HomeMy WebLinkAbout905 Willow Ave - Engineering
CITY OF PORT ANGELES i \ 1(; )
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date II - II -0 J
Time
L "/ C # f/ flJr4 rC tr
_ / , n Received by ,,/JPlP - (.1 II' (phone, person)
Location of Work to be inspected_
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
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Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date II - !I - V "3 Time 'f , tl II I' /11 By /( tJ IV
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Remarks ~ /l1AIIV 17;(;::-/1/(" /l/VI? [Ie Ei~41/C S;::-KVJC E
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RESTORATION REQUIRED
YES
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved ~avel
[] Repaired by City
[] Repaired by Permittee
o No Damage Found
D Asphalt D PCC 0 Other
Work Order # / I J >1
ff"COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
City of Port Angeles
Public Works Department
Water Distribution Repair Report
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IWork Order No wf:-- I' 3 Sf
Icrew R ~ IV pEll/lVIS 7/9-.Y~h I
I r
DATE REPORTED' 1/-1/- ~ }
CONDITION EMERGENCY rr'ROUTINE D CITIZEN COMPLAINT D
LEAKAGE SURVEY D OTHER D
DATE OF REPAIR. II - 1/ - v;3 TIME I ~ I > DA.M. IBP.M.
C1h Ie W/Lt-I7W
REP AIR LOCATION ADDRESS t v ./
DEPTH OF MAIN
C ,I.
; .-
J CLOSEST VALVE DEPTH. C PI/Lot) IV I
SIZE
}. "
TYPE OF MAIN
L pcftTe Vfit...I/c=:- fjl/llJcf)
COMPONENT REPAIRED.
MAIN JOINT D CIR. BREAK ~PLIT BELL D LONG BREAK D
HOLE fit"" CLAMP D OTHER
SERVICE TAP D CORP STOP 6' PIPE D CURB STOP D FIrrING D
METER SETTER D METER D
LINE VALVE. FLANGE NUTS/BOL TS D STEM D BONNET D
HYDRANT BRANCH D VALVE D BARREL D
OTHER.
COMPONENTS OF REPAIR. CLAMPrYI>RESSERD OTHER
SITE CONDITION GRAVEL vASPHALT D SIDEWALK D CURB D
TOP SOIL AREA D SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING TUBERCULATION-MINOR D SEVERE 0
EXTERNAL CORROSION LOCALIZED 9'" EXTENSIVE D
CHLORINE .l{CSIDUAL SAMPLE P.P.M.
WATER OFF FROM
M.TO
M.
FROM
M.TO
M.
APPARENT CAUSE OF LEAK. Iv' /t 7// rr A-{ 8~ e/? /('" , FtlfP/h Pcl /f' g t/ t. I?
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PUBILlC WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLlCANT
MAITLAND & SHARON PEET
905 WILLOW AVE
Port Angeles, WA 98362
000/604-2693
PROJECT INFO
Work is:
Issued: 9/06/2002
Permit No:
Work Order:
1316
o
PROPERTY LOCATION
905 WILLOW AVE
Lot: 16,17,18 &VAC ALLEY
J Subdivision: CHAMBERS ADDNT
Parcel No: 063301552034000 0
Block: 3
Long Legal
Value Work:
$0.00
Plans Required: Start Date: I I Finish Date: I I
Contractor: OWEST COMMUNICATIONS 360/000-0000
Performance Bond Required: Amount: $0.00
Proof of Insurance:
Work to Perform: 0 Install 0 Sanitary Sewer 0 Mise
o Repair 0 Storm Drain
o Watermain [g1 Underground Tele/Elec
PROJECT NOTES
placement of buried svc wire to include 100' along the right of way
with a 37' road push on Willow Ave.
FEES ASSESSMENT
1.) RIW Excav: $0.00 15.) Other San Sewer: $0.00
2.) Sidewalk: $000 16.) Sew Tap Wye/Man Tap: $0.00
3.) Curb/Gutter: $0.00 17.) Sew Capl W/M Removal: $0.00
4.) Driveway: $0.00 18.) Alter Repair Sewer: $000
5.) Dwy Culvert: $0.00 19.) Storm Drain: $0.00
6.) Street Cut: $0.00 20.) Catch Basin per ea: $0.00
7.) Other RIW: $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.) RIW Use Perm: $0.00
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
SEP 05 2002 14:59 FR TRAFTON B
253 471 1324 TO 13604174709
P.02/03
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7 '850 11f3" So. fra..4-0..
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P~rmit To Perform Work In Street Right-of-Way
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PIJAuO WOFl<S
APPLICATION is her~by made to the municipality of PORI' ANGELEs _ to perform work as
noted hereon and .s _hown on .llached drawing:
"PLEA5G <:.p.€- Ait'ACtf-€h ..5~=Jf.#woaS2~~~2
Pt;qc~'1E/VT Of BU'IEP :;UNIC.E VVII<E H:Jfe or.JR
c.U{,TO"'1cR 4r '(os vvlJ..t.Ovv .livE TO INavPE jOt) F~Er
'i{,ONt.:. TtlE ~1&H7'OF-vv"y Vv/7H A 57 PMT F-o/jJ)
PV5H. ~ )tfV~
r.A Approved:
Water Department - SUperintendent
Sewer DeplUtlnent - Superintendent
The estimated time for'completion of the above work Is 10 1::JAYS A-FTerL n Ft'F.lf"'l
Datc ~Efrf/1I!>GR t; '&D 02.
, .
By FUQlh'l
Ccmtractor Owner X
DWE..5T /ATf'l( :BSW i2.D0M.
7'8501/) TR"FTQN TI7C0/'1A1 -';jJ
,
THE ABOVE APPLICATION IS HEREBY GRANTED SUBJECT TO APPUCA!'oIT'S:
tAX
z. ~3 - VI- (~2 if
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Complying with all MUhicipal Ordinances;
Notifying the Street Superintendent of the time the work will star:, and when il will finish;
Prosecuting the work with dillgcncc and with due respect to all pr"'I'c:rty. contracts, pcnon.'
right6 and the in terests and convenien~ of the public;
Saving the Municipality harmJcSl from any and aU damale. which may accrue to any pcnon
or propcny because of this installation or the maintenance thereof;
ComplYin/: wllh follo....inll spcclal conditions:
~j;z- - 19
Date
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BV~J \ '>
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-III
5EP 05 2002 14:59 FR TRRFTON B
2534711324 TO 13604174709
P.03/03
'WOtJZ0'1 SS 3/Y 5ZC.
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11lis request for permit is for the piacement cfunci.cr~UJ1d telel'nolle service wire to our
customeT a.t tb.e following addreS5:
Q05 VV/LLOW A\JflVl.J~
TI'lis worle will r~~:
1"''''/
Trenching in the PJW (total footage) !:!!l
7;1
Push or bore 2 inch PVC or BlP unaer roadway (tOtal foctqe) '-
Push or bore 2 inch PVC or BIP ugcer multiple driveways (tota! footage)
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Push or bore 2 inch PVC or BIP untier driveway (tOtal footage)
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** TOTRL PRGE.03 **