HomeMy WebLinkAbout1625 S C St - Engineering
PUBILlC WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
BRAD WEATHERBEE
201 ROBINSON RD
Port Angeles. W A 98362
000/604-2310
PROJECT INFO
Work is:
Plans Required: Start Date:
Contractor: QWEST COMMUNICATIONS
Performance Bond Required: Amount:
Proof of Insurance:
Work to Perform:
Issued:
9/30/2002
Permit No:
Work Order:
1329
o
PROPERTY LOCATION
1625 5TH ST W
Lot: 14
Subdivision:
Parcel No:
Block: 129
TPA
063000012970000
D Long Legal
Value Work:
$0.00
I I
Finish Date:
360/000-0000
II
$0.00
L3:J Install
D Repair
D Watermain
D Sanitary Sewer
D Storm Drain
~ Underground TelelElec
D Misc
PROJECT NOTES
install conduit in alley 1625/1633 West 5th Street
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 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 (DRA) $0.00
11.) Other Water Service: $0.00 25.) DRA. $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: $0.00
<y~ r@l/ed 9)~
Pl.IRIIC WORKS
Permit To Perform Work In Street Right-of-Way
APPLICATION is hereby made to the municipality of PORI' ANGELES . to perform work as
noted hereon and as shown on attached drawing: JOB II 2:Z..W K ~ hS-
rivnd =t1- /3zq
>;'
CHRIS CHRISTENSEN
Qwest, ENGINEER
360-452-2184 Approved:
(p :, S ;..) OR-I,I" ICr'dC; G -;:P 12
/bef ArlLJt3lt5~ l.Ua...
9B~~L
Water Department -. Superintendent
Sewer Department - Superintendent
The estimated time for completion of the above work is /.0 -.;30.. 2.c9 0 2....
Date 9-2'7
2$)t92-
By t2~ (!d
Con tractor
Owner
(check one)
THE ABOVE APPLICATION IS HEREBY GRANTED SUBJECT TO APPLICANT'S:
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'
rights 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;
Compl ing with following special conditions:
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Date
,""hi..,. c-",,,,n""/on., PDn Ibwn'end-38S-1256
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