HomeMy WebLinkAbout320 Vashon Ave - Engineering
PUBILle WORKS & R/W PERMIT
[J Attached Notes
OWNER/APPLICANT
JULIE BIGGAR
320 V ASHON
Port Angeles, W A 98362
000/604-2607
PROJECT INFO
Work is
Plans Required
Contractor. OWNER
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
9/05/2002
Permit No
Work Order.
1315
o
PROPERTY LOCATION
320 V ASHON
Lot: 5 & 6
Subdivision PSCC 2ND ADDITION
Parcel No 063010500316000 D
Block. 3
Long Legal
Value Work.
$000
Start Date
I I
Finish Date
206/000-0000
I I
Amount:
$000
D Install
D Repair
D Watermain
D Sanitary Sewer
D Storm Drain
D Underground T ele/Elec
D Misc
PROJECT NOTES
depressed curb existing
FEES ASSESSMEN'F
1 ) R/W Excav. $45 00 15 ) Other San Sewer. $000
2 ) Sidewalk. $000 16) Sew Tap Wye/Man Tap $000
3 ) Curb/Gutter. $000 17 ) Sew Capl W 1M Removal $000
4 ) Driveway. $000 18 ) Alter Repair Sewer. $000
5 ) Dwy Culvert: $000 19 ) Storm Drain $000
6 ) Street Cut: $000 20 ) Catch Basin per ea. $000
7) Other R/W $000 21 ) Sewer System Dev. $000
8 ) Fire Hydrant: $000 22 ) Milwaukee Dr Sew Ass $000
9) Res Water Servo $000 23 ) R/W Use Perm $000
10) Comm Water Servo $000 24) Admin Cost (D RA) $000
11 ) Other Water Service $000 25 ) D RA. $000
12 )Water System Dev. $000 26 ) Misc. $000
13 ) San Sewer SFR: $000 TOTAL FEE. $45.00
14 ) San Sewer MFR $000
add unit 0 Amount Paid $45 00
Receipt No 7491
Inspection Fee $000 Balance Due $0.00
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT . . . . . .
.....
REQUEST ~
Date 9/ :r . .:;A
f I
Time
Received by
(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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Sewer Foundation Framing Chimney Plumbing Final
INSPECTION NOTES
Inspected Date / d~- I?, -0 2-- Time
Remarks
P Jt/J I
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RESTORA TION REQUIRED
YES
NO X
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Repaired by City
[] Repaired by Permittee
CJ No Damage Found
o Other
~
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . INSPECTION REPORT. . . . . . . .
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REQUEST
Date / I .-11 - f :?-
Time 1/,' IS ;91'1 Received by If IL L
(phone, person)
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Sewer Foundation Framing Chimney
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Phone No
Permit No
Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date / I - I ! - () ;?-
Remarks ~ I, C A J r :LA VIY
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Time
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C)f'/JC I( EP. r/-keJ? /A/ITH
RESTORATION REQUIRED
YES
NO ~
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SURFACE RESTORATION
SURFACE TYPE D Unimproved D Gravel D Asphalt D PCC D Other L /f w)/
D Repaired by City Work Order # ;1...?- S- '3
[] Repaired by Permittee g-coMPLETE
o No Damage Found D INCOMPLETE
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STREET SUPERINTENDENT (DATE)
(Continue on reverse side if necessary)
CIty of IJort Angeles
Public 'Vorks Departnlent
'Vater Distribution Repair Report
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IWork Order No
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DATE REPORTED /! - /1 - ~ ;;>-
CONDITION EMERGENCY ~UTINE 0 CITIZEN COMPLAINT 0
LEAKAGE SURVEY 0 OTHER 0
DATE OF REPAIR. II-It-/";;- TIME. I "J ~ DA.M. ~M.
3 ') C' J/..4 (I HI ~ N
REPAIR LOCATION ADDRESS r II /7 .,) V
TYPE OF MAIN
. ,
CA5'r ":;:jeV'N SIZE. ~
LL'
T CLOSEST VALVE DEPTH.
if I
DEPTH OF MAIN
COMPONENT REPAIRED. /
MAIN JOINT 0 CIR. BREAK l!f SPLIT BELL- 0 LONG BREAK 0
HOLE 0 CLAMP 0 OTHER
SERVICE TAP 0 CORP STOP 0 PIPE ~ CURB STOP D FITTING 0
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VALVED BARREL 0
OTHER.
COMPONENTS OF REP AIR. CLAMP~DRESSERO OTHER
SITE CONDITION GRA VEL 0 ASPHi\L T 0 SIDEWALK 0 CURB 0
TOP SOIL AREA e"'" SOIL TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _FT
MAIN CONDITION INTERNAL LINING TUHI;RCULA TION-MINOR 0 SEVERE 0
EXTERNAL CORROSION LOCALIZED r!f EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE .003 P.P.M.
WATER OFF FROM' '" tJ{) PM. TO ,? vi f M.
FROM
M.TO
M.
APPARENT CAUSE OF LEAK. fIrE eft A C 1'- E tJ
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