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"-.j ~ VJ \)~ ~ CD ()5'f. , ~ """'...... ~ -f- ~ 1'1 /~. ~ /~ .......... ~ ~ \:) ~ r:::t ~ s ~~ CITY OF PORT ANGELES PUBLIC WORKS - BUILDING DNISION 321 EAST srn STREET, PORT ANGELES, WA 98362 9/18/2000 PUBILIC WORKS & R/W PERMIT o Attached Notes OWNER/APPLICANT JANE ELDRIDGE 1710S OST Port Angeles, WA 98363 000/604-2277 PROJECT INFO Work is. Plans Required' Contractor' Performance Bond Required' Proof of Insurance: Work to Perform Issued Permit No' Work Order' PROPERTY LOCATION 17100STS Lot: 29 Subdivision. Parcel No 584 o Eagles Lair Block. 2 - [g] Long Legal --.j '-. V V) Value Work. $000 Start Date' 1 1 Finish Date: 000/000-0000 Amount: $000 [g] Install o Repair [g] Watermain [;8J Sanitary Sewer [;8J Storm Drain o Underground Tele/Elee [;8J Mise PROJECT NOTES all lots will requires new service lines / with meters, Its 27-32. received $640.00 for water meter 8/29/00 1 1 .a <;J ::: FEES ASSESSMENT- 1 ) RIW Excav' 2.) Sidewalk. 3.) Curb/Gutter' 4 ) Driveway' 5 ) Dwy Culvert: 6.) Street Cut: 7 ) Other RIW 8 ) Fire Hydrant: 9) Res Water Servo 5/8" 10 ) Comm Water Servo 0 11 ) Other Water Service. 12.)Water System Dev' 13) San Sewer SFR 14) San Sewer MFR add unit: 0 $000 15.) Other San Sewer' $000 16.) Sew Tap Wye/Man Tap: $000 17) Sew Capl W/M Removal: $145 00 18 ) Alter Repair Sewer' $0.00 19.) Storm Drain: $000 j0020 ) Catch Basin per ea. $000 glvt 21) Sewer System Dev' $0.00 1 J 22.) Milwaukee Dr Sew Ass. $640.00 ~ U$ 23 ) RIW Use Perm $0.00 }JFri 24) Admin Cost (0 RA) $0.00 1fY 25) D.RA $1,02500 26.) Misc: $95.00 $0.00 TOTAL FEE. Amount Paid Receipt No Inspection Fee 6681 $000 $0.00 $000 $0.00 $000 $0.00 $0.00 $745 00 $000 $000 $000 $0.00 $000 $2,650.00 $2,65000 q lid oD IZ-OJO~ Balance Due: $0.00 RW SANITARY WATER DWY STORM DRA OTHER Separate Permits are required for electrical work, utilities, private and public improvements. This permit becomes nuU 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 applcation 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. :c- lid Sianature of Corltractor or Authorized Acent Date Signature of Owner (if owner is builder) Date _'1:.__ D tV - :2.00 I - , " "'f CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . INSPECTION REPORT. . . . . . / REQUEST Date 1- F - [)D Time Received by (phone, person) 11ft} 5, [) 5+- , ~ L0 ,'\ L U .~ J '1::tll ~ f3 / Phone No I Permit No 58 C; Plumbing Final Sewer Excav Other LU c'~ +er- 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 INSPECTION NOTES Inspected Remarks Date By :2 U-.J~ +-CV- 5-e vul C-ZC- j1r / F ///JZ FV6 Wi Time '\ .G , ~)J S ~-' c""- ,51' // f D [- RESTORATION REQUIRED \1(OO';?(" > 'J 'v ~i' Y '.f' ([\t-. ~ yt\'pO ~ / ES / NO 1/ [ ~~\\!\ V I>- ~ ~ ,( ~ ~'-" ~ .~ ~~ SURFACE RESTORATION SURFACE TYPE D Unimproved 0 Gravel D Repaired by City D Repaired by Permittee [] No Damage Found o Asphalt 0 PCC / 0 Other Work)>rder # -1 b <1 Y ~OMPLETE q INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) PUB/LIe WORKS & R/W PERMIT OWNERlAPPLlCANT 0 Attached Notes JANE ELDRIDGE 1710 S. 0 ST Port Angeles, WA 98363 000/604-2277 PROJECT INFO Work is: Plans Required: Start Date: Contractor: QWEST COMMUNICATIONS Performance Bond Required: Amount: Proof of Insurance: Work to Perform: Issued: 11/13/2000 Permit No: Work Order: 1123 o PROPERTY LOCATION 17100STS Lot: 29 Subdivision: Parcel No: Block: 2 Eagles Lair IZI Long Legal Value Work: $0.00 I I Finish Date: 360/000-0000 II $0.00 IZI Install D Repair D Watermain D Sanitary Sewer D Storm Drain IZI Underground Tele/Elec D Misc PROJECT NOTES trenching along "0" 8t approx 150' FEES ASSESSMENT 1.) RIW Excav: $0.00 15.) Other San Sewer: $0.00 2.) Sidewalk: $0.00 16.) Sew Tap WyelMan Tap: $0.00 3.) Curb/Gutter: $0.00 17.) Sew Capl WIM 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.) DR.A. $000 12.)Water System Dev: $0.00 26.) Mise: $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 D~ v:z!)hd 5;t)~ PUBUC WORKS Permit To Perform Work In Street Right-of-Way APPLICATION is hereby made to the municipality of PORT ANGELES to perform work as I '0 ~-y . -Po \L ilLtrrJ c-' t+ h f \La ~ 150 / ~ LDJG noted hereon and as ~hown on attached drawing: --:pd::A::>f SEE AT\. Ac\-\E.b - ::J:L I J 2--- ?;> P ~ Approved: Sr.E TC Ii 00- b5 3 u Water Department - Superintendent Sewer Department - Superintendent The estimated time for completion of the above work is uJ \ Tl-1 I tJ 10 IYI yS of f2LCE, Pi By [~~~ ~ ~J 31.>0 - '-178 -'fL(Z Contractor wner US WEST / ATTN: MISTY ~I \ - ("I)l:- STREET -1)A:X..mfNT BREMERIDN. Wf\SHINGTDN 'i835 THE ABOVE APPLICATION IS HEREBY GRANTED SUBJECT TO APPLICANT'S: Date J'tr\! . ~. / 19 00 Complying with all Municipal Ordinances; Notifying the Street Superintendent of the time the work will start, and when it will finish; Prosecuting the work with diligence and with due respect to all property. contracts. persons' righ ts 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; Complying with following special conditions: J~~ II -1.3-- ZOOD --t'r City of "Po R."T NJG E.C ES Dale 11-02-00 08:12 FrOlll'"US WEST 835 N DAKRIDGE DR PA +13604522B33 T-30B P.Ol/O! F-033 sSW anltr Fonnll1&DtOh Numtl.~ fA) 00 Willi Center t.\ '3'2- PItt 8ullmilld '/ CD I.JTI aNI lOX ONL' lAt · or I_ INGIN,,,'NG Co PlfIPlfOVJ8ION,NG flU""" a.: .... '....r 1111 o QlIItr t 1. Aeqwll' DIOP ,raburl... g C TN a. 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