HomeMy WebLinkAbout518 S Race St - Engineering
PUBILlC WORKS & R/W PERMIT
L I Attached Notes
OWNERlAPPLlCANT--
GUYlUND
810 EAST 4TH ST
Port Angeles, W A 98362
000/604-2346
PROJECT INFO
Work is
Plans Required
Contractor'
Performance Bond Required
Proof of Insurance
Work to Perform
Issued
2/19/2002
1245
o
Permit No
Work Order'
PROPERTY LOCATION----
518 RACE S
lot: N2 l T 17/18 BlA 99-02
Subdivision TPA
Parcel No 0630001949500
Block. 194
[] long legal
Value Work.
$000
Start Date
1 1
Finish Date
0001000-0000
1 1
Amount:
$000
v/: Install
[I Repair
~j Watermain
1_ Sanitary Sewer
I i Storm Drain
Underground Tele/Elec
I Misc
PROJECT NOTES--
INSTALL WATER METER IN 2ND PART OF DUPLEX
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' $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 Sew 5/8" $640 00 23 ) R/W Use Perm $000
10) Comm Water Serv' $000 24 ) Admin Cost (D RA) $000
11 ) Other Water Service $000 25 ) D RA. $000
12 )Water System Dev' $000 26 ) Misc $000
13 ) San Sewer SFR $000 _..~ -
TOTAL FEE $640.00
14) San Sewer MFR $000 ---._---
add unit 0 Amount Paid $640 00
~-~
Receipt No 7380 --"-..--
----..._---
Inspection Fee $000 Balance Due $000
......
CITY OF PORT ANGELES hw. 2:7
DEPARTMENT OF PUBLIC WORKS /3/-}
. . . . . INSPECTION REPORT. . . . . . . . . . .
REQUEST
Date .3 - ( - 0 Z
Time
Received by
(phone, person)
Location of Work to be inspected 5/ g :S o. k.~:.. L e:..
Name of person requesting inspection Vt E.d.~lvv'sto lA-
Address of person requesting inspection ~Co,? jYo.-5d
Type of Inspection (circle appropriate one)
Sewer Foundation Framing
~~
one No
Permit No 12_
M-f
Chimney Plumbing Final Sewer Excav Oth
INSPECTION NOTES
Inspected Date
Remarks Ex. feV1.d 1(' fJ E
Time By
'-I z I +rbVlA- e)(15tfV\.~ tUc....fev 5e liJl~ .
t.. 70:3? j'::: Zg cf&~7C;
RESTORATION REQUIRED
YES
NO X
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2" C:f I\)
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
o Repaired by City
Cl Repaired by Permittee
o No Damage Found
o Asphalt 0 PCC 0 Other 6 r 4. <? <7
W~ Order # 265S-
0' COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT (DA TE)