HomeMy WebLinkAbout313 Marine Dr - Engineering
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PUBILlC WORKS & R/W PERMIT
D Attached Notes
OWNER/APPLICANT
CITY OF PORT ANGELES
321 E. 5TH
Port Angeles, WA 98362
000/600-0000
PROJECT INFO
Work is.
Plans Required
Contractor' OWNER
Performance Bond Required
Proof of Insurance
Work to Perform.
Issued'
7/06/2000
Permit No
Work Order'
1077
o
PROPERTY LOCA TIO~
313 MARINE DR
Lot:
Subdivision.
Parcel No
Block: 3
TLW
D Long Legal
Value Work:
$000
Start Date,
1 1
Finish Date.
2061000-0000
1 1
Amount:
$000
D Install
Repair
Watermain
D Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
D Misc
PROJECT NOTES-
install 2" compound meter 10' west of Pump station on Marine Drive
for estuary project
FEES ASSESSMENl"
1 ) RIW Excav' $000 15 ) Other San Sewer' $000
2.) Sidewalk: $000 16) Sew Tap Wye/Man Tap $000
3 ) Curb/Gutter' $000 17 ) Sew Capl W/M 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 RIW' $000 21 ) Sewer System Dev' $000
8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass: $000
9 ) Res Water Servo $000 23 ) RIW 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' $000 26 ) Misc: $000
13 ) San Sewer SFR $000 TOTAL FEE. $0.00
14) San Sewer MFR $000 ~~--------~
add unit: 0 Amount Paid' $000
Receipt No
Inspection Fee. $000 Balance Due. $0.00
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . INSPECTION REPORT. . . . . . . . . . .
/
REQUEST
Date '{--1- Ob
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)
JI; CJuAyiN~ Vir'
T Lu , \ (b,/'
Lltit ~ .B Phone No
Permit No
..j:Cf?C 1077
LA...) (A...-f'-e Y
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
Inspected Date
Remarks
Time By
i= )...) 5 f-ct I ~ IV -R- cU A: ( I-U C-L +-ev
5 c5?/L c.) · ~ t.U dh nl 0 '" c:l-e ell ~ ,- i( /j- S 5""';1
RESTORATION REQUIRED
YES
/
NO 1/
1"ftI
~,,~
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
[] Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC l 0 Other
Work Order # 6 :3 ~f _
~OMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
501 Marine Drive
~UBLIC WORKS CONSTRUCTION Issued 1/20/98 TF Permit No 792
& R/W PERMIT Cond Work Order 0
)WNER/APPLICANT------------------------PROPERTY LOCATION------------------------
PETTIT OIL : 501 MARINE DR
523 MARINE DR : Lot 18,19,20
Port Angeles,WA98362 : Block 36 Long Legal
360/457-3353 : Sub TPA
PROJECT INFO--------------------------------------------------------------------
Work is N/A traveled road Value Work $0 00
~
--
$0 00 ~
~.
Plans Required
Contractor
N/A
R J
SERVICES
Start
Finish
Performance Bond Required
Proof Insurance
Work to Perform
N/A
Amount
/
//
/
/
/
/
* Storm Drain
Underground Tele/Ele
Misc
NOTES-------------------------------------------------------------------~
~
::>ROJ ECT
INSTALL
Watermain
Sanitary Sewer
::>ROJECT FEES ASSESSMENT---------------------------------------------------------
R/W Excav *
Sidewalk
Curb/Gutter
Driveway
Dwy Culvert
Street Cut
Other R/W
Fire Hydrant
Res Water Serv
5/8"
3/4"
1"
Comm Water Serv
1"
1 1/2"
2"
Oth Water Serv
Water Sys Dev
Receipt No
Inspection Fee
$40 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
San Sewer SFR
San Sewer MFR
Add Unit
Other San Sewer
Sew Tap Wye/Man Tap
Sew Cap/ W/M Removal
Alter/Repair Sewer
Storm Drain Tap
Catch Basin per ea
Sewer System Dev
Milwaukee Dr Sew Assess
R/W Use Perm
D R A
Admin Costs (D R A)
Misc
o
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
$0 00
------------------------------
------------------------------
$0 00
$0 00
5?6~
$0 00
TOTAL FEE
AMT PAID
BAL DUE
$40 00
$40 00
$0 00
,
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