> INSPECTION REQUESTED ON _ @ <br /> DATE TIME <br /> ❑APPROVAL � PARTIAL APPROVAL <br /> ❑ VIOLATION �CORRECTION REQUESTED <br /> ❑ Corrections listed below lIAUST BE 9VIADE before work can be ap�roved. <br /> ❑ Please contact inspector and arrange for appointment. <br /> ❑ Was not able to perform inspection. <br /> �J CALL (425) 2�7-8�10 FOR R�IP�SPECTI�B� — 24 hour notice required. <br /> ---- - ---_ _ _ -- ---- ---- -- ---- --- - _ <br /> __ �L� _����u,�� ---���.S i-rr u 5,�- - <br /> . <br /> --- <br /> _ <br /> - - �--�-� -�?��� -_ __ _____- <br /> __ ___ _ ___ _ _ _ _____ __�_s���_ __ <br /> ___ _ __ , <br /> ___ <br /> Inspector _ Date � /8/ �3� <br /> �2�- 33�'-?�3 . <br /> EPSIR(6/06) DATABAR, INC. <br />