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HomeMy WebLinkAbout1044 Campbell Ave - Engineering PUBILlC WORKS & R/W PERMIT o Attached Notes OWNERlAPPLlCANT -- Issued: 3/10/2003 Permit No: Work Order: PROPERTY LOCATION 1044 CAMPBELL AVE Lot: 1 &2AND PART5WOFROAD Subdivision: ILLONOIS ADDN Parcel No: 063014540600000 0 1372 o Block: 6 Long Legal 1044 CAMPBELL AVE Port Angeles, W A 98362 000/604-7332 PROJECT INFO Work is: Plans Required: Start Date: Contractor: QWEST COMMUNICATIONS Performance Bond Required: Amount: Proof of Insurance: Work to Perform: ~ Install o Repair o Watermain PROJECT NOTES Value Work: $0.00 1 1 Finish Date: 3601000-0000 1 1 $0.00 o Sanitary Sewer o Storm Drain ~ Underground Tele/Elec ~ Mise Place buried service wire to 1044 Campbell Ave. work will require 30' road push FEES ASSESSMENT 1.) RIW Excav: 2.) Sidewalk: 3.) Curb/Gutter: 4.) Driveway: 5.) Dwy Culvert: 6.) Street Cut: 7.) Other RlW: 8.) Fire Hydrant: 9.) Res Water Serve 10.) Comm Water Serve 11.) Other Water Service: 12.)Water System Dev: 13.) San Sewer SFR: 14.) San Sewer MFR: add unit 0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Receipt No: Inspection Fee: $0.00 15.) Other San Sewer: 16.) Sew Tap Wye/Man Tap: 17.) Sew Capl W/M Removal: 18.) Alter Repair Sewer: 19.) Storm Drain: 20.) Catch Basin per ea: 21.) Sewer System Dev: 22.) Milwaukee Dr. Sew Ass: 23.) R/W Use Perm: 24.) Admin Cost (DR.A) 25.) ORA 26.) Mise: TOTAL FEE: Amount Paid: $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Balance Due: $0.00 -----::: - .. ~~ ii.., .--- -' (,:"-- , . -'----.- :JJ - ~\~1.\1 .,- ~ -' P.02/03 .... . .": ;',~';:i:,:::g'~ ',. "'\'-'~'/'I'~' l-\AR \ \} LcJ,J, "'",,'s''["i! ,- -- . ---=: ~:' ::::::;<~;#i . . . ". "";J ~:=~~.:~:;'.::o:::':,::,;:: :::,::,." or ";;;~,, . ,:-=,,,:.. '.~:II PLEA~ .5etE:. A\{ACtte b ...5~"'l+#' ':H2? Uo~1.D) .WbD3al(~1"'4S~ '(JUtte. RorelW ~Ulce- \.0\ 12~ lb .,:.~"iJ;~\iiMtl Del tt CW~~ () t 1l)44- Q..Atn P bQll ?tV 6,,::/,~triJ~ WOR-\(... WILL.. ~nu(r-e. Cl ~t ~a ffi:Sh:~,,/;':;Ji~% ., ..J ,1,,,:\\'iZ,..id' . ':, ";;b i\.~ ' .' "'. '.",.f'.' ': ".,'~ '~<r::~~?$.~~~~ , " ~"" . ,,i". ,'; ,,~~;~'''( , . ,,~I,'..i,;~~;,tJ.1 . , ," ::'\'/;,:~3~1! !' ~ '" ";:. ~:;'~::~:: ~ . ! t,,,\~.,. ,I' ~ 01, \., ':;~~';~'I"'~" , ' \")o.~'li)~~ Date 3-G,-b.3 BY~~ '>'-jr:{;:;.~ 283- 597- 5(~(P Con~actor . Owner . . ,:;;:<~iiL~; t'A'x. 2. Sj- '{7/- (~Zlf . ~U)~/ I}TiN f:,~~;~~~R~;._ Phone; 253-473-0788 18'50- B S: -rf2.A-FTOJJ ~J THE ABOVE APPLICATION IS HEREBY GRAI'(I"ED SUBJECT TOAPPlJCANT'S: W.4- "1rg:4il"l;.7}, , , :-::. ;'~;::',:~!~ ::'~:~: .' ';; ;';:~~ MAR 06 2003 13:10 FR TRAFTON B 2534711324 TO 13604174709 ~~ <@he/ g)~ '.-- IUIIIJC WOllll8 ..... -- Permit To 'Perform Work In Straet Riaht~r.W.y Approved: ~J3r;2- Water DepU'tment - Superinbmdel'lt S..". DepUQl\imc - Superint.8ndeiit ' The estimared time ror'completion of the above work' Is JD ?::JAYS Due Complylna with all Municipal Ordinances: Notifying the Street Superinundent of th!l time the work 9'i1l star:. and when it wiU tlnish; . Proaecurina the ....orle \With dililmce and With due respeet to all property, contrac:ts, penona.' ri&hu and the interests ~nd convenienC'l! or the public::: Savini the Munic::illalllY humleu.(rom any and all damages IIIhiGh rnay accrue to sny perrOn' Or property bCC"~lise orthil inatallariOD or tlla maintenance. thareof; . Complylna with fOllowln. ,pecial'conditions: ~ lID (()-3 I' City otl'ORC5 B~;f;M~~-~ ...- ....'.. '.',.; . ": ,<~Yl:.:,;: . . ~'., r:.i .', .~,Ui~::; ,~~~ -, .,' ", 1 ,rjl'~'t,~~ '.\;, '''''''~''~ '. ...';,;It MAR 06 2003 13:10 FR Qwe~t Job it TRAFTON B 253 471 1324 VV 0 U::JU IllO / - '-1'-"0 I' 1 TO 13604174709 P.03/03 .;.; .',: "'':;, , . 'J:'::.~ . : ".~".~ . ,.~.:..,~':'?'; ..".,;j.\:;~' Q ~ VI ~ I.u <:J:l "Z. <:( f .,';' , .:,r j . , , " .~ " , j,:. .,' .: :,' "".'.1 ""E1'!I'lI>.J~L o JCH~ I .. :':',~; , ~. "":', . 1- - - I !Oq~ .C-At--I-pbeLL AVE ,...... ' ,~ ';-::i~if:lq '- --' '':'" 3~ TOwnSfai 'Ra::::ze.;'1.I~ -', ..... )" - . . ' . :':...:~:-:::-:::-:- :.~ ".:-: -; :::;..'J'.~:1::5 -;.oc.:-ess: :-~':..:,...,; :' ~ ~ -: ':':-:-:::: _S ;'::l:- -::~ ;J;.;.ce:;:enr of '.lnde:-grounc " - '. ;e:,,:,:.~c:e ,"'.:," < (' /04'1 C A (VI P136'U-. AVEs. ...',./:',::.>; -:-:-::5 'va:-:-: '.\"i:: .:-e~''':::-':'; -~Q_' . ..... - ," to:"': .'oot=g"'_,' _ _ ...uC:::::~.~ ~,,~ .-.. ~ -......... - (/J '" ?'':SI: ,)r ~o:-';' .2 :::::-. "",'C IJr 3IP unde:- roadway (total footage) ,</:)/ (/) ?'~si-; x ',0:-0 .: :::::: =-.,'C 'x 3lP und.er drive'.vay (tOtal footagel ?'..:.sr: 'x lo:-e .: .n::: ?....C !Jr 3IP unde:- multiple driveways (total fOOtage/oj, , :' ".'., ,,:~ : .;.. ..-....- -.... - -' - '-'"":' ~....._) ** TOTAL PAGE.03 ** MRR 06 2003 13:10 FR TRRFTON B 2534711324 TO 13604174709 F'. 0! /0::' Fax Cover sheet March 6, 2003 Sender info Local Network 7850.8 S, Trafton' Taeoma, WA 98409' Offiee: (253) 471-1324. Fax: (253) 597-5136 TO: City of Port Angeles COM~ANY: FROM: Dona Thaut QWEST CC: FAX NUMBER: 360-417-4709 RE: PHONE NUMBER: TOTA" NO. OF PAGES INCLUDING CovER: 2 Comments: Permit Application W0301167.452M JOB 10 ll.IAI1IE5iris fH)W .~~. Qwest~~. ) I.. p, --<- ;;;: '" V' ;::\) ,~ - 7' r: 'Ac. TJ 0- c ,,;}.I > c!"-'j; <. ~.....,: ~ _ c..Jt,1'i;- (". ~. l~ ~~~ '" \ ~~Zq: ,~ ~<ro-- ~ ,,'.., Pee<. l:>()d '! I _~.4;) -",9,., f. v '1(;, JSlh I' ',1 q/ 07€ I' V 1/(, 'i9!: ('. 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