HomeMy WebLinkAbout904 Benjamin Ave - Engineering
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PUBLIC WORKS CONSTRUCTION Issued: 11/04/96 TF Permit No: 546
& R/W PERMI T Cond: Work. Order: 0
OUNER/APPLICANT...---------------------PROPERTY lOCATION~---.---_.-..-------..--
DAVID ANDERSON 904 BENJAMIN ST
904 BENJAMIN ST lot: 6
Port Angeles,WA98362 Block: II long legal:
360/452-6342 Sub: PINEBRDDK
PROJECT INFO--------------------------------------------------------------------
Work is OUTSIDE traveled road Value Work: SO.OO
Plans Required: N/A
Contractor: US WEST COMMUNICATIONS
Start:
Finish:
Performance Bond Required: N/A
Proof Insurance:
Amount:
Work to Perform:
Watermain
Storm Drain
Sanitary Sewer * Underground Tele/Ele
Mise
/ /
/ /
SD.OO
PROJECT NOTES-------------------------------------------------------------------
underground telephone spprox 175' seeross Benjamin Ave
PROJECT fEES ASSESSMENT--.----..---.----.....---.............----.----..........
R/Y Exeav: SO.OO San Sewer SFR: SO.OO
Sidewalk: SO.OO San Sewer MFR: SO.OO
Curb/Gutter: SO.OO Add Unit: 0
Driveway: SO.OO Other San Sewer:
Dwy Culvert: SO.OO Sew Tap Wye/Man Tap:
Street Cut: SO.OO Sew Capl W/M Removal:
Other R/W: SO.OO AlterlRepair Sewer:
Fire Hydrant: SO.OO Storm Drain Tap:
Res Water Serv: SO.OO Catch Basin per ea:
5/811 Sewer System Dev:
3/411 Mi lwaukee Dr. Sew Assess:
1"
Comm Water Serv:
SO.OO
R/W Use Perm:
D.R.A. :
Admin Costs (C.R.A):
Mise:
1"
1 1/211
2"
Oth Water Serv:
Water Sys Dev:
SO.DO
SD.OO
SO.OO
SD.DD
SO.OO
SD.OO
SD.OO
SO.OO
SO.OD
SO.OO
SO.OO
SO.OO
------------------------------
------------------------------
SD.OO
SO.OO
TOTAL fEE:
AMT PAID:
Receipt No:
Inspection Fee:
SO.OO
BAl DUE:
SO.OO
SO.OO
SO.OO
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PUBUC WORKS
Permil To Perform Work In Street Right-of-Way
APPLICA nON is hereby made to the municipality of PORT ANGElES to perform work as
noted hereon and as shown on attached drawing:
bU\f\;) -te)4JhonL iJJiVL \15' \JJ'dlJ( 'r.f c9\Dh~ beh ~mih Ave
~ a-t+aLhut 6VRW'In0 %LiU10\A
(f~ $4%
Approved:
Water Department - Superintendent
Sewer Department - Superintendent
The estimated time for completion of the above work is
By ~p IUUA( lL1J 1Z.\V ~l0
Contractor Owner
U S \N'FST / ATTN: j.-, i STI
~'Z.D J<EAN STREET - GARAGE
BREME.RTON. WJ\SHINGTDN q8~1~
THE ABOVE APPLICATION IS HEREBY GRANTED SUBJ ECT TO APPLICANT'S:
Date
Il:JlCl
,
19~
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; -
Complying with following special conditions:
Date
II /4
19 tf (/
City of
BY ~JA(~
SEQUIM
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