HomeMy WebLinkAbout1137 W 8th St - Engineering
PUBILIC WORKS & R/W PERMIT
,.-----" --
995
o
Issued' 10101/1999
Permit No
Work Order'
OWNER/APPLICANT 0 Attached Notes
DON WILSON
1137 W 8TH
PW'CITY, PW'State PW:Zip
000/600-0000
PROJECT INFO
Work is
Plans Required.
Contractor' OWNER
Performance Bond Required'
Proof of Insurance.
Work to Perform:
PROPERTY LOCATION
1137 8TH ST W
Lot: SPH 99-02
Subdivision TPA
Parcel No
Block: 242
D Long Legal
Value Work:
$000
Start Date.
1 1
Finish Date
206/000-0000
1 1
Amount:
$000
Install
D Repair
D Watermain
D Sanitary Sewer
D Storm Drain
D Underground Tele/Elec
D Misc
PROJECT NOTES
CHANGE EXISTING SAN SEWER TO SERVICE LOT A, PRESENTLY EXISTING SIDE
SEWER CROSSES LOT B
FEES ASSESSMENT
1 ) R/W Excav' $40 00 15 ) Other San Sewer' $000
2 ) Sidewalk: $000 16) Sew Tap Wye/Man Tap $000
3 ) Curb/Gutter' $000 17 ) Sew Capl W/M Removal: $000
4) Driveway' $000 18 ) Alter Repair Sewer' $30 00
5 ) Dwy Culvert: $000 19 ) Storm Drain $000
6 ) Street Cut: $200 00 20 ) Catch Basin per ea: $000
7 ) Other R/w' $000 21 ) Sewer System Dev' $000
8 ) Fire Hydrant: $000 22 ) Milwaukee Dr Sew Ass. $000
9 ) Res Water Servo $000 23 ) R/W Use Perm: $000
10 ) Comm Water Servo $000 24 ) Admin Cost (0 R.A) $000
11 ) Other Water Service $000 25 ) 0 RA $000
12 )Water System Dev' $000 26 ) Misc: $000
13 ) San Sewer SFR. $000 TOTAL FEE. $270.00
14 ) San Sewer MFR. $000
add unit: 0 Amount Paid $270 00
Receipt No :5 C;?;:;>---
Inspection Fee $000 Balance Due. $0.00
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CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
" " " " " " " " " " " INSPECTION REPORTd" " "" " " " " " "
REQUEST 7~ )
Date /6"" I q - 9 9 Time Received y .f ~(PhOne, person)
1/37 w q. TA
Location of Work to be inspected v
Name of person requesting inspection Don tAl I I ~. 0 h
Address of person requesting inspection
Type of Inspection (circle appropriate one)
BOUndatiOn Framing Chimney
Phone No
Permit No :} 4____<5
Plumbing Final Sewer Excav Other It} l>. / iff> D
Inspected
Remarks
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RESTORATION REQUIRED
YES
NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel 0 Asphalt 0 PCC
o Other
D Repaired by City
D Repaired by Permittee
[] No Damage Found
Work Order #
o COMPLETE
o INCOMPLETE
(Continue on reverse side if necessary)
STREET SUPERINTENDENT
(DATE)
.
CITY OF PORT ANGELES
DEPARTMENT OF PUBLIC WORKS
. . . . . . INSPECTION REPORT. . . . . .
REQUEST
Date /0//6/97
I
Time / -IS
Received by k,J ,
-~
(phone~.~~
Location of Work to be inspected / /J 7 0, B:b
Name of person requesting inspection r ~
Address of person requesting inspection
Type of Inspection (circle appropriate one)
Sewer Foundation Framing
Phone No
Permit No
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Chimney Plumbing Final, Sewer ~cav Other
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INSPECTION NOTES
Inspected Date /0/ / f/9'9
Remarks
Time / VS
By
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0)1 rp I / //lJtollr'd p~/ 1f{~It~:
RESTORATION REQUIRED. .
./
YES V NO
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SURFACE RESTORATION
SURFACE TYPE 0 Unimproved 0 Gravel ~Phalt 0 PCC
o Other
D Repaired by City
o Repaired by Permittee
o No Damage Found
Work Order #
~PLETE
o INCOMPLETE
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STREET SUPERINTENDENT
(DATE)