HomeMy WebLinkAbout4310 Newell Rd - Engineering
PUBILlC WORKS & R/W PERMIT
OWNER/APPLICANT 0 Attached Notes
NICK LOMBEST
4310 NEWELL RD
Port Angeles, WA 98363
000/605-5083
PROJECT INFO
Work is:
Plans Required: Start Date:
Contractor: QWEST COMMUNICATIONS
Performance Bond Required: Amount:
Proof of Insurance:
Work to Perform:
Issued:
9/19/2000
Permit No:
Work Order:
1109
o
PROPERTY LOCATION
4310 NEWELL RD
Lot:
Subdivision:
Parcel No:
Block:
CROFTS
o Long Legal
~ Install
~ Repair
o Watermain
PROJECT NOTES
BURY 3 PR BSW
Value Work:
$0.00
1 1
Finish Date:
3601000-0000
1 1
$0.00
o Misc
o Sanitary Sewer
o Storm Drain
~ Underground Tele/Elec
FEES ASSESSMENT
1.) RIW Excav: $0.00 15.) Other San Sewer: $0.00
2.) Sidewalk: $0.00 16.) Sew Tap Wye/Man Tap: $0.00
3.) Curb/Gutter: $0.00 17.) Sew Capl W/M Removal: $0.00
4.) Driveway: $0.00 18.) Alter Repair Sewer: $0.00
5.) Dwy Culvert: $0.00 19.) Storm Drain: $0.00
6.) Street Cut: $0.00 20.) Catch Basin per ea: $0.00
7.) Other RIW: $0.00 21.) Sewer System Dev: $0.00
8.) Fire Hydrant: $0.00 22.) Milwaukee Dr. Sew Ass: $0.00
9.) Res Water Serv: $0.00 23.) RIW Use Perm: $0.00
10.) Comm Water Serv: $0.00 24.) Admin Cost (D.R.A) $0.00
11.) Other Water Service: $0.00 25.) D.R.A. $0.00
12.)Water System Dev: $0.00 26.) Misc: $0.00
13.) San Sewer SFR: $0.00 TOTAL FEE: $0.00
14.) San Sewer MFR: $0.00
add unit: 0 Amount Paid: $0.00
Receipt No:
Inspection Fee: $0.00 Balance Due: $0.00
'611 \(j!}M 5V~
PUBUC WORKS
Permil To Perform Work In Slreet Right-of-Way
APPLICATION is hereby made to the municipality of PORT ANGELES to perform work as
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nOled hereon and as shown on attached drawing:
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Approved:
Water Department - Superintendent
Sewer Department - Superintendent
The estimated time for completion of the above work is uJ \ Tt-1 J rJ J 0 l:i\ yS of f2.EC5/ f'J
By fv\ L.o~
3<Po - '178 '-'f4Z'L
Contractor Owner
US WEST / ATTN: . MISTY
(",1 \ - (.,--r)t- STI\EET .1)A:x:.mfNT
. BREf"-IERTON I WF\,:::;rll NGTDN qB~5
THE ABOVE APPLlCA nON IS HEREB Y GRANTED SUBJ ECT TO APPLICANT'S:
Date
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Complying with all Municipal Ordinances;
Notifying the Street Superintendent of the time the work will start, and when it will finish:
Prosecuting th.e work with diligence and with due respect to all property. contracts. persons'
nghts and the Interests and convenience of the public:
Saving the Municipality harmless from any and all damages which may accrue to any person
or property because of this installation or the maintenance thereof;
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Complying with following special conditions:
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