HomeMy WebLinkAbout2703 Mt Angeles Rd - Engineering
PUBILIC WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT .
JED CUNNINGHAM
507 E FRONT ST
Port Angeles, W A 98362
000/604-2708
PROJECT INFO
Work is
Plans Required
Contractor' OWNER
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
9/25/2002
Permit No
Work Order'
1328
o
PROPERTY LOCATION
2703 MT ANGELES RD
Lot: 1
Subdivision
Parcel No
Block.
96(03)03
~ Long Legal
Value Work.
$000
Start Date
I I
Finish Date
206/000-0000
I I
Amount:
$000
~ Install
D Repair
~ Watermain
~ Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
D Misc
PROJECT NOTES
FEES ASSESSMENT
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' $745 00
8 ) Fire Hydrant: $000 22 ) Milwaukee Dr Sew Ass $000
9) Res Water Servo 5/8" $640 00 23 ) R/W Use Perm $000
10) Comm Water Servo $000 24 ) Admin Cost (0 RA) $000
11 ) Other Water Service $000 25 ) 0 RA. $000
12 )Water System Dev' $1,02500 26 ) Misc: $000
13 ) San Sewer SFR $95 00 TOTAL FEE. $2,550.00
14 ) San Sewer MFR $000
add unit 0 Amount Paid $640 00
Receipt No
Inspection Fee $000 Balance Due $1,910.00
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS ~ p~
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . .. ~ 1 ~~~
REQUEST / /, ZlJ
Date /'0-- jl- 62-. Time Received by (phone, person)
f)... 7 0 3 cp/{! A.~ (] -e{..p~ Ai
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1111 -t- B Phone No
Permit No I 3 '2.. B
Chimney Plumbing Final Sewer Excav Other l,0.!-'L.t-e }"'-
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
INSPECTION NOTES
Inspected
Remarks
Date
Time
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RESTORATION REQUIRED
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SURFACE RESTORATION
SURFACE TYPE D Unimproved 0 Gravel D Asphalt D PCC D Other
D Repaired by City Work Order # :l ~ ~ q
D Repaired by Permittee ~OMPLETE
[] No Damage Found 0 INCOMPLETE
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STREET SUPERINTENDENT
(DATE)