HomeMy WebLinkAbout1300 E Lauridsen Blvd - Engineering
PUBILIC WORKS & RIW PERMIT
Issued
10/10/2000
OWNER/APPLICANT 0 Attached Notes
Judy Jones Living Trust
504 NW 90th St
Vancouver, WA 98665
000/600-0000
PROJECT INFO _____
Work is.
Plans Required Start Date
Contractor. DON LOVE TRUCKING
Performance Bond Required. Amount:
Proof of Insurance
Work to Perform.
Permit No 1115
Work Order. 0
PROPERTY LOCATIO~_ _ _____ _ _ _ _
1300 LAURIDSEN BLVD E
Lot:
Subdivision
Parcel No
Cresthaven
063011550010000
Block: A
r J Long Legal
Value Work:
$000
-, - --- - - - .-
1 1
Finish Date
360/457-4071
1 1
$000
PROJECT NOTES
o Install
D Repair
D Watermain
o Sanitary Sewer
o Storm Drain
o Underground Tefe/E/ec
[J Misc
sidewalk
construct sidewalk curb and utilities on Blvd and Liberty Sts
inspection costs estimated @ $30 00 hr approximately 20-25 hrs to be
billed to Judy Jones payment for hot tap received 10/23/00 $950 00
received payment for inspection 10/16/2000 reC# 6661
-- -------. -------
FEES ASSESSMENT -----. - -- - -
1 ) RIW 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/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 R.A) $000
11 ) Other Water Service $000 25 ) 0 R.A. $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 6658 ~~ ------
Inspection Fee. $000 Balance Due $0.00
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
l) ().) . JJ("( - 171-18
REQUEST
Date It, - ~ > - PO Time Iv'? C -4""1 Received by
.....
location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
,b&) .
? cj- c:. 18 c,r.;> 7,1..-
17 /c L
(?~9L?
$/ L L (phone, person)
· J'7PtJ eZaU4<~
.
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
Phone No
Permit No ff I / I~-
INSPECTION NOTES
Inspected Date I V' - /- .> -c C/
Remarks (;;' H t/ r fA /.
Time / ~ - vt/ ~ /'? By K t"R
~
7
,
~
J
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RESTORA TION REQUIRED
YES
NO
~
SURFACE RESTORATION
SURFACE TYPE ~mproved 0 Gravel 0 Asphalt 0 PCC
,.
=
o Repaired by City
CJ Repaired by Permittee
CJ No Damage Found
Work Order #
~OMPlETE
o INCOMPLETE
o Other
I 7 I rr
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DA TE)