HomeMy WebLinkAbout516 E Front St - Engineering
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PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, W A 98362
PUBLIC WORKS CONSTRUCTION Issued: 6/25/96 TF Permit No: 437
& R/W PERMIT Cond: Work Order: 0
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
JOHN HAYDEN 516 FRONT E
804 W. 7TH STREET Lot: W 1/2 6 ALL 7
Port Angeles, WA 98363 Block: 20 Long Legal:
360/452-4646 Sub: N R SMITH
PROJECT INFO--------------------------------------------------------------------
Work is INSIDE traveled Road Value Work: $0.00
Plans Required: N/A
Contractor:
Start:
Finish:
Performance Bond Required: N/A
Amount:
Proof of
Insurance:
/ /
/ /
$0.00
Work to be
Performed:
Watermain
* Sanitary Sewer
storm Drain
Underground Tele/Ele
Misc
PROJECT NOTES-------------------------------------------------------------------
REPAIR
PROJECTR~~Eix~~e~S~M~~~~-------------------~~~-~~~~;-~;;~-------$~~~~---
Sidewalk: rr:oo San Sewer MFR: $0.00
Curb/Gutter:
Driveway:
Dwy Culvert:
Street Cut:
Other R/W:
Fire Hydrant:
Res Water Serv:
5/8"
3/4"
I"
Corom Water Serv:
I"
1 1/2"
2"
Oth Water Serv:
Water Sys Dev:
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Add unit: 0
Other San Sewer:
Sew Tap Wye/Man Tap:
Sew Cap/ W/M Removal:
Alter/Repair Sewer:
storm Drain Tap:
Catch Basin per ea:
Sewer System Dev:
Milwaukee Dr. Sew Assess:
R/W Use Perm:
D.R.A. :
Admin Costs (D.R.A):
Misc:
$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
$0.00
TOTAL FEE:
AMT PAID:
Receipt No:
Inspection Fee:
BAL DUE:
$0.00
$40.00
$0.00
$40.00
Separate Permits are required for electrical work, utilities, private and public improvements. This permrt becomes null and void ~ work or
construction authorized is not commenced within 180 days, ~ construction or work is suspended or abandoned for a period of 180 days after
the work as commenced, or ~ required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have
read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work
will be complied with whether specified herein or not. The granting of a permrt does not presume to give authority to violate or cancel the
provisions of any state or local law regulating construction or the performance of construction.
Sianature of OWner (~ owner is builder)
Date
Sianature of Contractor or Authorized Acent
Date