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ATTENTION: Ai �rL DATE: V '_ /
FROM: ,BUILDING DIVISION INSPECTOR: d }k u j
ADDRESS: ) 3 ) ( 3. W► N,,�i6Z G--�Y
PERMIT NO.: PLAN NO.:
f H _ Nl s`T7 _2/3_ o 9- 96/Z
CONTRACTOR: �, � o fir »__�-- PHONE NO.:
OWNER: PHONE NO.:
PLEASE INSPECT THE FOLLOWING ITEMS FOR CONFORMANCE WITH APPLICABLE DEPARTMENT
OF PUBLIC WORKS REQUIREMENTS.
Type of Inspection Date& Initial Date&Initial Final Approval
Meter Location
Blackflow Devices
- 4143
Irrigation System
Fire Sprinkler System
Meter Clear A.P.P.
Ej.;
Swimming Pool
COMMENTS: A k,, 2e9c06 S a� (iC
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