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Home My WebLink About1704 Melody Cir - Engineering e ~ ... -- ~"'" CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET. PORT ANGELES. WA 98362 PUBLIC WORKS CONSTRUCTION Issued: / / Permit No: 835 & R/W PERMIT Cond: Work Order: 0 OWNER/APPLICANT------------------------PROPERTY LOCATION---------------~-------- HIGHLAND COURTE ALZHEIMER COMM 1704 MELODY CIRCLE 618 S. PEABODY Lot: 3 Port Angeles,wA98362 Block: Long Legal: 360/452-1232 Sub: HIGHLAND COMMONS PROJECT INFO-------------------------------------------------------------------- Work is N/A traveled road Value Work: $0.00 Plans Required: N/A Contractor: Start: Finish: / / / / Performance Bond Required: N/A Proof Insurance: Amount: $0.00 * Storm Drain Underground Tele/Ele * Misc PROJECT NOTES------------------------------------------------------------------- 2 WATER METERS (1)1" irrigation meter $1000.00 system user fee $2,207.5 (1) domestic meter $2000.00 system user fee $7,064.00 Water FH to be supplied by owner PAID FOR HOT TAP 10/01/98 REC # 4442 $1950 PROJECT FEES ASSESSMENT--------------------------------------------------------- R/W Excav: * $40.00 San Sewer SFR: $0.00 Sidewalk: $0.00 San Sewer MFR: * $80.00 Curb/Gutter: $0.00 Add unit: 27 Driveway: * $125.00 Other San Sewer: $162.00 Dwy Culvert: $0.00 Sew Tap Wye/Man Tap: $0.00 Street Cut: $0.00 Sew Cap/ W/M Removal: $0.00 Other R/W: $0.00 Alter/Repair Sewer: $0.00 Fire Hydrant: * $1,950.00 Storm Drain Tap: $0.00 Res Water Serv: $0.00 Catch Basin per ea: $0.00 5/8" Sewer System Dev: * $5,136.00 3/4" Milwaukee Dr. Sew Assess: $0.00 I" R/W Use Perm: $0.00 Comm Water Serv: * $3,000.00 D.R.A.: $0.00 * I" Admin Costs (D.R.A): * $0.00 1 1/2" Misc: fh meter $25.00 * 2 II ============================== Oth Water Serv: $0.00 Water Sys Dev: * $9,271.50 Work to Perform: INSTALL * Watermain * Sanitary Sewer TOTAL FEE: AMT PAID: $19,789.50 $1,975.00 Receipt No: Inspection Fee: R/W SANITARY $0.00 WATER BAL DUE: $17,814.50 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 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. Signature of Contractor or Authorized Agent Signature of Owner (if owner is builder) Date Date LBR oJ< PUBLIC WORKS CONSTRUCTION Issued: / / Permit No: 835 & R/W PERMIT Cond: Work Order: 0 OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------ HIGHLAND COURTE ALZHEIMER COMM : 1704 MELODY CIRCLE 618 S. PEABODY : Lot: 3 Port Angeles,WA98362 : Block: Long Legal: 360/452-1232 : Sub: HIGHLANDS COMMONS PROJECT INFO-------------------------------------------------------------------- Work is N/A traveled road Value Work: $0.00 Plans Required: N/A Contractor: Start: Finish: Performance Bond Required: N/A Proof Insurance: Amoun t : Work to Perform: INSTALL * Watermain * Sanitary Sewer / / / / $0.00 * Storm Drain Underground Tele/Ele * Misc PROJECT NOTES------------------------------------------------------------------- 2 WATER METERS (1)1" irrigation meter $1000.00 system user fee $2,207.5 (1) domestic meter $2000.00 system user fee $7,064.00 hot tap by Speers or Pacific Water FH to be supplied by owner 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: $40.00 $0.00 $0.00 $125.00 $0.00 $0.00 $0.00 $0.00 $0.00 San Sewer SFR: San Sewer MFR: * Add Unit: 27 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: $3,000.00 $0.00 $80.00 $162.00 $0.00 $0.00 $0.00 $0.00 $0.00 $5,136.00 $0.00 $0.00 $0.00 $0.00 $0.00 ------------------------------ ------------------------------ $0.00 $9,271.50 TOTAL FEE: AMT PAID: $0.00 BAL DUE: $17,814.50 $0.00 $17,814.50 s/,s-lq 'B U p D ^ T e::-D r- ee.... s -pe y- R. A-r, d.. Q.r':;O'>'/ c...t4-A.-w'qe (N ^'-E:\E:R. 'S I e-b F W. l-b-\oT T,o".p - O\J...)Yl~r TV~l~ "CJ... AeJ STATE OF WASHINGTON DEPARTMENT OF HEALTH WATER BACTERIOLOGICAL ANALYSIS SAMPLE COLLECTION: READ INSTRUCTIONS ON BACK OF GOLDENROD COPY If Instructions are not 1ollowed, sample will be rejected. DATE COLLECTED TIME COLLECTED COUNTY NAME MONTH DAY YE^" ? /5' , / 'I IC/;2?/ 7J ,~ I li- J" DAM [t] PM Cp, - _.-- -- TYPE OF SYSTEM IF PUBLIC SYSTEM, COMPLETE: [tJ PUBLIC II.D,NOIIt-k 1:1 s-t(+~1 CIRC4; GROUP o INDIVIDUAL (IS B {serves only 1 residence) - ,-- NAME OF SYSTEM _f / /cA/lr ;JI)r-/~.~./i S __'__ SPECIFIC LOCATION WHERE SAMPLE COLLECTED TELEPHONE NO. "-;~r,""- "f' /1 -'_I-I'Vt-~ ~;eC,j:,:; ;;~; h ~;~~~,~: ,,_, 'I' ~; , , --, SOURCE TYPE 0 GROUND WATER UNDER SURFAC-E INFLUENCE - o SUR'ACE ~ WELL 0' D SPRING [l PURCHASED 0' 0 COMBINATION WELL FIELD INTEATIE or OTHER SEND REPORT TO: (7t~ Ft1!5'/~~?t?: ~n~JiP Code) -"- ., iP,' I' '.1 . ( , / -u]<' ( I.JL' .r t.:l tf T ;4.t '1 e/~ li. WASHINGTON )Y5 h.;J- TYPE OF SAMPLE (check only one in this column) o ~2~~~~ WATER 0 Chlorinated (Residual: __ Total~~' Free) check treatment t 0 Filtered o ;Untrealed or Other __ ____ o REPEAT SAMPLE Previous coliform presence lab # Date U RAW SOURCE WATER Source 1/ ~ D-l :J NEW CONSTRUCTION or REPAIRS d ~ OTHER (Specify) ~l Total Coliiorm [l Fecal Coliform REMARKS: -----. ---.-..---- --.--- - (LAB USE ONLY) DRINKING WATER RESULTS [J "'.".~,~,_.- 1 D'"""="'~ Cohforms absent REPEAT 0 E. Coli present 0 E. Coli absent SAMPLES REQUIRED 0 Fecal present 0 Fecal absent ---- ,-. TQTALCOLlFORM ~ /100ml E.COLl _/1ooml FECAL COLIFORM _1100 ml PLATE COUNT Iml ANOTHER SAMPLE REQURED OTHER LABORATORY RESULTS SAMPLE NOT TESTED BECAUSE: ~ Sample too old n Wrong container :J Incomplete form c, L~------ TEST UNSUITABLE BECAUSE: o Con/luent growth o TNTC [J Turbid culture n Excess debris ,(1; :'-qc:,~~":-kO' G\-lf-T';:,,~ ~!Oflt^"'.A~.-' I', ~.: DAlE. REPQRTE.D LAB NO_ (7 DIGITS) DATE, TIME RECEIVED RECEIVED BY REMARi<.S DOH 30')-002 (REV ,,",'n) (POh,? HOt '1~ , I I q OJ'] 7 I 4J1 /+oT-r~ I I I I Iw I I I ! I I i , ! r /704 /Vl~CuUz N" /;\) \j' ~, \ \.l 11 J ( '01 . ,-,...L -1' ",f Ie: ....' c;~ w , " J <'ff\ q f' s 't/It -e I Del Y <::.- \ Y:-c \..,e.. " E ~ .?!:~ i.'*' -l~ ct::. ' '. '1f/J2!6 cd i ,', E , ~ Olf] z.. ' s - 0.. ~'l-- ",<- ' STATE OF WASHINGTON DEP.ARTMENT OF HEALTH WATER BACTERIOLOGICAL ANALYSIS SAMPLE COLLECTION: READ INSTRUCTIONS ON BACK OF GOLDENROD COpy If Instructions .re not followed, ..mple will be rejected. , DATE COLLECTED TI~E COLLECTED COUNTY NAME 'lJ,TH / cr / 77" I ,00 /' ~ II DAM .~ c tI / I <"'pi TYPE OF SYSTEM IF PUBLIC SYSTEM. COMPLETE: iLl PUBLIC IW.No.1 It! I.~ sts-klA'1 CIRGL~pROUP . D INDIVIDUAL {A' B (selV8Sonly 1 residence) " NAME OF SYSTEM ,i _..J .' -_.Q~ r. ~I / i~ ..." .....,:.:..: ~ ;..- T l I~ .r: ",' y "_,./.. .:.<. SPECIFIC LOCATION WHERE SAMPLE COlLECTED TELEPHONE NO. DAY'll'-' ) '-/ 17.- II F (-:-. '-.i ...:. /7C)lf fi{.,./td.J (1;"..,./(' EVENING ( ) SAMPLE COLLECTW~Y: (Name) SYSTEM OWNER/MGR.: (Name) ':::t- ")1.... L/ ;:;-1/" ,. ',' I." ,....,...- V" I ~ r . r, I __,. ( . . r. SOURCE TYPE D GROUND WATER UNDER SURFACE INFLUENCE D SURFACE [2] WELL or D SPRING D PURCHASED Of D COMBINATION WELL FIELD INTERTIE or OTHER SEND REPORT TO: tPrint,F.u.U tJ,me, Address a~..zip Code) /'"<~ L~ If :A-.J( it r/ /- (. fh--l II 5"t .Yr:" r Af~B/r ~. W"".GTON '7 g-?: 0- TYPE OF SAMPLE (check only one iri this column) o ~~~~~~ WATER . ..,' 111 Chlorinated (Residual: _Total """ Free) check treatment I 0 Rltered o Untreated ,'1' Other D REPEAT SAMPLE Previous coliform presence lab' Dalo D RAW SOURCE WATER Source' [I] rn l2'J NEW CONSTRUCTION or REPAIRS D OTHER (Specily) D Total Coliform o Fecal Coliform REMARKS: (LAB USE ONLY) DRINKING WATER RESULTS D UNSATISFACTORY. CoI~Ofms present D SATISFACTORY. Co!iforms absent REPEAT D E. CoIl present D E. Coli absent SAMPLES REQUIRED D Fecal present D Feoal ebsen! OTHER LABORATORY RESULTS TOTAL COLlFORM.....Q. /100 ml E. COU _/looml FECAL COUFORM _/100 ml PLATE COUNT Iml ANOTHER $AMPLE REQURED $AMPLE NOT TESTED BECAUSE: .. TEST UNSUITABLE BECAUSE: D Sample 100 o~ D Connuent growth D Wrong container D TNTC D Incomplelo form D Turbid culture D o Excess debris r i I r I , , I SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS LAB NO. (7 DIGITS) DATE, TIME RECEIVED ,/q Q'1 2:tjo R~C;:EIVED BY --!/-- /j Ul Z ()().!Sf DATE REPORTED l.AB<)AATORY: 2/497 O,,~ REMARKS DOH 305-002 (REV. ""2) '_'~-rr-n ....... ~nnl 'r:'n "nn,' . ry L T I~709 JRN 04'99 15:14 No.OOS P.01 / /4 {q~ ,..: WORKS CONSTRUCTION I ~sued: 1 1 Perm! t No: 835 & R/W PERMIT Cond: Work Order: 0 ~NER/APPLICANT------------------------PROPERTY LOCATION-------~---_____________ HIOKLAND COURTE ALZKEIMER COMM : 1704 MELODY CIRCLE 618 S. PEABODY : '-ot; 3 Port Angeles,WA98362 : Block: Long Legal: 360/452-1232 : sub; HIGKLAND COMMONS PROJECT INFO------------________________________________________________________ Work ie N/A tr~veled r6ad Value Work: $0.00 Plans Required: N/A Contractor: Start: Finish: / / / / Performance Bond Required: N/A Proof Insurance: Amoun t : $0.00 work to Perform: INSTALL + Watermain + Sanitary Sewer * Storm Drain Underground Tele/Ele * Misc. PROJECT NOTES---------------____________________________________________________ 2 WATER METERS (1)1" irrigation meter $JOOO.OO "y~t81R \lser ~ $2.207.5 (1) domestic meter $2000.0<(!YStem user fee $7,064.00/) Wa ter PH to be supp 1 i ed by owner -. __ PAID FOR HOT TAP 10/01/98 REC # 4442 $1950 pd $25.00 for FH meter PROJECT FEES ASSESSMENT----------_____________________~___~_____________________ R/WExcav:. $40.00 4D~ '. SanSewerSFR:' $0.00. Sidewalk: $0.00 . San Sewer MFR: + $80.00 ~l) Curb/Gutter: $0.00 Add Unit: 27 Driveway: + $125.00 I Z.SoO Other San ,Sewer: $162.00 l(p~ Dwy Culvert: $0.00 'Sew Tap Wye/Man Tap: $0.00 Street Cut: $0.00 Sew Cap/ W/M Removal; $0.00' Other R/W: $0.00 Alter/Repair Sewer: $0.00 Fire Hydrant:.. $1.950.00 Storm Drain Tap: $0.00 Res Water Serv: $0.00 Catch Basin per ea: $0.00 5/8" Sewer System Dev: +C$5,136.007) 3/4" Milwaukee Dr. Sew Assess: $U.OO I" R/W Use Perm: $0,00 Comm Water Serv: + $3,000.00 D.R.A.: SO.OO * 1" Admin Costa (D.R.A): .. $0.00 1 1/2" Mise: fh meter $25.00 * 2" ==;=====~~===~==;=====~======= Oth Water Serv: $0.00 '5D Water SYS Dev:" $9,271.50 2.7-07- Receipt No: _______________________ Inspection Fee: $0.00 BAL DUE: $14,814.50 '7 0 btl OCl '!I'+i-f 075'050)(..).\tJ pc{ fq 50ft' Her TA-p k:)"":Re.dI- ~tH.. 10Id'16" -_/ ZC;~ F'V'e.. hid... 'N\e: r ~ooo~ lz-') wl\tY\',3 ~e& ~.o.~o u>I'l..,I,a- ~L1 Q7~~ \" \V'v'ttj~ r, -, z" {;(o.....es+lc- TOTA'- FEE; AMT PAID: $19,789.50 $4,975.00 ~'..M~'7\ PORT ANGELES CITY LT 10:360-417-4709 ~iN -,/'wt.l:-/'-"'-.- 't.:::;> L_- .le 1<\(,,, ------ JAN 14'99 CM-;:\ ~\:'I-'<. 15:23 No.004 P.Ol -I~"-' "i.n-<\'OO"I UOLIC WORKS CONSTRUCTION 18~ued: / / Permit No: 835 & R/W PERMIT Cond: Work Order: 0 WNER/ APPL I CANT- - - ____n__ -- - --- - - -- - -.. PROP liRTY LOCA T I ON-n--- --_ ____ _ ___ _n ____ HIGHLAND COURTE ALZHEIMER COMM : 1704 MELODY CIRCLE 618 S, PEABODY Lot: 3 Port Angeles,WA98362 Block: Long Legal: 360/452-1232 Sub: HIGHLAND COMMONS ROJECT INFO--------------------------------..------------_______________________ Work is N/A traveled road Value Work: $0.00 Plans Required: N/A Contractor: Star t : Finish: f / / / Performance Bond Required: N/A Proof Insurance: Amount: $0.00 Work to Perform: INSTALL * Watermain . Sanitary Sewer · Storm Drain Underground Tele/Ele * Misc ROJECT NOTES---~-----------------------------------._________________________~ 2 WATER METERS (1)1" irri.gation meter $1000.00 system U8"r fee J. ~ $2,207.5 (I) domestic meter $2000.00 system usel- reeQ7,064.00::::>--f .I;A,\q~ Water PH to be supplied by owner . 1'r: PAID FOR HOT TAP 10/01/98 REC # 4442 $1950 pa $25.00 for PH meter ROJECT FEES ASSESSMENT---------------------...--~---_----_______________________ R/W Excav: * $40.00 San Sewer SFR: SO.OO Sidewalk: SO.OO San Sewer MPR: * $80.00 Curb/Outter: $0.00 Add Unit: 27 Driveway: * S125.00 Other San Sewer: $162.00 Dwy Culvert: SO.OO _ ~~~\q~. Sew Tap Wye/Man Tap: $0,00 StTeet Cut: $0.00 ~ 10\\ Sew Cap/ W/M Removal: SO.OO Other R/W: $0,00 eJ... Alter/Repair Sewer: $0.00 Fire Hydrant: "' ($I,950.Ug::,f' Storm Drain Tap: $0.00 Rea Water Serv: $0.00 Catch Basin peT ea: SO.OO 5/8" Sewer System Dev: * S5.136.00 3/4" Milwaukee Dr. Sew Assess: SO.OO 1" c1- R/W Use Perm: $0.00 ::omm Water Serv: * Q3,OOO~ f'v~? \.J \r.<{ D.R.A.: $0.00 * 1" ~.L>A ..,.... Admin Costs (D.R.A): * SO.OO ~D\7.-1 * ~,,1/2" ~~~~~=~~=~=~=::=========S~::~~UJ t:'S Oth Water Serv: SO.OO 4'1,\-1 Water SY6 Dev: * $9.271.50 TOTAL FEE: $19,789.50 IO~ AMT PAID: S12,039.00 j Receipt No: 4723 Inspection Fee: --------------- SO.OO BAL DUE: $7,750.50 {lcP";J 0 'E'-- 019 #- 2JO&( ct /0- q ( . -Z - rJ-i!J--fLo Pd '4 f ~1 h Oe. (){ / 0(,( 111"'\\CJ'1 TF <---- THE CITT OF PORT ANGELES R990014214 02/10/99 andE'rson homes Cho"k ANbERSDN HOHES/8J5 $165.00 ANDERSON HOHES/8J5 12,207.50 ANDERSON HOHfS/8J5 f5,136.00 ANDERSON HOHES/835 f80.00 ANDERSON HOHES/835 f162.00 -------------- Chk# $7,750.50 le-2 ._-"- -- --- -- -- - - --- -- -- -- -- --- ~ s ~'""" CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DIVISION 321 EAST 5TH STREET, PORT ANGELES, WA 98362 PUBLIC WORKS CONSTRUCTION Issued: 6/01/98 TF Permit No: 835 & R/W PERMIT Cond: Work Order: 0 OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------ HIGHLAND COURTE ALZHEIMER COMM 1704 MELODY CIRCLE 618 S. PEABODY Lot: 3 Port Angeles,WA98362 Block: Long Legal: 360/452-1232 Sub: HIGHLAND COMMONS PROJECT INFO-------------------------------------------------------------------- Work is N/A traveled road Value Work: $0.00 Plans Required: N/A Contractor: Start: Finish: / / / / Performance Bond Required: N/A Proof Insurance: Amount: $0.00 Work to Perform: INSTALL * Watermain * Sanitary Sewer * Storm Drain Underground Tele/Ele * Misc PROJECT NOTES------------------------------------------------------------------- 2 WATER METERS (1)1" irrigation meter $1000.00 system user fee $2,207.5 (1) domestic meter $2000.00 system user fee $7,064.00 Water FH to be supplied by owner PAID $7755.50 2/10/99 PD IN FULL PAID FOR HOT TAP 10/01/98 REC # 4442 $1950 pd $25.00 for FH meter PROJECT FEES ASSESSMENT--------------------------------------------------------- R/W Excav: * $40.00 San Sewer SFR: $0.00 Sidewalk: $0.00 San Sewer MFR: * $80.00 Curb/Gutter: $0.00 Add unit: 27 Driveway: * $125.00 Other San Sewer: $162.00 Dwy Culvert: $0.00 Sew Tap Wye/Man Tap: $0.00 Street. Cut: $0.00 Sew Cap/ W/M Removal: $0.00 Other R/W: $0.00 Alter/Repair Sewer: $0.00 Fire Hydrant: * $1,950.00 Storm Drain Tap: $0.00 Res Water Serv: $0.00 Catch Basin per ea: $0.00 5/8" Sewer System Dev: * $5,136.00 3/4" Milwaukee Dr. Sew Assess: $0.00 1" R/W Use Perm: $0.00 Comm Water Serv: * $3,000.00 D.R.A.: $0.00 * 1" Admin Costs (D.R.A): * $0.00 1 1/2" Misc: fh meter $25.00 * 2 I' ============================== Oth Water Serv: $0.00 Water Sys Dev: * $9,271.50 TOTAL FEE: AMT PAID: $19,789.50 $19,789.50 Receipt No: 4723 Inspection Fee: RJW SANITARY $0.00 WATER BAL DUE: $0.00 DWY STORM DRA OTHER Separate Permits are required for electrical work, utilities, private and public improvements. This permit becomes null and void jf work or construction authorized is not commenced within 180 days, if construction or work ;s 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. :/ Date Signature of Owner (if owner is builder) Date 'UBLIC WORKS CONSTRUCTION Issued: / / Permit No: 835 & R/W PERMIT Cond: Work Order: 0 )WNER/APPLICANT------------------------PROPERTY LOCATION------------------------ HIGHLAND COURTE ALZHEIMER COMM : 1704 MELODY CIRCLE 618 S. PEABODY : Lot: 3 Port Angeles,WA98362 : Block: Long Legal: 360/452-1232 : Sub: HIGHLAND COMMONS 'ROJECT INFO-------------------------------------------------------------------- Work is N/A traveled road Value Work: $0.00 Plans Required: N/A Contractor: Start: Finish: / / / / Performance Bond Required: N/A Proof Insurance: Amoun t : $0.00 * Storm Drain Underground Tele/Ele * Misc 'ROJECT NOTES------------------------------------------------------------------- 2 WATER METERS (1)1" irrigation meter $1000.00 system user fee $2,207.5 (1) domestic meter $2000.00 system user fee $7,064.00 Water FH to be supplied by owner PAID FOR HOT TAP 10/01/98 REC # 4442 $1950 pd $25.00 for FH meter 'ROJECT FEES ASSESSMENT--------------------------------------------------------- R/W Excav: * $40.00 San Sewer SFR: $0.00 Sidewalk: $0.00 San Sewer MFR: * $80.00 Curb/Gutter: $0.00 Add Unit: 27 Driveway: * $125.00 Other San Sewer: $162.00 Dwy Culvert: $0.00 Sew Tap Wye/Man Tap: $0.00 Street Cut: $0.00 Sew Cap/ W/M Removal: $0.00 Other R/W: $0.00 Alter/Repair Sewer: $0.00 Fire Hydrant: * $1,950.00 Storm Drain Tap: $0.00 Res Water Serv: $0.00 Catch Basin per ea: $0.00 5/8" Sewer System Dev: * $5,136.00 3/4" Milwaukee Dr. Sew Assess: $0.00 1" /-----~~ '-f;J R/W Use Perm: $0.00 Comm Water Serv: * ($3,000.00_' 'f/ D.R.A.: $0.00 * 1" '---t-'~~-;e/7,'f- /1440 Admin Costs (D.R.A): * $0.00 1 1/2" I vI ~~'-t' Misc: fh meter $25.00 * 211 ============================== Oth Water Serv: $0.00 Water Sys Dev: * $9,271.50 Work to Perform: INSTALL * Watermain * Sanitary Sewer TOTAL FEE: AMT PAID: $19,789.50 $4,975.00 Receipt No: Inspection Fee: $0.00 BAL DUE: $14,814.50 ,. ACCOUNT PERMIT ACCOUNT DOLLAR NAME NUMBER NUMBER AMOUNT I......onsuucoon IUU.~Lll IPlan Check ~ee 700.~44~ l:surcharge ($4.bO) 001. IPlumblng IUU.~L1L IMechanlcal IUU.~Ll~ 1:Slgn IUU.~L14 Iclectncal Permlls I Inspections 911.9237 IHouse Moving 700.9626 ildewall<lUnveway/Curb Perml\lRlght of Way Perm~ 700.9228 pUblications IUU.~4U~ ~Iuepnnts- Aenal IUU.~4L~ Englneenng Service Fees IU~ l;learlGrade Perm~ IUU. 11 Ire InspecllPerm~ ~ee OUU.~OII Ire :spnnKler Plan Kevlew ~ee 600.9449 "omlnlstration Lost (0"10) /UU.94LO UKA ~ees "'US Interest UU1. P"'A :::;:::~:~~::::::: ?M ~HtftM~!t~U~k .... .................ft~QtWJ@W!! td%H8#1 ~]MW.j:W;l~f:%t wm;;!~n.~ " .......... ...;im%H@ ~MWM*.W@M:MMW!WIFwnMt storm Drain/ Tap 10L.~ol~ Streell Alley Kestoration 10L.~L4L o-Op f OL. ~oLo ?::~H+.~:!j@:r.WM~N@W:. . .. :./HWmn,":} tmwmw ::~@t~: , ..;..(......{f1;. %:::::~::::.: . )]MNM ;~:;H:?:~':::i~:M~W?:h~f::j~~~~~:~tMtHmW:; .'....... .. .... ......... .. ........._.... ... ,':." Jtner ~un :;:;~~g' '"'::::::':':< "::. ,"t:oUJ\lIJ}"w" :.;.,:.:<.;. j:MN ....:::tNt XHt~1~t.~.~ .......MHtM =:HHWWM:t@]@MMMH1HMWN1@ .. '" :.;=;:...;:, :.......:..;:~%;:;:; ;:;::.;:::::;: ... L .,~ roperty >>a es f 1 0.~o~4 ::",::::::::=: ;;:;jN;';;4Q;JAU;'MllfiWIIlRQ~fl:!NQ;;;';; .:,;.;.z.:.:.: ... .. ........ :::::::::::::: . ........... :':':':''-:':' .. '.w. ......,.... .w...... :::::::::::::=:'::. .' :....':::.::..::...::.. ..... ....::::::::;.:;::r:::~:::~ >'Valer >>yslem uevelopemem Lnarge f 0~.~4U~ HOt lap (watermaln) fO~.9019 . .H. Instalu Meter ,/ /. / " , fb~.9019 .n >'V 1M Installation / /rr~'n/ Z ./)om~1-/c. 1\ --:7," fb~.9019 #w;;ii';<~;.~tMW ~tf.M~iW~unMNUht. ~ .,:. C. . . :t~~~'~i :.J .:.:. :..: ....: .J~~~M@:~:~~W~~~i~H~~N~:~~~~:iiW ::::::@:: . :::~n~i~~ NN!~t. '. .~. .L.,. }~gW~!i sanrtary Sewer Tap/Cap or MH Tap 354.9619 ~ewer >>yslem uevelopement Lharge 3b4.94U3 ~an~ary:sewerperm~ ~~%:~~:;:~8~*=W~:Wt .' . .. #~f::#:~:;:W~:~:g8}M~;~ :;:::::~:::::::' J:;;:~:;;:~{~it::~ ::::::;::;:~'t ::::;!:~W:Z.::::f:@'::::f;~@~~:::f.!~:i~m~:::f:::::.M .. .. . . . IMllWauKee Ur Assessment 755.9403 .. ~~hW:tHWtt@i. :. .. ... ....... ...., :.. ....'..":.::... ~:'.:;:..:...:...:'..J~n'm~m~mMtM HW%MM tlMB .........:AMHW ~:::;~:0l~:M*tMW::Mt~MlMtg;:::;;:Nf4~ . WHtMt3: . ;' ....::\...:i*W~\.. ~ .. . .'~ ~im:~g.:,;f:~m ~%:1Mf#"~r:nb1:~ t9~v:~' .' ...;:#iiW~ :it~#WM~~~~*~:~M~tnl:tiWl~tWf:rW .... ...-' ..,. .. :.:. ...... .:~ ... ... >>econoary >>ewer ASSessment fof.9033 .' .. :::~ ,.' .~::?::iM:~~:~~~~:~;:!~:~~~:~~~:;:W~::~~~: ~:m:~:~~:~:~:::*:::t:::~:~:~@i;: ~..~:.:~::.., ""', )::@~~::::j::: .::;...:t?:}~:::::;'j.~t~~$: ;::~{::M:::rr:r:i:!:::tMl?~:%::t.:@t ~';'~X';':~'.. .. .. RECEIPT # N 0 4 4 4 0 i.~llr,li.it~f.~lfrtlf.IJft~f~111~ .lii[~_~I~ - ~ILL-I I ~LY- . ~u w>> IUIJ-\L CITY OF PORT ANGELES PUBLIC WORKS DEPARTMENT )-//YJ~~ tV~ J ~ /J<:/Vn,p //r-J, . ~ /);, p1 _ ) .. ?! /o!qy CITY OF PORT ANGELES PUBLIC WORKS DEPARTMENT ACCOUNT NAME PERMIT NUMBER C-onSfructJon Ian Check Fee SUrcnarge ($4.50\ 'Iumblng MechanIcal Sign JOfectncal Permits tlnspectlons House Moving SRlewalkIDrivewaytCurb PermiVRlght 01 Way Permit l'uEiications IBluepnnj,.- Aenai nglneenng Service Fees Clear/Grane Permit 8remspecUPermit Fee Fire Spni1Kler-pfanKevlewTee Administration Cost 15%) ITRATees Plus Interest Q'~~ J5BlA r lSlorm lJralnTT ap ISlreet! Alley Restoration rs7\I\TCo-cp }';:r~;~:i:;::\~::~;::::r~m& ::;;~:::::;:'~:;.':: i;:::?~:@;:i:~ ., :::::W~~~~W~ ::~l::g:~:.:.. . ,:}:@i~:::m::m OlIler Fund ;:H1MHI,T01L..,,: ",~"",~,,,,""""'" .... ........ .... ..... .....:. ;::;~:~;~:!I~.:;~:?:;:;:::~ ;::W;:; wn:19::r~ ~8::::: Property -safes :t~t[PJAWt Wafef1>ystem LJeveIQpemenfCnarge / HotTapiwatermalm F.H. InstiillTMeter WIMTnstaifation ~~.::::. ;'.. .,.......... .......... ........ ...........,. ... :::;:;:;~~: :::J::~:::;m:m:~::::f ;$;:,(:;: . '.:.:.~:.:.> S-aMary-s8wer Tap/Cap or Mf- Tap Sewef1>ySfem LJevefopemenfCnarge Sanrtary:sewe~ermrt ACCOUNT NUMBER (UU.YLll 700.9449 001. 700.9212 700.9213 700.9214 911.9237 700.9626 700.9228 700.9409 700.9429 700.9462 700.9241 600.9677 600.9449 700.9426 001. DOLLAR AMOUNT / 4i:::J! '" :::- 650.2319200 ".w. .w ; :. ,. . :;:::;:;:::~;:~:::~:;: ;;:::::::::::::~: ... .:. ~;: :'. .::;. .': .'. . ...... ..:,.,:~::,~:,::::.:::,~ 752.9619 752.9242 752.9626 .....::::#t::~::::~ :~~t ~!~!:!::fN%t,i,:9:fj: ::~:>:::~:::::f/::n::m@w! t:vv:: ....J ......... ......!WmN!.: (1 ~.Y534 I I I I ........ :::: ...., ;::::::::...;:.........:: ::. ...... .........~: "':..':':.;.:.:.,. :::::::::::::~:~: (~3.9403 753.9619 (53.9611 (~3.Y511 'l7n7 ~~ ::;:m:~~~: :.,.".;.,.,... .. ..... .. ...,".,:)~?:MW ~Ff:W~W~W@?;~8~;~~::t:;'M::Wf.%%pm 354.9619 9:Z..::: 304.9403 :,ii ,t . ~t:;4. z ::;:~:::,;:::::;., '::" '. :. ":. . ..,....}l,_,.I.1:l...~ ..... . ..... .. I!itillll ~ ~. ....k Ai:-"" ') - / ? &>&1 Wh#!.~:!Wd:~:!:::@~t.:>.': f..\iIWaUKee Dr Assessment ::;:;@;~::::@ !:::::?n@::% M:M~:~~}~!::Wt:/..: ......... ..X.: ";:;.:' .......... .:...-:..PJmQ~:~!mWtnVh :W~:::d~JN~:.::m:Hr NWV.. .,. ISecondary SewerAssessment :::~:!.~:~~:~:~:~~;:~ ::::~:Wr~~~w::t~:t~~@~~~:;:::~:;i~:: 755.9403 nunH! };t*JMJ:HJ!~!~rH J}{ MjhMM} '.Aktm n*i;:h&AMt@M%MWhMN@t:;,~ 757.9533 ..,..;. '.~.~.i:l'.;jl~i;i;llr.l.it.'liii;iil~ill!~liii;lil! .... .. --. -...".".".... . .. . . . $14WMM%jWtW::~~:;:Wrm?-Of:~:W'~ :ii~l~i1il~II}._}il. RECEIPT # NO 47 53 HLL-IN I I ~L y- .f-UNUS I1nder50'7 !--/-r?rn ~ / 7 /)~ .ffJ~k(V/.pd~ IUIAL ~ ACCOUNT PERMIT ACCOUNT DOLLAR NAME NUMBER NUMBER AMOUNT l,;onsuucnon 11 Plan ChecK Fee 700.9449 Surcharge 001.2291000 Plumbing (uu.~L12 Mechanical 13 Sign Electncal permits /Inspections 911.9237 House Moving Sldewall<lDnveway/Curb Permit/Right of Way Perm~ . PUblications Bluepflnts- Aeflal Englneenng \:ServIce t-ees Clear/Grade Permit t-Ire Insp~rmit t-ee Ire \:Spnn er t-'Ian l"<eVlew t-ee Administration \Jost (:)"I.) DRA Fees Plus Interest 001. IP1:lIA obO.2319200 mH1HW%tg~Mf~a~: 'h. , :~::: "", :.Mm;~W:~WWWif% t%i .. .;., 'd. .~:6H Mt(r!IJ;,.::..::::;:.. .... ...@@rMi :~:W 1itWWm\mkMYMV:iMWiW:W~: ... .... .. i:storm uraln/ lap /52.9519 i:streev Alley Kestoration 752.1 ~" o-up 75Z' 1@,.:~@]~:i:it'mB:~Wi~iNW..:.. . ., .~:W;:~~i~igP~1rld~:~~:::J::;h n~t ..\~W fWA]:; , ,. , ..k-:;;;~*::~8::i mirf.:n~i%iMJ.~iMWt%MW1MiWf@m:~ .-.." .....,. ...... .. ... Jtner runa . t}f:H~~r~~: , ",. , w , ~: , ....tlHi~#t :.;.;.:."". ::ij,%i :f:::~~B~' .:ii:: ,. -...:;.:Z!i!#1:k ::51" ,.<:--:>,,> :i:~nKWilmf.fi1iiWif: _'h ,; .. ...... . ..~... :;::~:~~:~. .: .... :.~::::. ~roperty Sales 715.9634 i~MW:%g?1i?n..: ., . lQ. .,.'*..' W\ iitnW iim:~ ~;~;::.;:~. :....:.~:ntt .~.:. .~;.;.... , :jWJM~t: "}::ttMl~WltiliH:~lW:t@: ~j~W@Hi.~\ .... ... ..;::1-..... .........;,...'....;...,.. ...... .;.~:::. ......N. ;.;, :::;:~:. .. , .::, ., .. <.. n IIVater Syslem ueve opement Charge <;<~c::... 753.9403 r7-'" =--- Hot Tap \watermaln) ~ 753.9619 F.H. InstalV Meter 753.9619 . IIVIM Installation 753.9619 ~ ~%W~~:;::;m~::;~!~~WtN~M.~ , .',. ~ .....:..:tf#~?~jWtHn:#nilim1~ ~:::@;. , .:.~nN ::~:~~g: .." ~" )?it%MK :;JJ{;@ ..,::$ w ,. .:.')::::::!:~::~r~im: .. .., , .... ,. ....., .. ,.. .,.~:.:.:" .. .. , .. .... ^ SaMary "ewer ap/\Jap orMH lap ~b4.~ol ~ Sewer Syslem uevelopement Charge 354.9403 san~ary Sewer Perm~ 354.9223 ::~::~NM@W'~: ~~:~~~ ., ... , }W?:j:::~?M:g:;:H:j :~ :}%~~:~::i:;:;:::tM:~<=.~tN :t::tt. .':, , ',r\ ;;:;'" " ,,' , " tM~:~#:::i .;. .'~ " < ^ ) , MIlWaUKee ur Assessment /bb.94U~ .... .w...... .'. ............... ...~. . ,. ....:.:fmttt::: MWii MilikttMt:MW~ WtlWHH~M N:::~:::~:::'~"?::~:~~::::::m:::%: ....iI: ....... ... ~8;#~::~~WM1 .:.:: \,~li:.... , ,. .....Ak:~nm:i.:~8i: :~:t::~m::'::t.@*Mf:{ :~n:w ..lMhH ~M~i~WN:WW:~WiHn:::@:~:1~bd%+id .'~. ..... ., ... .. , "" .... ..'~ .:, Secon ary t:iewer Assessment 75{.903~ .. .. . ,. .. ~:: %W:tMrMng@::~ . . ;;::~::::::;;;~:::::,;, ~::..~ RECEIPT # N 0 4 7 2 3 ~.illlil~~lt1I!~t~lj~lj~1j~r~f~J1~[!r[~~1~~jlii - ~ILL-IN ,I cL Y-I U IAL ALL IUIAL CITY OF PORT ANGELES PUBLIC WORKS DEPARTMENT A-nclerSt1/7 ~t6 V7IJd J/;U../~h f!.tAtI../.. , pd 11/4/11 ~Th Yh~ ~S2-01~6 - ~ ~ I(A:. T~,,-, 4n-<\'001 PUBLIC WORKS CONSTRUCTION Issued: / / Permit No: 835 & R/W PERMIT Cond: Work Order: 0 OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------ HIGHLAND COURTE ALZHEIMER COMM : 1704 MELODY CIRCLE 618 S. PEABODY : Lot: 3 Port Angeles,WA98362 : Block: Long Legal: 360/452-1232 : Sub: HIGHLAND COMMONS PROJECT INFO-------------------------------------------------------------------- Work is N/A traveled road Value Work: $0.00 Plans Required: N/A Contractor: Start: Finish: / / / / Performance Bond Required: N/A Proof Insurance: Amoun t : $0.00 Work to Perform: INSTALL * Watermain * Sanitary Sewer * Storm Drain Underground Tele/Ele * Mi sc PROJECT NOTES-----------------------------------------------------------------f1Zb 2 WATER METERS (1)1" irrigation meter $1000.00 system user fee cR ~ $2,207.5 (1) domestic meter $2000.00 system user feeCf7,064.00:>---f' JI\"\\C\Cj, Water FH to be supplied by owner ~~ PAID FOR HOT TAP 10/01/98 REC # 4442 $1950 pd $25.00 for FH meter PROJECT FEES ASSESSMENT--------------------------------------------------------- R/W Excav: * $40.00 San Sewer SFR: $0.00 Sidewalk: $0.00 San Sewer MFR: * $80.00 Curb/Gutter: $0.00 Add Unit: 27 Driveway: * $125.00 Other San Sewer: $162.00 Dwy Culvert: $0.00 ~~~\~q Sew Tap Wye/Man Tap: $0.00 Street Cut: $0.00 ~ 10\\ Sew Cap/ W/M Removal: $0.00 Other R/W: $0.00 J- Alter/Repair Sewer: $0.00 Fire Hydrant: * ($1,950.oQ::>f Storm Drain Tap: $0.00 Res Water Serv; $0.00 Catch Basin per ea: $0.00 5/8" Sewer System Dev; * $5,136.00 3/4" Milwaukee Dr. Sew Assess: $0.00 1" cL R/W Use Perm: $0.00 Comm Water Serv: * (!3,OOO#rPv>-?\) \"d D.R.A.: $0.00 * 1" ~~ .., "\"& Admin Costs (D.R.A): * $0.00 ~O\-z" 1 1/2" Misc: fh meter c$:.!5.0Vpa * 211 ============================== ~c Oth Water Serv: $0.00 4-4' Water Sys Dev: * $9,271.50 TOTAL FEE: $19,789.50 ,a, AMT PAID: $12,039.00 Receipt No: 4723 Inspection Fee: $0.00 BAL DUE: $7,750.50 1!,.q\C1C\ Tr- ctv m~ 1/4(0~ PUBLIC WORKS CONSTRUCTION Issued: / / Permit No: 835 & R/W PERMIT Cond: Work Order: 0 OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------ HIGHLAND COURTE ALZHEIMER COMM : 1704 MELODY CIRCLE 618 S. PEABODY : Lot: 3 Port Angeles,WA98362 : Block: Long Legal: 360/452-1232 : Sub: HIGHLAND COMMONS PROJECT INFO-------------------------------------------------------------------- Work is N/A traveled road Value Work: $0.00 Plans Required: N/A Contractor: Start: Finish: / / / / Performance Bond Required: N/A Proof Insurance: Amoun t : $0.00 Work to Perform: INSTALL * Watermain * Sanitary Sewer * Storm Drain Underground Tele/Ele * Misc PROJECT NOTES------------------------------------------------------------------- 2 WATER METERS (1)1" irrigation meter $1000.00 system user fee 1 $2,207.5 (1) domestic meter $2000.00 system user fee<f7,064.OQ-)f~ 1/,4;tj4 Water FH to be supplied by owner PAID FOR HOT TAP 10/01/98 REC # 4442 $1950 pd $25.00 for FH meter PROJECT FEES ASSESSMENT--------------------------------------------------------- R/W Excav: * $40.00 San Sewer SFR: $0.00 Sidewalk: $0.00 San Sewer MFR: * $80.00 Curb/Gutter: $0.00 Add Unit: 27 Driveway: * $125.00 Other San Sewer: $162.00 Dwy Culvert: $0.00 Sew Tap Wye/Man Tap: $0.00 Street Cut: $0.00 Sew Cap/ W/M Removal: $0.00 Other R/W: $0.00 Alter/Repair Sewer: $0.00 Fire Hydrant: *($1,950.00:J Storm Drain Tap: $0.00 Res Water Serv: $0.00 Catch Basin per ea: $0.00 5/8" Sewer System Dev: * $5,136.00 3/4" Milwaukee Dr. Sew Assess: $0.00 1" R/W Use Perm: $0.00 Comm Water Serv: * (f3,000.00::> D.R.A.: $0.00 * 1" Admin Costs (D.R.A): * $0.00 * ~,,1/2" ~~=~~=~~=:=~=~====_____<C~=:~~V Oth Water Serv: $0.00 Water Sys Dev: * $9,271.50 TOTAL FEE: AMT PAID: $19,789.50 $4,975.00 Receipt No: Inspection Fee: $0.00 BAL DUE: $14,814.50 70@4 !:!2 . D ;ill so D_ lolllqr rol-t.-]\q8" ~.- pJ. I q So!?P f-foi TA.p ""'? "0 h ..1 W\~*,r) ,",*e.&- 'H4: 'Z.. 2'5"'"' 'F I v'e.. \ u. "" ~ OOD~ (2.) wlm\.s - \2.e.c:;:l .,4~D fLi tJ7~~ III \V'v~'1~ I -r Z'I clD""eS+l<::_- ~'. .M1/U2:rHf\ 0... "- / 0'f" /\~ STATE OF WASHINGTON DEPARTMENT OF HEALTH WATER BACTERIOLOGICAL ANALYSIS SAMPLE COLLECTION: READ INSTRUCTIONS ON BACIfOF GOLDENROD COpy 11 Instruction. are not followed, sample will be rejected. DATE COLLECTED ~E CO:LECTED COUNTY NAME MONTH DAY YEAR C/o. / I i?\ ly\ '3 /2-1-./ qq -1iQQ. '~ EiJ AM DpM TYPE OF SYSTEM IF PUBLIC SYSTEM, COMPLETE: [2f'PUBLlC II.DND,II~ li)SI510111\1 Clg GROUP o INDIVIDUAL A B (serves only 1 residence) '(}11 0 1,) \ f 1.-",,- !'--"{./, '- NAME OF SYSTEM I C.-I+ SPECIFIC LOCATIO, , TYPE OF SAMPLE (check only one in this column) o ~~~~~~WATER D Chlorinated(Residual:_Total~Free) , check treatment J D Filtered o Untreated Of Other o REPEAT SAMPLE Previous coliform presence Lab # Date o RAW SOURCE WATER So"C6' [I] []] ".KJ NEW CONSTRUCTION or REPAIRS o OTHER (Spedfy) o Total Coliform o Fecal Coliform REMARKS: . (LAB USE ONLY) DRINKING WATER RESULTS o UNSATISFACTORY, Colifonns present o SATISFACTORY, Coliforms absent REPEAT o E. Coli present o E. Coli absent SAMPLES REQUIRED o Fecal present o Fecal absent OTHER LABORATORY RESULTS ,TOTAL GOUFORM ~ /100 ml E. COLI _/l00m! FECAL COUFORM /looml PLATE COUNT Iml ANOTHER SAMPLE REQURED . SAMPLE NOT TESTED BECAUSE: TEST UNSUITABLE BECAUSE: o Sampieloo old o Confl'ent growth o Wrong oontainer . 0 TNTC o Irlcomplete tonn o Turbidculture o . .. o Excess debris . SEE REVERSE SIDE OF GAEEN.coPY FOR EXPLANATION OF RESULTS LAB NO. (701GITS) 'OATE. TlMERECEIVEO AECEJVEDBY ff{;)-60&'-I I lABORATORY: ~ REMARKS DOH 30S-C02 (!'lEV. 4I'n) \.. A-r..-.-. ...... '..........., 1..-...... .......-........., CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . .. .. INSPECTION REPORT. . . . . . REQUEST: Date Cf //'~./ q '9 Time Received by (phone. person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. F 35 Sewer Foundation Framing Chimney Plumbi~erExcav. Other~- / 7CJ'1 /7/~?~~ , -r~ INSPECTION NOTES: Inspected: Date "i - / <j.-'1t Remarks: ~c...>'1 C> K Time KI11. Byr----<4 RESTORATION REQUIRED . . . . .. YES NO J( SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC 0 Other o Repaired by City [] Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATEl CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . INSPECTION REPORT. . . . . . . . . . REQUEST: Date / - z-8-9 7 Time / / .. - Received by R - ~ ~o~person) Location of Work to be inspected & ~~ Q Name of person requesting inspection ;::-e-vrri Address of person requesting inspection Type of Inspection (circle appropriate one): ~w~ Foundation Framing Chimney Plumbing ~(~r~"-<; ~-r--..l , Phone No. Permit No. Final Sewer Excav. Other INSPECTION NOTES: Inspected: Date l/r'p'/97 Remarks: Time /2,;,70 By kG! RESTORA TlPN REQUIRED. . . . .. YES MJ!. to "/7/JS, f)EfJ{t/.~ (j!!- r %o[LLJ 15~ p;:,Pll! ~ 7 0 I NO PUl ---- SNEer // / / , EMf G 'trle .s61.1/EI< 680r:G"flVC ~710~6'~ ro "!fVlJlb1 MHo? ~ v NOTe; co, r./wT /lYf/Pb par;, Pre" (()IJIN/lrT()/{ SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved DGravel 0 Asphalt 0 PCC o Other o Repaired by City o Repaired by Permittee o 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. . . . . . . . . . . REQUEST: Date J 6 - ~ - qq " v Time Received by (phone. person) Location of Work to be inspected 17 D L( '1Y/.Q. 16d yet' y-- C..f.-L Name of person requesting inspection -rW j'\ ~~ Address of person requesting inspection I 7+* ~ 8 Phone No. Type of Inspection (circle appropriate one): Permit No. !S3~ Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other (1 I~ INSPECTION NOTES: Inspected: Date Remarks: Time . f/t+--rof +~)- :)fr /V\ kl-e 5 By 6J4)' 'X" - c... fOD P /~ -e i-/Iv -'<- ~ RESTORATION REQUIRED. . YES NOV ~/ \j; .~ 1~ 4" 9; ~f ~r::tJR- :x n \.-1 " r...:v...... N' r' "Il:<;) ~ qiliL 16C1 f c. IK I-e.. ~"c- qoo H-y d /rant CoWt'W\6n<;,. lb\D.w~ ) 1n-e/6Jy J-.4.YI..e.:. SURFACE RESTOR)rTION: SURFACE TYPE: !if Unimproved OGravel 0 Asphalt 0 PCC o Repaired by City o Repaired by Permittee o No Damage Found Wor~der # g--tOMPLETE o INCOMPLETE o Other / '). ?- '5 (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . REQUEST: Date 3-1- 99 /~-.... ~ .' . Time Received by (phone, person) Location of Work to be inspected CfJ1-e I ~ d ~ it i~ rc!;:- Name of person requesting inspection - J I J C Address of person requesting inspection J l"flt <6- B Type of Inspection (circle appropriate one): Phone No. Sewer Foundation Framing Chimney Plumbing Final Permit No. Sewer Excav. Other V-J"'l ~ DW;lOIC, INSPECTION NOTES: Inspected: Date Remarks: Time -M~ $> i< "9 X (( q~f'1 'n;; By c.- 960 -r:::.e --<- ir LU ('+11 '1? I' l/Ci It/J.? . -- RESTORATION REQUIRED . . YES NO 1-{'7 , trf ~~Q'\ ~ ~\, )J{w '~S+ Cl)Wlfl~f7 . -xl{I' 'i k ~~p ~ - SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel 0 Asphalt o Repaired by City o Repaired by Permittee o No Damage Found OPCC o Other I.)~O Wor~rder # [9"'COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date 3 - J- 5' ~ q r '-' " ~ Time Received by (phone, person) Location of Work to be inspected 170 j.-.-- ~ -e /6 ('"J T C 1),- C ) ~ Name of person requesting inspection I . (... \ I I C'IO X- I Address of person requesting inspection I 111( iJ 8 Phone No. Type of Inspection (circle appropriate one): Permit No. Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other WCi.. +e y- D t.<..) 2ocF3 INSPECTION NOTES: Inspected: Date Remarks: Time DY{>n &- ~ r:? 'b- f I By ,AI J'( 1---.. 6' 0. A ~r UO +-J,~ I L/}uZ /' NOL/ \ (j'rJ-z 11161~~' r UJ Y'" SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC o Repaired by City o Repaired by Permittee o No Damage Found Work Order # G-CUNiPLETE o INCOMPLETE o Other 1'3 '>~ (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: I Date /ZI-- b - ~ -; J 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): 1/0 l{ . tf)n e-Io)t Yw\ \ ~r- L:::Lth ~ / {; Ci-rc-/~ Phone No. Permit No. '7:53S' Wt:Ll--ev {) uJ 3607 Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other INSPECTION NOTES: Inspected: Date Remarks: fh ~e ~f 'lx 6 1-~ ( By J:-cyy r-/r< Hydr RESTORATION REQUIRED. 11/.1: YES NOV 6 f6v 1-1 'rR- j.Jycl, ~y Q ~ ~-j4f ~ ~ v /0 9J? I J ( u C' -elc,cI. . /)..c/~~ , ~ V f~t G7J /' _t .t ((~~~ .~ ~ 66 ~r- { ~ N~ Co M (. y..e+- ~ ~' Va.u\-\-' I / SURFACE RESTORpION. SURFACE TYPE: [ttUnimproved DGravel o Repaired by City o Repaired by Permittee o No Damage Found o Asphalt, 0 PCC Wor~rder # g"'COMPLETE o INCOMPLETE o Other / ?-.. ?- 2- . (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) a ~31\fM ~I W 00~ 0<; , I o S3739N't' .J.I:IOd~ f;- r 9 ~ :10 .A..J./:J '~:lnelld G rc; l [L o "- " "') C':, I L 1 ( n ~ 7' ~ >- r 0 / 0 -! W :2 -[1 ~I'~ ~ " ~$J~..... '---J ....t~~j~ ~r- ~ '\7 . A ~ t;f\Jl ~1 -+- ~~ (J N 9.! t:~~ _ x. ___ ~ I~ ~ \t-I; IV) "Q ------" ... I' " .v.r-11 ~:::::::=-.~, ~~~"1 f~ ~~ \ N ~ 1\ -i ~ i ~ . ~t VI' - ,. "I 0- ~ i ~.....~ j I-- 1t" ~ l-rf VI ~h -.........\ x l::( --- "'- " , -' '- ~.' ~f 5 ~ .( ..J' r .1 \ -=( aJl~~ Xx . ~1ll;,) 'i' "- f - !1..~ g ~ '-x '\ ~~~ r -2. Ill-$ ( \:\(::z.), "- r ____ ---IT ~ o o <t "' ~ . w n X "' w "< o f- :0 ::i * *- ~~ ~~~ ~ \\ I :::::-=~J~\ . () 0 ~ .0 k ) - ~"q~~~~~~:.;~,=~:~~~;~ .~ ~ ~- 06~~~~~~ ====-n~ \.-..... ( R "< o f- ~ ~ ~~3.lVM ~I ~ 00l 0>; , C' r 9 S3739N"- .J.I:IOd~ b C, ~ dO ,I..1I:J SlOIICWI:H1Bl'\d [L I L I ( '" ~. 7' -@ G _--:::--- --- - 'u ~.. ~ v ~ '" x ~ " o f- <l: '" ~ ~ ) ~ \~\~\ VR ~ . 0 '- ------0 % \\ \ 0.1 n . n /,,<3. 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