HomeMy WebLinkAbout101 E Railroad Ave - Engineering
PUBILle WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
BLACK BALL TRANSPORT
101 E RAILROAD
Port Angeles, W A 98362
000/604-7491
PROJECT INFO
Work is
Plans Required
Contractor' R J SERVICES
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
1/09/2002
Permit No
Work Order'
1231
o
PROPERTY LOCATION
101 RAILROAD E
Lot:
Subdivision
Parcel No
Block.
BLACKBALL PROP #0701201
063000500685001 D Long Legal
Value Work.
$000
Start Date
I I
Finish Date
360/457 -1420
I I
Amount:
$000
[gJ Install [gJ
D Repair D
[gJ Watermain D
Sanitary Sewer
Storm Drain
Underground Tele/Elec
D Misc
PROJECT NOTES
hot tap 6" on 12" by city forces, street restoration full cut across
Railroad Ave.(asphalt by city- concrete by contractor)
FEES ASSESSMEN"F
1 ) R/W Excav' $45 00 15 ) Other San Sewer' $95 00
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: $600 00 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 Serv' $000 23 ) RIW Use Perm $000
10 ) Comm Water Servo $000 24 ) Admin Cost (0 R.A) $000
11 ) Other Water Service $000 25 ) 0 RA. $000
12 )Water System Dev' $000 26 ) Misc' hot tap $950 00
13 ) San Sewer SFR $000 TOTAL FEE. $1,690.00
14) San Sewer MFR. $000
add unit 0 Amount Paid $1,69000
Receipt No 7392
Inspection Fee $000 Balance Due $0.00
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
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REQUEST
Date J - J D - D.2 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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Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
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INSPECTION NOTES
Inspected
Remarks
Date Time By
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RESTORATION REQUIRED.
. YES
/
NOV
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 11 0 Other
0<-61 ~
Work Order #
~MPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DA TE)