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.;
eu'y M CJoM1'aELL
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Caapbell, Q .5001
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appl1oaUoa.Date 10/3/88
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CITY OF CAMPBELL
PUBLIC WORKS ENCROACHMENT PERMIT/PROJECT
INSPECTION REPORT
DATE: 12-2-91
PERMIT/PROJECT NO.: 89-237
TRACT NO.
ADDRESS:2365 Winchester Blvd.
TYPE OF WORK: STREET:
STORM:
SANITARY:
SIGNALS
LIGHTING:
SIGNING:
STRIPING:
IRRIGATION:
PLANTING: X
P.C.C.:~PARKWAY:
OTHER:
PRELIMINARY INSPECTION WITH DEFICIENCY LIST:
(Date)
FINAL INSPECTION AND ACCEPTANCE:
(Date)
SIGNED PLANS?
COUNCIL ACTION?
C E ACTION?
FILE NOC?
YES_
YES_
YES_
YES_
NO_
NO_
NO_
NO_
CHARGES AGAINST DEPOSIT? YES_
NO_
OVERTIME:
HRS. @ $
PER HOUR - $
EQUIPMENT RENTAL: TYPE:
AMOUNT: $
DATE:
REASON:
TOTAL CHARGES:$
ONE YEAR MAINTENANCE WITH DEFICIENCY LIST
X
ONE YEAR MAINTENANCE ACCEPTANCE
H. Imokawa
INSPECTOR
12-2-91
DATE
f:pw insp
9/91