HomeMy WebLinkAbout800 Church Ave - Engineering
PUBILlC WORKS & R/W PERMIT
o Attached Notes
OWNERlAPPLlCANT
CITY
Issued: 1/30/2003
Permit No:
Work Order:
1364
o
PROPERTY LOCATION
800 CHURCH AVE
Lot: Block:
Subdivision: GLENBROOK
Parcel No: D Long Legal
Port Angeles, WA 98360
000/600-0000
PROJECT INFO
Work is:
Value Work: $0.00
Plans Required: Start Date: 1 1 Finish Date: 1 1
Contractor: OWEST COMMUNICATIONS 360/000-0000
Performance Bond Required: Amount: $0.00
Proof of Insurance:
Work to Perform: D Install D Sanitary Sewer D Misc
~ Repair 0 Storm Drain
D Watermain ~ Underground Tele/Elec
PROJECT NOTES
REPLACE DEFECTIVE CABLE ALONG CHURCH AVE BETWEEN McDOUGAL AND McGill
NORTH SIDE OF CHURCH AVE
FEES ASSESSMENl'
1.) RIW Excav: $45.00 15.) Other San Sewer: $0.00
2.) Sidewalk: $000 16.) Sew Tap Wye/Man Tap: $0.00
3.) Curb/Gutter: $0.00 17.) Sew Capl W/M Re~oval: $0.00
4.) Driveway: $145.00 18.) Aller Repair Sewer: $0.00
5.) Dwy Culvert: $0.00 19.) Storm Drain: $0.00
6.) Street Cut: $230.00 20.) Catch Basin per ea: $0.00
7.) Other RIW: $0.00 21.) Sewer System Dev: $745.00
8.) Fire Hydrant: $0.00 22.) Milwaukee Dr. Sew Ass: $0.00
9.) Res Water Serv: 5/8" $640.00 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.RA $0.00
12.)Water System Dev: $1,025.00 26.) Mise: $0.00
13.) San Sewer SFR: $95.00 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: $2,925.00
~~. t@//ed g)~
pt IRI Ie WORKS
Permit To Perform Work In Street Right-of-Way
APPLICA nON is hereby made to the municipality of PORI' ANGELES . to perform work as
noted hereon and as shown on attached drawing: JOB # 32 WI12 77
p~ /3&4
CHRIS CHRISTENSEN
Qwest, ENGJ;NEER
360-452-2~84
h35" N. ~1D6t D~
?O'<J rJr-ltxtkS W/1
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Approved:
Water Department - Superintendent
Sewer Department - Superintendent
The estimated time for completion of the above work is
Daie .J11 tV 31
2003
BY~~_~~~
Contractor ' 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 convenie"nce of the public;
I
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{)h? ~
(
Date
City of PORI' ANGELES
~~~
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