HomeMy WebLinkAbout2624 S Lincoln St - Engineering
PUBILIC WORKS & R/W PERMIT
,_:I Attached Notes
OWNER/APPLICANT ---- _____
GEORGE B YOUNT
2624 SO LINCOLN STREET
Port Angeles, W A 98362
000/604-7953
PROJECT INFO
Work is
Plans Required Start Date
Contractor. GARY'S PLUMBING & HEATING
Performance Bond Required Amount:
Proof of Insurance
Work to Perform
Permit No
Work Order.
PROPERTY LOCATION----- _____
2624 LINCOLN S
Lot: 19 & 20
Subdivision PSCC 2ND ADDNT
I Parcel No 063015005760000 [-
--~ ----
I 1 Install
l ~ Repair
1 Watermain
PROJECT NOTES
repair existing san. sewer lateral
FEES ASSESSMENT-
1 ) R/W Excav.
2 ) Sidewalk.
3 ) Curb/Gutter.
4 ) Driveway.
5 ) Dwy Culvert:
6 ) Street Cut:
7 ) Other R/W
8 ) Fire Hydrant:
9) Res Water Servo 5/8"
10) Comm Water Servo
11 ) Other Water Service
12.)Water System Dev.
13 ) San Sewer SFR
14) San Sewer MFR
add unit 0
Receipt No 9345
Inspection Fee $0 00
Issued
11/25/2002
Value Work.
I I
Finish Date
360/457-8249
$000
~ Sanitary Sewer
: J Storm Drain
Ll Underground Tele/Elec
$45 00
$000
$000
$000
$000
$230 00
$000
$000
$000
$000
$000
$000
$000
$000
I : Misc
15 ) Other San Sewer.
16) Sew Tap Wye/Man Tap
17 ) Sew Capl W 1M Removal
18 ) Alter Repair Sewer.
19 ) Storm Drain
20 ) Catch Basin per ea.
21 ) Sewer System Dev.
22) Milwaukee Dr Sew Ass
23 ) R/W Use Perm
24 ) Admin Cost (D RA)
25 ) D RA.
26 ) Misc.
TOTAL FEE
Amount Paid
Balance Due
1346
o
Block. 5
Long Legal
$000
I I
$000
$000
$000
$35 00
$000
$000
$000
$000
$000
$000
$000
$000
$310.00
$310 00
$000
Date
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
II/Z'->J:7nme
Received by
(phone, person)
REQUEST
Location of Work to be inspected
Name of person requesting inspection
Address of person requesting inspection
Type of Inspection (circle appropriate one)
-zlPz4 <$ t:.-/ncd0
r::7/1 '/""Lf /5' !7/I'Y/7b/r71 ,- )/f/l/ " "
Phone No
Permit No /31;"/
Sewer Foundation Framing Chimney Plumbing Fi~er E~ther
INSPECTION NOTES Iz /;
Inspected Date II z(;;J jJ z---
I I
Remarks ~....-vV1 f l-p ~ ~
Time
Pr17
By ( ~AJd
RESTORATION REQUIRED
\) N -:,'
YES ,X NO
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SURFACE RESTORATION 3 X. Cf
SURFACE TYPE 0 Unimproved 0 Gravel Qf Asphalt 0 PCC
o Other
[] Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
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STREET SUPERINTENDENT
(DATE)