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. _� E�4'(�I�V�ERINIG / P�l�LIC SERVICES <br /> �����'=�--� INSPECTION REQUEST <br /> �. <br /> Address ���-f-����'- ��.��' _ <br /> - -�r.�.�'c%��' <br /> Contractor____- _________ _ __ ��_ <br /> , � <br /> Owner ��'J`�_����/ �/`ui�_��� �3 <br /> � <br /> Date __�=��_/ ____ ____ Permit No. <br /> TYPE OF INSPECTION REQUESTED <br /> u SIDE SEWER <br /> U CURB/GUTTER/SIDEWALK <br /> �:.i STREET <br /> � �'E���"/�����_��_ ����� ,���� c��'�L�-- _- <br /> INSPECTION REQUESTED ON @ <br /> ___-- <br /> DATE TIME <br /> .��PPFiOVAL `�9 PARTIAL APPROVAL <br /> � ViOLATION � COR�ECTION REQUESTED <br /> � Cor�ections listed k�elovv �US� �� nl9�C�� before work can be approved. <br /> _i Please co��iact inspector and arrange for appointment. <br /> e� 41,'as not able to perform inspection. <br /> _.� �'-;;�.�� � �� >. ��°�,;�,� �� ���� ���,�w������'�+�� -- ?� ��our notice required. <br /> _ _ _ <br /> Cf: c!� ����_ �� �r��•�,�s_ _ <br /> - <br /> _ � -��� ����7�✓_,��_�r��;�7� <br /> - - __��,�r�.:4-� �� _,::,�+�7�,�7'�-r/_�� _ _ <br /> -- - ��t� -- __.���c.�<_ -�- t� .� - <br /> � � �-- �� ����_ ��� <br /> ��s7- �� _ _���r�v� _i�__C��_ b� <br /> ���i� �'�'�� T �iY�-� <br /> � �j���j�%i9�7 G�r�/ � ��✓7�� � <br /> �. <br /> ���f/�i�r� ��-r/�'/rt/c�� <br /> Ins���ctor Date ? � `-�i G — <br /> - <br />