Loading...
HomeMy WebLinkAbout1229 W Lauridsen Blvd - Engineering tI 'M ~~ CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 PUBLIC WORKS CONSTRUCTION Issued: 12/18/97 LC Permit No: 784 & R/W PERMIT Cond: Work Order: 0 OWNER/APPLICANT-------------------_____PROPERTY LOCATION---------_______________ HANKINS 1229 LAURIDSEN BLVD W Lot: 13 ____ Port Angeles,WA98363 Block: 458 Long Legal: ~ 360/000-0000 Sub: ~ PROJECT INFO---------___________________________________________________________~ Work is N/A traveled road Value Work: $O.OO~ ~ ~o.oo t Plans Required: N/A Contractor: OWNER Start: Finish: Performance Bond Required: N/A Proof Insurance: Amount: Work to Perform: INSTALL * Watermain Sanitary Sewer Storm Drain Underground Tele/Ele Misc NOTES---------__________________~_______________________________________ PROJECT ttup0v- ~ 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" Corom Water Serv: 1" 1 1/2" 2" Oth Water Serv: Water Sys Dev: Receipt No: 3707 Inspection Fee: R/W SANITARY $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $125.00 San Sewer SFR: San Sewer MFR: Add Unit: 0 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 ------------------------------ ------------------------------ $125.00 $125 00 BAL DUE: ----------------------- $0.00 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 complied with whether specified herein or not. The granting of a. permit doesfot 'osume to gNe authority to '""late., cancel..e. p'_on, of any state 0' local low regulating construction", the perto'maje of co~ .on~ 1)( fig} - - /iu~-V\ ~ ~2 A~ I( SiQnature of Contractor or Authorized AQent Date / Sianature of Owner (if owner is builder) Date $0.00 TOTAL FEE: AMT PAID: $0.00 WATER DWY STORM DRA OTHER