HomeMy WebLinkAbout3709 Park Knoll Dr - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET PORT ANGELES. WA 98362
/
PUB~~~ ~v~~ ~v~~~~u~~~v~ ~ssuea: 8/12/98 TF Permit No: 861
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT---------------------___PROPERTY LOCATION-------------___________
ROBERT SCHMIDT 3709 PARK KNOLL
3709 PARK KNOLL Lot:
Port Angeles,WA98362 Block: Long Legal:
206/457-7870 Sub: CAHILL SUBDIVISION ~
PROJECT INFO--------------_____________________________________________________~
Work is N/A traveled road Value Work: $O.O~
Plans Required: N/A
Contractor: OWNER
Start:
Finish:
Performance Bond Required: N/A
Proof Insurance:
Amount:
Work to Perform: INSTALL * Watermain
Sanitary Sewer
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;0. 00 ~
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Storm Drain
Underground Tele/Ele
Misc
NOTES------------_______________________________________________________
PROJECT
~
PROJECT FEES ASSESSMENT-----------______________________________________________
R/W Excav:
Sidewalk:
Curb/Gutter:
Driveway:
Dwy Culvert:
Street Cut:
Other R/W:
Fire Hydrant:
Res Water Serv: *
5/8"
3/4"
* 1"
Comm Water Serv:
* 1"
1 1/2"
2"
Oth Water Serv:
Water Sys Dev:
Receipt No: 4312
Inspection Fee:
R/W
SANIT \RY
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$600.00
$0.00
San Sewer SFR:
San Sewer MFR:
Add Unit:
Other San Sewer:
Sew Tap Wye/Man Tap:
Sew Cap/ W/M Removal:
Alter/Repair Sewer:
Storm Drain Tap:
Catch Basin per ea:
Sewer System Dev:
Milwaukee Dr. Sew Assess:
R/W Use Perm:
D.R.A. :
Admin Costs (D.R.A):
Misc:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
==============================
o
TOTAL FEE:
AMT PAID:
$600.00
$600.00
$0.00
BAL DUE:
-----------------------
$0.00
WATER
DWY
STORM
DRA
OTHER
Separate Permits are required for electrical work, 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 compiled 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 ~ture of Owner (If owner IS bUilder) Date
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . INSPECTION REPORT . . . . . .
. . . .
.....
REQUEST
Date .g.- t 1- q.,q
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 Final Sewer Excav
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Phone No
Permit No ?' V /
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Other LI) /Lt-t }-
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INSPECTION NOTES
Inspected Date
Remarks
Time By
r.IUS~ JU--ew Jy I I~~
( L (\, .Co .5>C,. Y' V C ~ 1 < ," I. )
c 7 B47
F 1- 72/4/10
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RESTORATION REQUIRED
NO
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IV yvvt LR-
J?hod~ ~
Roo-
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel
D Repaired by City
o Repaired by Permittee
o No Damage Found
o Asphalt OPCC jOthe.
Work Order # II '9
~PLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
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