HomeMy WebLinkAbout1326 Campbell Ave - Engineering
PUBILlC WORKS & R/W PERMIT
I-i Attached Notes
OWNER/APPLICANT ~='--
city of Port Angeles
Issued:
6/30/2004
Permit No:
Work Order:
1406
o
Port Angeles, W A 98360
000/600-0000
PROJECT INFO
Work is:
Plans Required: Start Date:
Contractor: QWEST COMMUNICATIONS
Performance Bond Required: Amount:
Proof of Insurance:
Work to Perform:
-PROPERTY LOCATION-
;
I' 1326 CAMPBELL AVE
Lot:
Subdivision:
Parcel No:
Block:
Beacon Hill
D Long Legal
Value Work:
$0.00
II
Finish Date:
I I
3601000-0000
$0.00
f2g Install
D Repair
D Watermain
D Sanitary Sewer
D Storm Drain
~ Underground TelelElec
D Mise
PROJECT NOTES
placement of buried service wire for customer @ 1326 Campbell # 7 to
include 125 feet on the right of way.
FEES ASSESSMENT
1.) R/W 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 W 1M 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 R/W: $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.) R/W 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.) 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
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JUN 28 2004 15:54 FR TRRFTON B
253 471
1324 TO 13604174708
78508 S. Trafton
Tacoma, WA 98409
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To: City of Port Angeles Fa>:: 360-417-4709
From: Qwest Communications Date: 06/28/04
Re: Pages: 3
cc: Ryan Fuqua
D Urgenl D For RaVlow D PIaase Comment CJ PIeas8 RIlpIy
CJ PI8ase ~
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Nat\ls:
T. Funston,
reimit'applioations:
W004034321452M
Thank you,
-Ryan
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Placement of buried service wire for our custmmer at 1326 ;":":;'iP~~~'::'~
Campbell #7 to include 125 feet on the right-of-way_ "':;,'~~Q,:;i
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THE ABOVE APPUCATION IS HEREBY GRANTED SUBJECT TO APPl,ICANT'S: ',"", ,'?:;;,~tW~
Complying with all Municipal Ordinances; , , "".h",
Notifying the Street Superintendent of the time the work will star:, and wilen it will- finish; ",,',:r/,!ll,:i~
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JUN 28 2004 15:54 FR TRRFTON B
2534711324 TO 13604174709
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lUlUC WORKS
Permit To Perform Work In Street Rillllt-(lf.Way
APPLICATION is hereby m~de to the municipality of PORl' ANGE:LE:S
to perform work as
nored hereon and ~s <holl<n on all.ched drawing:
~/V\/VlJ=_ -d:L- J 4 0 V
Approved:
Wll.ter Department - Superintendent
Prosecuting the work with diligence and with due respect to all property, contracts. persons'
ri~ts and the interests and c:onvenience of tile public;
Date
Saving tile Municipality harmless from any Ilnd all damages which nay acaue to any penon
or property because of this installation or tile maintenance thereof;
Complying wl.h follo",ln; speel"" conditions:
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** TOTAL PAGE.03 **
JUN 28 2004 15:55 FR TRAFTON B
2534711324 TO 13604174709
Qwest Job #
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Section:
ownshi
Ran e:
This request for permit is for the placement of underground telephone
our customer at the following address:
1>2.6
C~wrf5f/..L
A:6 tc~
POf!:.T
A1Vc,[t..E5
This work will require:
Trenching in the R/W (total footage)
Push or bore 2 inch PVC or BIP under roadway (total footage)
Push or bore 2 inch PVC or BIP under driveway (total footage)
?ush or bore 2 inch PVC or BlP under multipl~ driveways (total footage)
Applicant Signature/Date K\-;~- '-Z8~P'l
Road Number
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