HomeMy WebLinkAbout719 S E St - Engineering
PUBILIC WORKS & R/W PERMIT
I Attached Notes
OWNER/APPLICANT
DON WILSON
1137 W 8TH STREET
Port Angeles, W A 98362
000/604-7195
PROJECT INFO
Work is
Plans Required
Contractor' OWNER
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
1 1
1196
o
Permit No
Work Order'
PROPERTY LOCATIO~----.- .
719 ESTS
Lot: N 1/2 L T 11&12
Subdivision TPA
Parcel No 063099024220000 D Long Legal
Block. 242
L
Value Work,
$000
Start Date
1 1
Finish Date
206/000-0000
1 1
Amount:
$000
~ Install
[' Repair
C2.J Watermain
~ Sanitary Sewer
L><J Storm Drain
Underground Tele/Elec
n Misc
PROJECT NOTES-
dwy off alley Water meter to be installed off 'E" SI. place stake
in ground at location where customer would perter meter installed
Existing sanitary sewer lateral which serves Lt A of this SHP may also
used to serve Lt BAY connection is to be placed on the 6" pipe to
serve Lt B 2 cleanouts are to be installed 1 for each properly
FEES ASSESSMENT
1 ) R/W Excav' $000 15 ) Other San Sewer' $000
2 ) Sidewalk. $000 16) Sew Tap Wye/Man Tap $000
3 ) Curb/Gutter' $0 00 \ 17) Sew Capl W/M Removal $000
4 ) Driveway' $0 00 ~(J 18 ) Alter Repair Sewer' $000
5 ) Dwy Culvert: $0 00 ~ 19 ) Storm Drain $000
6 ) Street Cut: $0 00 , 20 ) Catch Basin per ea $000
7 ) Other R/W $000 f 21 ) Sewer System Dev' $74500
8 ) Fire Hydrant: $000 22 ) Milwaukee Dr Sew Ass $000
9) Res Water Serv' 5/8" ~ 23 ) R/W Use Perm $000
10 ) Comm Water Servo $0 00 \ 24 ) Admin Cost (D R.A) $000
11 ) Other Water Service $0 00 ~<J 25) D RA $000
12 )Water System Dev' $1,02500 ~ 26 ) Misc' $000
13 ) San Sewer SFR. ~ TOTAL FEE. $2,505.00
14) San Sewer MFR. $000
add unit 0 Amount Paid $735 00
-------
Receipt No
Inspection Fee $000 Balance Due $1,77000
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . INSPECTION REPORT. . . . . .
Date
Jjk--
Time
Received by
(phone, person)
REQUEST
YJ, ~J C1 S ll't-11
Location of Work to be inspected ~_ ::+ c:=..
Name of person requesting inspection / ~a .J
Address of person requesting inspection Phone No
Type of Inspection (circle appropriate one) ~ Permit No
Sewer Foundation Framing Chimney Plumbin~ewer Excav Other
INSPECTION NOTES
Inspected Date
Remarks
Time
By
RESTORATION REQUIRED
YES
NO
rI . < ~
(J{I "'(')1 ~LJ
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
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. . . . . . . . . . .
REQU~: ~
Date:)'Y-/ - /J "2- Time Received by t?)
~./
(phone. person)
Location of Work to be inspected 7 / 1 s e. s;;;f ,
Name of person requesting inspection
Address of person requesting inspection Phone No.
Type of Inspection (circle appropriate one) Permit No ,1"2 ~56
Sewer Foundation Framing Chimney Plumbing FinarOExcav Other /fA) / / q (,t:?
W/fT2f7e-Ll~~
INSPECTION NOTES:
Inspected Date 5'.. /... 0 '",
Remarks:
Time
By
'cI?
RESTORATION
NO
\
~
~ 1
I
If~
S-Fe
- --"'._~-_._--------
L~~J
i
, \
i
SURFACE RESTORATION:
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
o Repaired by City
o Repaired by Permittee
o No Damage Found
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. . . . . .
uw - 2-0el(' <oe~
/
. . . .. //}f~~
REQUEST
Date t.{ - 5 ~ 0 2..
Time
Received by
(phone, person)
Location of Work to be inspected 7 l'1 5 t: 'S 1-
Name of person requesting inspection !)~ r dj I """!\+o '-.
Address of person requesting inspection G:,,,..... /) y~...,,-;f ( 7 f'; ~ is Phone No
I
Type of Inspection (circle appropriate one) Permit No __
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Oth~~ h,:....r
INSPECTION NOTES
Inspected Date Time
Remarks .~ ;:1;;<d 8 ff A c W 1ft.. l;t -rei/) J e. 'f...+e r'\.d
,I I '
-tc> p1 ra J1 e 1"1 v .
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By
I (t () E
,
-tv b( ~,
ZS '
RESTORATION REQUIRED
YES X
NO
- w1~ r1J
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C)\ Z ('. 7/& f!-({(1
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel .KJ Asphalt 0 PCC
o Other
D Repaired by City
D Repaired by Permittee
o No Damage Found
Work Order # 208 Z
[!2(' COMPLETE
o INCOMPLETE
~ "'f.rOz.,
(DATE I