The URL can be used to link to this page

Home My WebLink About1318 W 15th St - Engineering ~~ .\11 CrtY0F' PORT ANGELES , " . DEPARTMENT OF (::O~ DEVELOP~ -BUILDING DIVISION 321 EAST5THS~ET, PORT ANGELES, WA~8362 Application Number Pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use . . . . property zoning . . . Application valuation 04-00000592 Date .235408 1318 W15'P:l ST 06-30~00~0-4~3322-0000- RES MANUFAC~. H~'~' RESIDENTAL.:.SF '"70 00 RS7 RESDfITL SING~.FAM:ELY 7833.3 7/26/04 : Owne;r Contractor. ------------------------ THAYER, JOSHUA/JEANNE P. O. BOX 531 CLALLAM BAY (360) 68-1077 ------ Structure Information Construction Type Occupancy Type Other struct info WA.9832lS BUY RITE. HQfo!ES . 3543 W.STATE:HWY .16 SEBRING (479) " 795 1600 SF MANUFACTURED HOME TYPE V NON~RATED.. SINGLE FAM & C;:ONGREGATES TOTAL %~COVERAGE " EXISTING LOT COVERAGE LOT SIZE . .,' PROPOSED '. LOT. COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS" FL, 25,00 1.00 7000.00 '.1750.00 1750.00 1.00 ------.------------------------------~-------~--~~~--~----------------------- Permit Additional desc Permit. Fee Issue Date Expiration Date PUBLIC WORKS RES WATER SERV 640.00 7/26/04 1/23/05 plan ChElclt .l"ee Valuation .OQ 78333 ~ - ~ Qty Unit Charge Per 1. 00 640.0000 EA PW W/M 1 "SERY 518" METER Extension 640': 00 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - :- - - - ~.._'- - - - - - - - - - -.~ - - - - - - - - - - - -- Permit RIGHT OF WAY Additional desc Permit Fee Issue Date Expiration Date t. 45.00, 7/26/04 1/23/05 Plan' Check Fee " Valuation .00 78333 Qty Unit Charge Per 1.00 45.0000 ECH RIGHT OF WAY PERMIT Extension 45.00 CJ\' ~ ------~~--------------------------------------~--~---~---------------------- Permit Additional desc Permit Fee Issue Date Expiration Date STREET ALLEY RESTORATION 230.00 7/26/04 1/23/05 Plan Check Fee. ValUcltion .00 78333 ~. ":i Qty Unit Charge Per BASE FEE Extension 230.00 ------~--------------------------------------------------------------------- }, . Permit Additional desc Permit Fee Issue Date Expiration Date SANITARY SEWER HOOK UP 95.00 7/26/04 1/23/05 Plan '. Check c' Fee -ValUation .00 78333 Qty Unit Charge Per Extension Sepa~e ~~rmlts are requiredfor electrical work, ~~Pf'.;~~.O'r~lin~IESe.,.:~tili~~s, J>~Yat7:.and public improv~mtll1ts..:cUiIs Perrol! beco~s null and void if WOrk or construction authorized is notcom(l1eltceowith'%18~~d8ys;if cQnstJ;Uctionony.C)~I..iirSpericJ.lic:t.()ra~andoned for a period of 180. days after the work as comrnenced,iqrif r~uir~dim~p:'C,.ion~have n.9t been requestea~~ 8n,d!lYSfrOll:I the last '. InspectIon. I hereby certify that I have read and exalTlinedifJis appli~tion.and know the same to be true and ,correct AIl provisions of laws and ordinances governing this type of work willbe'compJieClWithWll~th~r specifi~d herein or not .The granting ofap8'r:m1t does not presume to give authority to violate or cancel. the provisions of any state' or local law regulating construCtion or the performance of construction. . ,Signature of Owner (if owner Is builder) Date T:\PLANNING\FORMS\II02.1S [11/14120031 "~ . _ ~.i ,~~:;o~',-\ :if;Jl~~. ~:\, ~.;.,--~ . .:l,,- ~ ,'~ ,-i.~- " i ";, BUll.DING PERMIT INSPECTION RECORD " >1'> 'CALL 417-4815 FOR BUILDIN~ INSPECTIONS. CALL 417-4735 FOR ELECTRICAL I:~PECTIONS. \ PLEASE PROVIDE A MINIMUM 24 HOUR.NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE. I ~., ~ ~ ...11. INSPECTION TYPE DATE ACCEPTED COMMENTS YES NO FOUNDATION: FOOTINGS I WALLS FOUNDA1JON DRAlNAGEIDOWN SPOUTS " ELECTRICAL (LImIT DEPl) SEPARATE PERl\tIT: # ROUGH-IN I j " PLUMBING UNDER FLOOR! SLAB ROUGH-IN WATER LINE (METER TO BLOG) GAS LINE BACK FLOW ! WATER AI~ SEAL WALLS I CEILING I FRAMING , , JOISTS! GIRDERS SHEAR W ALUHOLD DOWNS WALLS! ROOF! CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T-BAR INSULATION SLAB I I WALL! FLOOR! CEILING I I MECHANICAL HEAT PUMP GAS LINE WOOD STOVE! PELLET! CHIMNEY HOOD! DUCTS PW UTILITIES I SITE WORK (Engineering Division) SEPARATE PERMIT I/'s: WATERLINE I METER SEWER CONNECTION , SANITARY . STORM PLANNING DEPT. SEPARATE PERMlT#'s SEPA: PARKlNGlLIGHTlNG ESA: LANDSCAPING . SHORELINE: FlNAl,IN,SPECTIONS REQUIRED PRIOR TO OCC~PANCVro.SE I .. u , ., , RESIDENTIAL DATE YES' NO COMMERCLo\L IT DATE ACCEPTED " " " YES ;'NO "" ELECTRICAL - UGHT DEPT. 417-473S ELECTRICAL UGHT DEPT CONSTRUCTION R. W.I PWI CONSTRUCTION - R. W. I ,. ENGINEERING 417-4807 PW I ENGINEERING . I , ,^'\ " '. J>: ',; FlREDEPr. .. .:" ',-I., fiX 1 . f 1 ~i. r I FIRE 417-46S3 } . l~ ;'".., "'-,~:."r" ..'. , ,; PLANNING DEPT. 417-47So' PLANNING DEI>T." . i I,' " BUILDING ,.' 0'" ..... BUILDING 417-481S }" T:\PLANNlNG\FORMS\11 02.1 S [11114(2003) \; ;'\' ~\; '~.' ,~ ~~ CITYOFPORTANGELES DEPARTMENT OF(20~'J?EVE~qPMENT - BUILDING DMSION 321 EAST 5TIt'STREIrf, PORTA:NGELES, WA98362 Application Numbe~ pin number . . '.' 04-00000592" .235408 ~ Page 2 Date 7/26/04 Qty Unit Charge Per 1.00 95.0000 EA SAN SBWERHOOIan> Extension 95~()() -.-:':.~ - - -~ - - - - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - - - - - - - - - -.... - -,.,~"":- - - - - -<- -.-.~. - - - - - - - - -.- -- Special Notes andConunents .... ' . :>.;:.~;:~~.~;~~I Building address. sign shall not be less, than 6" ,& .notmore than 12,". in height. Numbers colors must, contrastwith;wall colo,r they are m01mted on. (Ord.14.36.050--E) When roof gutters 'are installed, drains ~ril located in dry wells or piped to approved storm drain locations', Manufactured home must be pit set so that no more than 12" of skirting is v:Lsable above grade. ' AN. ENGINEERED COMPACTION TEST REPORT MUST BESUBMITED, PRIOR TO FOUNDATION/FOOTING INSECTION. . Proposalwillresult inmfghome on RS~7lot. Setbacks are good, lot coverage, is 25%. No land use iS8ues..,are not~c;l. Electrical load calculations and elctrical permits are ' required. Any modifications to the City'S electrical ,facilities will be at the customer's expense. ' " --- - -..;. --- ~ ~-- -";';;;;'..;. ----..;.,-"-,',;,;, --..;.--- -- -.;.;. - - - - ~'~ - - - - ..;.,-'.... -.;. - -;.;..,;';.;;. - .,- .;.;.'...:- - - -::- -:: -,- - - - - - - -- Other Fees . . . . . . . .. SEWER SY:S~ I?ELV CHARGE STATE SUR~E PW WATER,SYSTBM'USE FEE 745.00 4.50 ' 1025.00 Fee sununary Charged Paid Credited Due -:---~------------ ---------- ---------- -.-------.- ,- - - - - - - - -- Permit Fee Total 1010.00 1010.00 .00 .00 Plan Check Total .00 .00 .00 .00 Other Fee Total 1774.50 1774.50 .00 .00 Grand Total 2784.50 2784.50 .00 .00 Separate Permits are required for electrical. work. SERA, S.hqF-~!iQe.ESA;tJtiliti~~, priVl3te..alld puhl!~ im,~"QXe./l1~~~!).,TbiS,,I?~.rt:TlJ~:~e~om~s nuUand void if work orconstruction authorized is not commenced within 180 days, If construction or wprk Is SUSpendflct or ai:>andoned for a period of 180 days after the work as commenced~ or If,reqiJired inl!pe~,()nS/;lave notbeenrequ~~ted ~thih ~~80:aays frOin'the last inspection. I. hereby certify that I have read and examine(j this applicati()rr~nd know the, same to be true alld correct, All provisions of laws,and ordinances governing this type of .....()rk wm,'lje ,complie~;Y"th W~Elt~~r specified herein or not. The granting ofap~rmlt does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction 01' the performance of construction. . Signature of Contractor or Authorized Agent' Date. Signature-of Owner (if owneris builder) ,Date,. T:\PLANNlNG\FORMS\1102.1S [11/14120031 BUILDING P.ERMIT INSPECTION RECORD Iit-:.. .. ~,- CALL 417-4815 FOR BUILDING INSPECTIONS. CALL 417-4735 FOR ELECfRICAL INSPECfIONS. i PLEASE PROVIDE A MINIMUM 24 HOUR NOTICE. IT IS UNLAWFUL TO COVER, INSULATE OR CONCEAL ANY WORKBBFORE INSPECTED AND ACCEPTED. POST PERMIT IN A CONSPICUOUS LOCATION. KEEP PERMIT CARD AND APPROVED PLANS AT JOB SITE , . INSPECTION TYPE DATE I ACCEPTED COMMENTS I YES NO I I FOUNDATION: FOOTINGS ! -t r'r . '1 WALLS -- ._~- FOUNDATION DRAINAGFJDOWN SPOlITS I : . . ELECTRICAL (UGHT DEPl) SEPARATE PERMIT: # ROUGH-IN I . PLUMBING . I UNDER FLOOR I SLAB ROUGH-IN WATER LINE (METER TO BLOG) . I GAS LINE . BACK FLOW I WATER AI~ SEAL WALLS I CEILING I FRAMING JOISTS I GIRDERS I SHEAR W ALLlHOLD DOWNS WALLS I ROOF I CEILING DRYWALL (INTERIOR BRACED PANEL ONLY) T -BAR ! INSULATION SLAB I WALL I FLOOR I CEaING I . MECHANICAL i - HEAT PUMP GAS UNE WOOD STOVE I PELLET I ClDMNEY I HOOD I DUCTS - PW UTILITIES I SITE WORK (Engineering Division) SEPARATEPERMITII's: ; WATERLINE I METER i SEWER CONNECTION . SANITARY . STORM PLANNING DEPT. SEPARATE PERMIT#'s SEPA: ! PARKINGlLIGHTING ESA: , . LANDS<1\PIl,:/G .. SHORELINE: ...... , .' . .-- , ~, i FINAL II'i,SP~IONS REQUIRED PRIOR TO OCCUPANCYIl!~E '. , .. . . " \ 'RESIDENTIAL DATE. YES NO COMMERCIAL. DATE ""ACCEPT~> YES NO . , . ELECTRICAL - LIGHT DEPT. 417-4735 ELECTRICAL UGHT DEPT i . CONSTRUCTION R. W.I PWI CONSTRUCTION - R. W. ENGINEERING 417-4807 PW I ENGINEERING FIRE 417-4~3 FIRE DEPT. PLANNING DEPT. 417-4750 PLANNING DEPT. BuaDING 411-4815 BUILDING i.. . " ... 'r" T:\PLANNlNG\FORMS\II02.15 [11114120031 , " d< ~OIlT"';~ l~"(t. ~ . -- ^",""" CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 0 4 _ S q z.. Application Number Pin number Property Address ASSESSOR PARCEL NUMBER: Application description Subdivision Name Property Use Property zoning . . . Application valuation 04-00000592 Date .23540B 1318 W 15TH ST 06-30-00-0-4-3322-0000- RES MANUFACTURED HOME 7/26/04 l~l2> lAJ15~ RESIDENTAL SF 7000 RS7 RESDNTL SINGLE FAMILY 78333 Owner Contractor J, Ih~€Y THAYER, JOSHUA/JEANNE P. D. BOX 531 CLALLAM BAY (360) 68-1077 Structure Information Construction Type Occupancy Type Other struct info WA 98326 BUY RITE HOMES 3543 W.STATE HWY 16 SEBRING (479) 795 1600 SF MANUFACTURED HOME TYPE V NON-RATED SINGLE FAM & CONGREGATES TOTAL % LOT COVERAGE EXISTING LOT COVERAGE LOT SIZE PROPOSED LOT COVERAGE TOTAL LOT COVERAGE NUMBER OF UNITS FL 25.00 1. 00 7000.00 1750.00 1750.00 1. 00 Permit PUBLIC WORKS RES WATER SERV Additional desc Permit Fee 640.00 Plan Check Fee .00 Issue Date 7/26/04 Valuation 78333 Expiration Date 1/23/05 / Qty Unit Charge Per Extension --------=~~~------~~~~~~~~-~~----~~-~~~-=:_~~~~-=~~:_~~=~~-------~~~~~~~ Permit Additional desc Permit Fee Issue Date Expiration Date RIGHT OF WAY 45.00 7/26/04 1/23/05 Plan Check Fee valuation .00 78333 Qty Unit Charge Per Extension ________=~~~_______~=~~~~~_~~~___~=~~=_~~_~~=_~~~==______________~ 45.00 ~ Permit STREET ALLEY RESTORATION Additional desc Permit Fee 230.00 plan Check Fee .00 Issue Date 7/26/04 Valuation 78333 Expiration Date 1/23/05 Qty Unit Charge Per Extension _________________________________~~~~_~~~________________________~ 230.0u ~ Permit SANITARY SEWER HOOK UP Additional desc Permit Fee 95.00 Plan Check Fee .00 Issue Date 7/26/04 Valuation 78333 Expiration Date 1/23/05 Qty Unit Charge Per Extension Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utilities, private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Authorized Agent Date Signature of Owner (if owner is builder) Date T:\PLANNING\fORlvlS\1 102.15 [11/]4/2003] / .~, ~POR'~~ l~<'(<".. r&i ... -- "".""" CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY DEVELOPMENT - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 Page 2 Appl~catlon Number 04-00000592 Date 7/26/04 Pln number .235408 ~ Qty un~t . c~a~g~ . Per Extensw~ / 1.00 95.0000 EA SAN SEWER HOOKUP ~ 95.00 ~ ________________________________________________________________L __ Special Notes and Comments Building address sign shall not be less than 6" & not more than 12" in height. Numbers colors must contrast with wall color they are mounted on. (Grd. 14.36.0S0-E) When roof gutters are installed, drains will located in dry wells or piped to approved storm drain locations. Manufactured home must be pit set so that no more than 12" of skirting is visable above grade. AN ENGINEERED COMPACTION TEST REPORT MUST BE SUBMITED PRIOR TO FOUNDATION/FOOTING INSECTION. proposal will result in mfg home on RS-7 lot. Setbacks are good, lot coverage is 25%. No land use issues are noted. Electrical load calculations and elctrical permits are required. Any modifications to the City's electrical facilities will be at the customer's expense. Other Fees SEWER SYSTEM DELV CHARGE STATE SURCHARGE PW WATER SYSTEM USE FEE C745.00 ....J 4.50 C l020.00- ~ Fee sununary Charged Paid Credited Due Permit Fee Total plan Check Total Other Fee Total Grand Total 1010.00 .00 1774.50 2784.50 1010.00 .00 1774.50 2784.50 .00 .00 .00 .00 .00 .00 .00 .00 Separate Permits are required for electrical work, SEPA, Shoreline, ESA, utililies, private and public improvements. This permit becomes null and void jf work or construction authorized is not commenced within 180 days, if construction or work is suspended or abandoned for a period of 180 days after the work as commenced, or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. Signature of Contractor or Aulhorized Agent Date Signature of Owner (if owner is builder) Date T:\PLANNING\FORMS\1 102.15 [11/14/2003J , 'F c. '':) tv', .0\ ,-" iV01t 1'4.10<;, -Olel APPLICATION FOR WATER City Water Department Port Angeles, Wosh. ( f-, r.. j . :<'C<:.> '-{ ,19_ I hereby apply for water to be furnished in accordance with rates and rules of the City for the following premises: Nome of Applicont ~I'-- I~ {,k., Address )31 R> w 1 -5 - (l~30rYY'>d:s~zy Renewol 0 New Service 0 Blk13-3LoL.:2 ,Add 7PA- .' , ft c..ay-<4(,,1,. / i. . Meter Numberr..."-t -( '1-;-~<fg ~OOC>Oo( I,{- ~\),'1- t~ \-to .eS' Service Left On 0 Service Left Of~ Signed \~~ ~Ol V~ S)n,p-1V\ P..er")V\n-tb-OCj~~ btJ-0771 Size of Service Instolled by Remarks: <j Vt\ D~ 1; f) z:,-iE N '.. ;, l-l... - - ~ w , 5/{ (p 25Z' "" If11L A I Icy c-"loO E s . ~< . CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date 1/2 Ll I D1_ 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): Sewer Foundation Framing Chimney Plumbing \~\n llJ\cj~ #ru~ - [) { (l/yY14){J ~- Phone No. Permit No. Final ~er EX~ Other O~-Sq~ INSPECTION NOTES:...) J I Inspected: Date '6/;:<~ D4~ Time Remarks: By RESTORATION REQUiRED...... YES NO J'/ ~\ \%\40 ~\\)~ /-.... . V) ,o( Q 'V :, ~ v.~ 'fii' lJ)1 9? it . ~:~I t~* f;v " ~ ~~?) ( ~'- :.;.,,~ I &"'11".;;1 L- ,,= ' -.- g ?-12f-@.m!;(1 / '\ I -0 SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel OAsphalt OPCC o Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side jf necessary) STREET SUPERINTENDENT IDATEI CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . INSPECTION REPORT. . . . . REQUEST: I I Date It) II I /J1. Time Received by Location of Work to be inspected I '3 I n u. )\ -5 t.f:J Name of person requesting inspection j.--/.. .4 " j e..Q. ) Address of person requesting inspection / Phone No. Type of Inspection (circle appropriate one): ~~ Permit No. t"? 4--51;::] Sewer Foundation Framing Chimney PIUmbing~.,ewer Excav. Other ,,(phone, person) INSPECTION NOTES: / / Inspected: Date ,If) /1/ !JL;/ Time By Remarks: ~ I fA) flJJJr, ,7 L_! Of 5P,.WI/ 'i?/0!11 Of tt'/?t}~1'J RESTORATION REQUIRED . . . . .. YES NO 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 CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . :~~UEST' il tI [! ~ Tim. R."I... by 'pb.,". p""o' Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one): J3-~l? tzi I d~ , , Phone No. Permit No. t:J <1 -6'9'~ Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other INSPECTION NOTES: } )~/ Inspected: Date !- D!f2t) Time Remarks: 1 ~ -fn(Ja::te 121J'J-Lrt~~ ~ 9- . LOC~-7Es" By J Q:,~..jF- p v€:f\ RESTORATION REQUIRED . . . . .. YES NO } r SURFACE RESTORATION: SURFACE TYPE: D Unimproved DGravel D Asphalt D PCC D Other o Repaired by City [] Repaired by Permittee [] No Damage Found Work Order # [] COMPLETE D INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) OCT 11 2004 12:33 Qw..:" Job 1/ FR TRAFTON B 253 471 ItJf)O(J,oc;):i./O - 4PriQ." 1324 TO 13604174709 P.03 Section: TU\lJnshic; Rom o;e: i", "^ I: f'31B I 0_ -~~ - -.. W ISit, sr <-. :-C::-"';'C::: ;or ?e!'":7:.1:: :s :-or ":::e ?~ace:-::e.:1t of :..J.nde.:grounci :ele!:~cm~ service Wlre :';..;.sro::-.:::- :"1: :.he !'OdOWlr:; ::ldc.:-~~s: 1~\2 IN IS+h Sl ~i'::s "-vo.:-l: ".'o.Iii .:-ecuire: 7:e::.c::.:n'g :n ~he '?./'W' (rocai f:,o:a.cre: ,.)Cf)' _J.."":sh or ~orc ..2 :nc~ P'.'C or 3IF '..J.nde=- :""oa.dway (tOtnJ footQ,,~e: ~ Z"-.l3n or 'oore ., inc!1 PlfC or !:lIP unde:- driveway (totwlootage, -e-- p;Jsh .or bo.:-e :2 inch pVC or SIP 1..:nder multiple driveways (tOtal footagel 0 ** TOTAL PUBILlC WORKS & R/W PERMIT D Attached Notes OWNER/APPLICANT Issued: 10/12/2004 Permit No: 1418 Work Order: 0 PROPERTY LOCATION 1318 -+liTH W Lot: 15" Subdivision: Parcel No: Block: Port Angeles, WA 98360 000/600-0000 PROJECT INFO Work is: Plans Required: Start Date: Contractor: OW EST COMMUNICATIONS Performance B Proof of Insura Work to Perfor o Long Legal Value Work: $0.00 1 1 Finish Date: 3601000-0000 1 1 PROJECT NOTES place 200' ond Required: Amount: $0.00 AX~I......""' nce: ~ m: t><J Install 0 Sanitary Sewer 0 Mise 0 Repair 0 Storm Drain OCT 1 2 2004 0 Watermain t><J Underground T ele/Elec .) bswin r/w at 1318 W 15th FEES ASSESSMENT 1.) RIW Excav: $0.00 15.) Other San Sewer: $0.00 2.) Sidewalk: $0.00 16.) Sew Tap Wye/Man Tap: $0.00 3.) Curb/Gutter: $0.00 17.) Sew Cap/W/M Removal: $0.00 4.) Driveway: $0.00 18.) Alter Repair Sewer: $0.00 5.) Dwy Culvert: $0.00 19.) Storm Drain: $0.00 6.) Street Cut: $0.00 20.) Catch Basin per ea: $0.00 7.) Other RIW: $0.00 21.) Sewer System Dev: $0.00 8.) Fire Hydrant: $0.00 22.) Milwaukee Dr. Sew Ass: $0.00 9.) Res Water Serv: $0.00 23.) RIW Use Perm: $0.00 10.) Comm Water Serve $0.00 24.) Admin Cost (D.R.A) $0.00 11.) Other Water Service: $0.00 25.) D.RA $0.00 12.)Water System Dev: $0.00 26.) Mise: $0.00 13.) San Sewer SFR: $0.00 TOTAL FEE: $0.00 14.) San Sewer MFR: $0.00 add unit 0 Amount Paid: $0.00 Receipt No: Inspection Fee: $0.00 Balance Due: $0.00 : ~./ ~f,;~5~ .,;,i'jJ~f . . 1-/.\ ),~, I -:.: ':'~~-'\flt<~ . :.~~\;i\~i.~ ','n~' :~" :,,~',::~: UOIu'I '. """",,;.;, .-, \ - ~ ;",'i.,;:i,}.'~; -.,,/''1 ,. S if '17':~'~_;.:.I;'; . .: j:~l~\'~\ OCT 11 2004 12:32 FR TRRFTON B 2534711324 TO 13604174709 w~ <q!he/ 9)~ lUlI.Je we_ P.nn;t To PerfOml Work In !lrre., Rillht-<>f-Way \10 FrOL/D/SLJ-'2fe,- 45d-.C- APPLICATION is ~e".y ""de 10 ,he ",unicip.lity of POlfI' ~ .Ia perfarrn work as nOfed her:ol'l and a! ~ho,*n on dUlI,hcd draW'i"g~ ~E. A1'1' Actfe b 6.s'\,J LCD' uV P(tNIM loQQ J~Jfr7)Y\Q.. ~v f~H ST. 'PLEASE. Pb.c..2 'to cd- I:,l~ ..s~:.ft~ ;e, D - t.J 3f2.iW LL.Q.) Approved: f~/ltl~ Water DeJlaztment - Superintend"/lt Sew..r OePertml!!lt - Sllperintendent The ~5tirnlfed Ijm~ forcornplo.iun of the .bo~e Work I. If) "bAYS AFTelL RLc.e,P"j' Dy~qhtil,,--t Contractor X Owner DwE.s:r /A'IT-N ; 13S\IJ 1?f501 S' TI< /j (.To,,", r"''''~''il I THE ABOVE APPLICATION IS HEREBY GRANTED SUBJ~CT To APPI,ICANrs; D '0 f'r-J:- 11 ?I::I...D4- f~ -#- 253 311 t,. 13 ~ .fAX J.b?JQ11. I ?:/(J-L/-- CDmplYin&, Wilh a.JJ MunicijlE! Ordfnan(:l!.$i NUlifyini the Srro., SUpolint.n~llnt or 'he time tho work will .1.", .nu ...hon 1t will finl.h: Pt"C3;1:::.cunng rne wnrle with. c3.jHslM'\c~ and with du~ l'CSpOl;r lu all propl!r~. r.:nnrra~~. J"Iefton~' riJ,.hIli iilnd I}le interesrs: and ccnven~~ncc af the ~blic;; Savin! the Municipality h.armle:lS! from any and aU d.amllKC:1I whic.h rnay acetUl! to any panon or 'PToperty blc::.use Qf thi.s instaJJarion or rhe maintenaT1ce (hereof; 'cUowin.c .pcd,s! conditJon~: D.lfh! 19 <':ltyofPOR~ ~~ 8~~~UAt(4 -.p~~. -- _.~....u. . A~~Y P.02