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87-131 Cv, <;;'-\tEE., - AJORE:-{ AvE... \W\V'~~"evv\.EN\~_. 61'1\ = ,(c.. e cNO O~8l<.. '",F::>. wES'1 S\OE..ot= Y?A.~CE:L. T (c. ELEv.::: 2~. "g 1- E;'. So t\-. t. = :z.5"2. ..(~ . GJ Ro9 c;- , 3G" '(;ES'R€P Eu:.y'. '24<.. . (,k' . elF. e,! o,!.i... E:LEv'. , :2 t.{c, /62. <.Y s- . ?.~ :L4~, cr'-! ~4-f. 17~. c/o !J; 6> r::; t 2h ;;z..L/.~/1z.. ?-4<O. 81 cl 0. ~ ..TC).. . T(e \0 (7/ ~1 . Q ~~$€, . f\ ?AJ2..T , ~..S.:rO.Eo.c. T(~ -r/e, W 5.0'1?-@ ?-1~, '(~ clo'.i.. rle,; ~,J or-- p ,/ II) · j~ 1~-t'l")l ~1 to BM ~: 2.4a." ~ _~__ '_~H .__. ~ .-._..~,...__._...-.. , . .j ..- . -. ...-.- ~ . ._'" '" .-...,-. -... ..-.. i , .-. 25' '2-;;' '2...0' " '., PUBLIC WORKS INSPECTION REPORT Date Permit or Project No. '8'7- /3 / Address /~~ ~ Type of work a Street ........... Storm Other (describe) Sanitary Electrical o PRELIMINARY INSPECTION WITH DEFICIENCY LIST (attached) o FINAL INSPECTION WITH DEFICIENCY LIST (attached) o FINAL INSPECTION - ACCEPTANCE Signed plallli? Y N (If signed, Council acceptance.) Charges against deposit? Y N Overtime s hrs. @ $ /hr. . $ Date , reasons Barricade rental (attach invoice)? y Date , rea.ona N $ Other? $ $ $ · Refund $ Total charges deducted from deposita (Cash Deposit $ less charges $ [JONE YEAR MAINTENANCE WITH DEFICIENCY LIST (attached) ck. req.) i25l ONE YEAR MAINTENANCE - ACCEPTANCE (Release'maintenance bond. Check Request if cash.) Engineer ~or