HomeMy WebLinkAbout206 S Valley St - Engineering
PUSILlC WORKS & R/W PERMIT
I Attached Notes
OWNER/APPLICANT ~ ~
CITY OF PORT ANGELES
321 E 5TH ST
Port Angeles, W A 99360
000/604-7011
PROJECT INFO
Work is
Plans Required
Contractor' OWNER
Performance Bond Required
Proof of Insurance
Work to Perform
Start Date
Amount:
Permit No
Work Order'
PROPERTY LOCATION-~------~---
206 VALLEY S
Lot: 1-4 & 16-20
Subdivision TPA
Parcel No
Issued
2/04/2002
Value Work.
I I
Finish Date
2061000-0000
$000
Install D Sanitary Sewer
Repair [l Storm Drain
Watermain D Underground Tele/Elec
PROJECT NOTES-
install 1 svc line with 5/8" meter on Valley Street
Capital project 93-71 Fire safety compliance
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 Serv'
11 ) Other Water Service
12 )Water System Dev'
13 ) San Sewer SFR
14) San Sewer MFR
add unit
Receipt No
Inspection Fee
$000
$000
$000
$000
$000
$000
$000
$000
$000
$640 00
$000
$000
$000
$000
$000
o
I 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
1240
o
Block. 50
Long Legal
$000
I I
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$000
$640 00
$000
$640 00
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST '\
Date '~- {- D .r-
Time
Received by
(phone, person)
Location of Work to be inspected '?--" ) {, {; {c II -f j }- , 'J h ~ O-ep I '
Name of person requesting inspection /1.0 11 co j
Address of person requesting inspection 1 7 +-4 to 6 Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
~ U );J
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LutCHV
INSPECTION NOTES
Inspected Date
Remarks
Time By
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RESTORATION REQUIRED
YES r/" NO
C 3?j67 ~}it C/ $'+'
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SURFACE RESTORATION
.
SURFACE TYPE 0 Ummproved 0 Gravel
o Repaired by City
o Repaired by Permittee
[] No Damage Found
~phalt 0 PCC 0 Other
Work Order # 20[( / .
~ COMPLETE-<~ D-LJ 9-00 (
o INCOMPLETE
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(Continue on re erse side if necessary)
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STREET SUPERINTENDENT (DATE)