HomeMy WebLinkAbout933 E 1st St - Engineering
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CITY OF PORT ANGELES
PUBLIC WORKS - BUILDING DIVISION
321 EAST STII STREET, PORT ANGELES, WA 98362
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PUBILIC WORKS & R/W PERMIT
o Attached Notes
OWNER/APPLICANT
howard ratzmam
803 Indian Bend Rd
Umpqua, OR 97486
000/060-0000
PROJECT INFO
Work is:
Plans Required: Start Date:
Contractor: J & J CONSTRUCTION
Performance Bond Required:. Amount:
Proof of Insurance:
Work to Perform:
Issued:
9/11/2000
Permit No:
Work Order:
1107
o
PROPERTY LOCATION
933 1ST ST E
Lot: 14-19
Subdivision: WILLIAMS & CRAMERS
Parcel No: ~
Block:
Long Legal
Value Work:
$0.00
1 1
Finish Date:
360/457-1809
1 1
$0.00
~ Install
o Repair
o Watermain
o Sanitary Sewer
o Storm Drain
o Underground Tele/Elec
~ Misc
dwy
PROJECT NOTES
FEES ASSESSMENT
1.) R/W Excav: $45.00 15.) Other San Sewer: $0.00
2.) Sidewalk: $0.00 16.) Sew Tap Wye/Man Tap: $0.00
3.) Curb/Gutter: $0.00 17.) Sew Capl W/M 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.) Misc: $0.00
13.) San Sewer SFR: $0.00 TOTAL FEE: $45.00
14.) San Sewer MFR: $0.00
add unit: 0 Amount Paid: $45.00
. Receipt No: 5862
Inspection Fee: $0.00 . Balance Due: $0.00
RW SANITARY WATER DWY STORM DRA OTHER
Separate Permits are required for electrical work, utilities, private and public improvements. This permit becomes nuB and void if work or
construction authorized is not commenced within 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 within 180 days from the last inspection. I hereby certify that I have
read and examined this appication 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 permit does not presume to give authority to violate or cancel the
pro f any state or lac re ating construction or the performance of construction.
Date
Si nature of Owner if owner is builder
Date
Il)