HomeMy WebLinkAbout1507 E Lauridsen Blvd - Engineering
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PUBLIC WORKS - BUILDING DIVISION
321 EAST 5TH STREET, PORT ANGELES, WA 98362
PUBLIC WORKS ~O~~~R~i~~~ IS~~~~: ~ /tf;;1V w~~~m~;d~~: 50~
OWNER/APPLICANT------------------------PROPERTY LOCATION------------------------
ROGER BLANCHARD 1507 LAURIDSEN BLVD E
1500 WEST LAURIDSEN Lot: 2
Port Angeles,WA98363 Block: J Long Legal:
360/457-4252 Sub: CRESTHAVEN
PROJECT INFO--------------------------------------------------------------------
Work is INSIDE traveled road Value Work: $0.00
Plans Required: NO Start: / /
Contractor: .CHRISTIAN BROTHERS CONSTRUCTION Finish: / /
Performance Bond Required: YES Amount: $0.00
Proof Insurance: Work over $2000: 200K PI/500K Per Inc/l00K Prop
Work to Perform: INSTALL * Watermain
* Sanitary Sewer
.* Storm Drain
Underground Tele/Ele
* Mise
PROJECT NOTES-------------------------------------------------------------------
san sewer connection may be made between lots to the North easement
allowing-or connect to main by way of Blvd if grade can be met.
PROJECT FEES ASSESSMENT---------------------------------------------------------
R/W Excav: * $40.00
Sidewalk: $0.00
Curb/Gutter: $0.00
Driveway: $0.00
Dwy Culvert: $0.00
Street Cut: * $200.00
Other R/W: $0.00
Fire Hydrant: $0.00
Res Water Serv: * $550.00
* 5/8"
3/4"
I"
Comm Water Serv: $0.00
I"
1 1/2"
2"
Oth Water Serv: $0.00
Water Sys Dev: * $883.00
Receipt NO~
Inspection Fee~ $0.00
San Sewer SFR: *
San Sewer MFR:
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):
Mise:
$80.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$642.00
$0.00
$0.00
$0.00
$0.00
$0.00
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,
I
I
TOTAL FEE: $2,395.00 I
~~~:~~;~--~-$;~;~~~~dl'
Separate Permits are required for electrical work, utilities, private and public improvements. This perm~ becomes null and void if work or
construction authorized is not commenced ~hin 180 days, if construction or work is suspended or abandoned for a period of 180 days after
the work as commenced, or if required inspections have not been requested ~hin 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 perm~ 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.
Sin nature of Owner (if owner is builder)
Date
Sin nature of Contractor or Authorized Anent
Date