HomeMy WebLinkAbout1424 W 7th St - Engineering
PUBILlC WORKS & R/W PERMIT
OWNER/APPLICANT 0 Attached Notes
Gary Crabb
1426 W 7th St
Port Angeles, WA 98363
000/604-7495
PROJECT INFO
Work is:
Plans Required
Contractor' OWNER
Performance Bond Required
Proof of Insurance
Work to Perform:
Issued: 12118/2000
Permit No
Work Order'
1131
o
PROPERTY LOCATION
1424 7TH ST W
Lot:
Subdivision
Parcel No.
Block: 245
TPA
D Long Legal
Value Work:
$000
Start Date.
1 1
Finish Date.
206/000-0000
1 1
Amount:
$000
~ Install
D Repair
D Watermain
D Sanitary Sewer
[3J Storm Drain
D Underground Tele/Elec
[] Misc
curb drain
PROJECT NOTES
install curb drain
FEES ASSESSMENT
1 ) R/W 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 R/w' $000 21 ) Sewer System Dev' $000
8 ) Fire Hydrant: $000 22.) Milwaukee Dr Sew Ass. $000
9 ) Res Water Servo $000 23.) R/W 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. $45.00
14) San Sewer MFR $000
add unit: 0 Amount Paid $45 00
Receipt No. 6946
Inspection Fee $000 Balance Due $0.00
.....
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
.....
REQUEST
Date
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)
.Icf~c/ lI/7~
Phone No
Permit No
//3/
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
INSPECTION NOTES
By -rF
Inspected Date
Remarks
RESTORATION REQUIRED
YES
NO
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
[] Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)