HomeMy WebLinkAbout1738 W 12th St - Engineering
PUBILle WORKS & R/W PERMIT
I~ ~J Attached Notes
OWNER/APPLICANT -
DAN DAVIDSON
Issued:
6/01/2004
Permit No:
Work Order:
1402
o
Port Angeles, WA 98360
000/600~0000
PROJECT INFO
Work is:
Plans Required: Start Date:
Contractor: QWEST COMMUNICATIONS
Performance Bond Required: Amount:
Proof of Insurance:
Work to Perform:
~ __ _.PROPERTY LOCATION~
,
1738 12TH ST W
Lot: 10
Subdivision:
Parcel No:
Block: 362
TOA
o Long Legal
Value Work:
$0.00
/ /
Finish Date:
/ /
360/000~0000
$000
IZ-J Install
o Repair
o Watermain
o Sanitary Sewer
o Storm Drain
l><J Underground Tele/Elec
o Misc
PROJECT NOTES
PLACEMENT OF BURIED SERVICE WIRE TO INCLUDE 171' OF RIGHT OF WAY AND
18' ROAD CROSSING AT 12/13/ ALLEY EAST OF "L" ST.
FEES ASSESSMENT
1.) R/W Excav: $0.00 15.) Other San Sewer: $0.00
2.) Sidewalk: $0.00 16.) Sew Tap Wye/Man Tap: $0.00
3.) Curb/Gutter: $0.00 17.) Sew Cap/ W/M Removal: $0.00
4.) Driveway: $0.00 18.) Alter Repair Sewer: $0.00
5.) Dwy Culvert: $0.00 19.) Storm Drain: $0.00
6.) Street Cut: $0.00 20.) Catch Basin per ea: $0.00
7.) Other R/W: $0.00 21.) Sewer System Dev: $0.00
8.) Fire Hydrant: $0.00 22.) Milwaukee Dr. Sew Ass: $0.00
9.) Res Water Serv: $0.00 23.) R/W Use Perm: $000
10.) Comm Water Serv: $0.00 24.) Admin Cost (D.R.A) $0.00
11.) Other Water Service: $0.00 25.) ORA $0.00
12.)Water System Dev: $0.00 26.) Mise: $0.00
13.) San Sewer SFR: $0.00 TOTAL FEE: $0.00
14.) San Sewer MFR: $0.00
add unit 0 Amount Paid: $0.00
Receipt No:
Inspection Fee: $0.00 Balance Due: $0.00
MAY 27 2004 11
35 FR TRAFTON B
253 471
1324 TO 13604174709
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To; City of Port Angel.. Fa,.: 360-417-4709
From: Qwest Communications Dale: 05127/04
Re: Pas....: 3
cc: Ryan FUqua
o Urgent o For RevIew o Please Comment o PIGase Reply o P~'RacycIe
" " " " " " " "
Nota;:
T. Funston,
Permit applications:
WOO402900/452C
Thank you,
-Ryan
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NotifYing the Street Superintendent of the time the work will star:, and .....hen it will tlnish; ':J':.'!~,~01
Prosecuting th. "'ork with dillsenc. and with due respect to all prol'or!)'. contnters. penons',
rights and [he interesrs and convcnillnl;:Cl of [he JNblic; '(.,\{\;
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MRY 27 2004 11:35 FR TRRFTON B
2534711324 TO 13504174709
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F'Ul;Jc WCI'I<S
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Permit 'To Perform Work In Street Rilht-of.Way
APPLICATION is hereby malie [0 the muni!;:ipaJity of Pcin' ANaE:LEs
nored hereon and as ,\Oo",n on a[rachca drawing;
PLEA'f:::E <:::..p.E Ai1' AC#e b
The estimared time for'completion ~f lhe llbove work is JD J:JAYS
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MRY 27 2004 11:36 FR TRAFTON B
253 471
1324 TO 13604174708
Qwest Job #
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V'E<;T
11TH
$r~fET
[tng 1
(ftiLfY)
This request for permit is for the placement of Underground telephone service wire. to
OUr customer at the following address:
173 ~
w
12TH
5 TR,EEr
This work wiIl require:
Trenching in the R/W (total footage)
Push or bore :2 inch PVC or BIP under roadway (total footage) " $' ,
Push or bore 2 inch PVC or BIP under driveway (total footage)
Push or bore :2 inch PVC or BIP under multiple driveways (total footage)
ApplicantSignature/Date ./ I"'~ 7- ';-2-6-0'1
Road Nurnber_
/711
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4
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