HomeMy WebLinkAbout512 E Ahlvers Rd - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
PUBLIC WORKS CONSTRUCTION Issued: 5/14/99 LEH Permit No: 870
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
MS NORDSKOG 512 AHLVERS RD E
512 EAST AHLVERS RD Lot: 1
Port Angeles,WA98362 Block: Long Legal:
360/000-0000 Sub: SHP 79-5-5
PROJECT INFO--------------------------------------------------------------------
Work is N/A traveled road Value Work: $0.00
/ / ~
/ / ~
$O.OO~
~
* Misc DWY ~
NOTES------------------------------------------------------------------~
Plans Required: N/A
Contractor:
Start:
Finish:
Performance Bond Required: N/A
Proof Insurance:
Amount:
Work to Perform: INSTALL
Watermain
sanitary Sewer
Storm Drain
Underground Tele/Ele
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:
Inspection Fee:
R/W
SANIT AR Y
$0.00
$0.00
$0.00
$125.00
$0.00
$0.00
$0.00
$0.00
$0.00
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
$0.00
TOTAL FEE:
AMT PAID:
$0.00
BAL DUE:
$125.00
$125.00
$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 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.
WATER
DWY
STORM
OTHER
DRA
Date
Signature of Owner (if owner is builder)
Date
Signature of Contractor or Authorized Agent
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . .
/
REQUEST
Date
if h~Jl11Time
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)
5 I 2- Ah / l.; e-rs. ~ e<:L
l~
Phone No
Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other
Y7C)
ClAd-
INSPECTION NOTES
Inspected
Remarks
Date
d' ~ ./L.!/;Jt/., ?f'f
Time
t[t."t.~~
By
C' .l'Cld I --
. I
. ~/~ ,)-'";
. .>Jt_ _" .I
RESTORATION REQUIRED
YES
NO
SURFACE RESTORATION
SURFACE TYPE D Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
D Repaired by City
[] Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . . . INSPECTION REPORT. . . . . . . . .
!)w-20dr~Z-C>"'\3
REQUEST
Date ]-;- o~
/f/
/~~
/
Time
Received by
(phone, person)
Location of Work to be inspected ;; / ::L Ii I~ J--. V'-f}' :7 /?c>cJ /
Name of person requesting inspection ----r-:/ ~ ; ) c.? ~ )C
Address of person requesting inspection /1 t1l ~ b Phone No
Type of Inspection (circle appropriate one) Permit No
Sewer Foundation Framing Chimney Plumbing Final Sewer Excav Other ~
INSPECTION NOTES
Inspected Date
Remarks
7/ Time. By
A-eFq(~~cd II' j/k S-p,yU/(~
J--:tJ-Z' b:'.' / J, c ; + ()..!,z:> (/'0/ Y (50 Ie< 1-,,< h~
If-N
11 rt~~JJL
u,~
RESTORATION REQUIRED YES
L/ c
'l'(~
Vd~~
&1 ~ ~ )-~ u>:q-
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A-HL V-fV5 f(J
c-.
~9
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--9.'~
. ;...- ~J;(.R ~rn1.IV~V?
L0 0€v 5"/?- {f'l ~j. (
D Repaired by City
D Repaired by Permittee
o No Damage Found
~ pOther
Work Order # :;;l.b 6 :3 :J---.O nl
o COMPLETE f}~w -
o INCOMPLETE
SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt
/7~-8:.c-;;#-:~h-L-
\...,-llY V1 rUI l AllgeJes
Public Works Departnlent
"1 ater Distribution Repair Report
bw "''2:.-001-- 20'3
'Work Order No.
.~(jb rJ
ICrew-
7/C/
I
]
DATE REPORTED ~ -~ 6 - 6 2-
CONDITION EMERGENCY D ROUTINE D CITIZEN COMPLAINT /'
LEAKAGE SURVEY D OTIIER D
DATE OF REPAIR. J -- 7-- () 2- TIME. / ft.. f'1J1 DA.M. DP.M.
REPAIRLOCATI0N ADDRESS 5"- /?- /f!+1-. (/--t? J.,r> X ell'
t'( /Ie
TYPE OF MAIN
SIZE.
DEPlli OF MAIN
CLOSEST VALVE DEPTH.
COMPONENT REPAIRED.
MAIN JOINT 0 CIR. BREAK 0 SPLIT BELL. 0 LONG BREAK 0
HOLE D CLAMP D OTIIER
SERVICE. TAP 0 CORP STOP 0 PIPE ~ CURB STOP 0 FITTING 0
METER SETTER 0 METER 0
LINE VALVE. FLANGE NUTS/BOL TS 0 STEM 0 BONNET 0
HYDRANT BRANCH 0 VAL VE 0 BARREL 0
OTIIER.
r
COMPONENTS OF REPAIR. CLAMPD DRESSERD OTIIER ':3 r 0 r- I 'r /,,E //~ }~;~
SITE CONDITION GRA VEL 0 ASPHALT ~IDEW ALK 0 CURB 0
TOP SOn.. AREA 0 SOn.. TYPE
CUTS ASPHALT CUT _FT CURB CUT _FT SIDEWALK_FT
DRIVEWAY CUT _IT
MAIN CONDITION INTERNAL LINING TUBERCULA nON-MINOR 0 SEVERE 0
EXTERNAL CORROS10N LOCALIZED 0 EXTENSIVE 0
CHLORINE RESIDUAL SAMPLE / '3? P.P.M.
WATER OFF FROM / J... rr M. TO :2 r M.
FROM M. TO
M. -.L.Ll
rJ) f-{ TTT-e
P6/y 8U+CLkh~
(
APPARENT CAUSE OF LEAK.
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