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Home My WebLink About1600 Delores Pl - Building \~o() ~ D res 1a~ r ~ I'ORT.q", ",'" 0 ~"< C; -- ~ ~ r-~ 111 'L. ......... ...., -- - ,o~", l/ltLle Wov--+: June 2, 1995 SU5 z.(p 8 As5fq.~Met+, (/ F - CITY OF PORT ANGELES 321 E. FlFTH . P.O. BOX 1150 PHONE (360) 457.0411 PORT ANGELES. WASHINGTON 98362.3206 FAX, (3601 452.0353 Mr. Tony Palzer 403 S. 305th SI. Federal Way Wa. 98003 RE: Bonding/Assignment of Savings for Peach Tree Estates Phje 2. o...~,-,\~..o ~ ~o')) 0[0 (ph 1~ Dear Mr. Palzer: .4.-- F'-- We have reviewed and engineers estimate for improvements associated with the referenced su ivi' rfonnance and payment bond or assignment of savings i~ the amount of $ ill be required for a right of way permit to construct the improvements in the street right of way. A performance and payment bond form is enclosed along with an assignment of savings form for your use.. Very truly yours, /\ L~ '~enworthY P.-E-:--C> City Engineer ~ GWK:gk ene Copies: J. Plttl_, Dtr. Reppa" t:;t. "Z'l..'t...-1cx::>~ Dlf~: O\wp~lrtl< tlph2bnd.gwk ~~~ '7:1.30 J8(;kPiUa,DirKtorlm120) G'ryK.~y. CityEl'Igi~[ell'l12O] R.Ip/'IEltI'M:wth.W.terS~rmtenlWnt[l!rt247] Mlk.R~.W~Supennte!>detltll!xll831 K.nRidoutDeputvDirectar[.rt 1221 l'rTJ'Romig, Bllildil'lOOITicl'llnxl 1211 Tim Smith, Contrectl Mministrlllor felt ~ PhyffisRnlet.AdminismltlwAUl5tantlert.12Ol O.I.W.mer$treetSuperintend.l'Itj.rt 164] Bob ~ Solid w..te SupenrrtenMnt [.xt 228] Pete BUfTt!ll Equip. SNcs. Supenntendenllt"llt 1~ \ j ). .' Ih~ I' :z: , > 0 , -I - n .... -- -I " _-I' V> :r .... 0 <= 0 ....0 ~.' n -1<= 03: J ,." r -I :z: :r-l ,." - .0 :z: <= I. ,. -I , r :r -- -I V> 4 -< " ~. !i'i;;:; 3: -I,." :r ....- V> 0 or n,." c::: V> , 3: v> , ,." :z:n ( -I r ,." ,. '" -I :r ,. :z: -I :r - V> :z: 0 -I - n ,." - r .J ASSIGNMENT OF SAVINGS '..... ."".........~ . I I I I l CITYP~~r:l:RJ:,~~~~LES the purpose of fulfilling the following 1it:t.;t:IVl::lJ JUN I 6 1995 I J " THIS AGREEMENT is for requirements: Securing the cost of constructing certain improvements within the public right-of-way in accordance with ROW Permit No. 2.0€> The undersigned does hereby assign, transfer and set over unto the City of Port Angeles all right, title and interest in and to ONE HUNDRED NINE THOUSAND DOLLARS Dollars ($ 109,000.00) with full power and authority to demand, collect and receive said deposit and to give receipt and acquittance therefor, for the uses and purposes prescribed by said City of Port Angeles. If the owner(s) CATHY PALZER do (esl not perform the improvements with1~ the public right-of-way as set forth in ROW Permit No. ___ Z~~ as required by the City Engineer, then the City may withdraw from the savings account the amount necessary to complete the improvements up to and including the entire amount set forth in this assignment of savings. The City of Port Angeles shall give the owner's designated agent at least 24 hours' notice prior to commencing any work. The notice requirement is for the purpose of affording the owner an opportunity to perform the work; the notice requirement shall not apply in the event of an emergency, as is determined in the sole discretion of the City Engineer. It is understood and agreed that S~AFIRST RANK holds the said savings account in its possession in account number q144~-1?R and agrees to hold ONE HUNDRED NINE THOflSi\ND dollars ($lnq nnn nn ) until a release of this assignment is received from the City of Port Angeles. CITY OF PORT ANGELES By A ,L.,. J~ '- -:!c-j'1J-- Ti tle ~'""1 c: t---b-i "-'~V'-- OWNER(S) ;J;;~1 /~ CATHY ELZER , ..../ BANK: SEAFIRST BANK Sno almie JUNE 12. ] qq'j By, T~t1 Date Account Address 'AJ f/_ '--11/-75 No. 93445-328 P.O. Box 2012 Snoqualmie, WA 98065 Telephone: (206) 888- 2233 A:\AOS , ,.. I CITY OF PORT ANGELES 321 E. FIFTH. P.O. BOX llsn PHONE (360l457.0411 PORT ANGELES. WA$H1NG.roN.~:~.'1 ""7: . . FA~ (~~1;~53 \~.)~~:\" ,d , l-i,';1 [: .' t.,,( p\ I -J~.:~r I. ,,_1 Mr. Tony Palzer 403 S. 305th St. Federal Way Wa. 98003 I rc-I. ~ RE: Assignment of Savings Release for Peach Tree Estates Phase 2. fILE.: L. Dear Mr. Palzer: The public improvements for Phase 2 of Peach Tree Estates have been completed and accepted by the City. Tile attached assignment of savings held by Seafirst Bank in the amount of $109,000.00 for the right of way permit to construct the phase 2 improvements in the street right of way may now be released. 4-+.;:: Gary W. Kenworthy P.E. City Engineer <: ~ \ I Very truly yours, ' GWK:gk one Coplot: J. Plttls. 01,. P\e,nnlng Cathy p,tzor s.anrwt a.nk Dille O'lwplprOJectel973O.twt>""reI.gwI< FIIo: ;2-30.10 Ja<;Io,Pitt!s,Olrectof 0.1)' Kenworthy, CIfIt E"Vi_ Tim &n/Cll. COnlnlm Admlnt.lnI\01 j(~RIOoulDeputy 6ob.,lc)nn, Solfd w..te Suplnnt.nOenl Pm BurT'tft. Eq...lpmenl ~ 0.'- Wlme<', SttHI Sup.tn""f'ldlnl ~"ph Ell.worth. WIfei' SUplnntenll.nl Pflyll" Ru..., Adm.....htMt A,,'III"" .\", ~ I'ORT 4.... ,0 Q~ . ~<~ r~4a l:... r:.(.7~':"..3f ~ .o~~ fJlJ!/c wo~-+;. June 19, 1995 CITY OF PORT ANGELES PORT ANGELES. WASHINGTON 98362-3206 FAX, (3601 452.0353 321 E FIFTH' P.O. BOX 1150 PHONE (360l457.0411 pt:Ullr.WI')l1~l FII.E t.'t.1PY LIOl?II!I...~ -"'- - ~ -1= - - !- .. ~~ ~ ~. - ~ FILE: ---- , Mr. Tony Palzer 403 S. 305th St. Federal Way Wa. 98003 RE: Assignment of Savings for Peach Tree Estates Phase 2. Dear Mr. Palzer: We are in redept of the assignment of savings in the revised Rmount of $ 109,000.00 for a right of way permit to construct the phase 2 improvements in the street right of way. A signed copy is enclosed for your records. Very truly yours, Gk~rt~ City Engineer GWK:gk eno eope.: J. Plttl., Dlr. Cathy Palzer Seanrat Bank ~OCI.\923O'<wprmt$.gwk :_0 q1...-3o, I v Jec1r.P1ttl..DlrKtor[exl12O\ G.ryK.llWI;lfthy,CItyEl'IgirlH\'llllt1291 TIm Smiltl. Conlrll~ AdmlnllUltof (m 22el Ken RidOut, DeputyDilectOl' [ext. 1221 8o)bJorl", SotidW.",Superlnt1lnd.nl[ut, 228] p".Burrett.Equip.StveI.$uperint.ndllnt[1Il'l155\ PhylliIRnllt,AdminiSlrltNeA"lltant\ert 1201 O.\eW.mllr, Streel Supenntendent lert 10~1 Ralph ElllWOM, Wll,r Supennlendenl!el1 2.7) Mike Robel'tl.on, Wnlewllte, Supe"nlendenl'[.rt Hl3) t " i :z: . , 0 , -1 ~ n l ,.., ~~ -i .., _ -i' V> :I: ,.., 0 c: 0 ""0 j. n -i c: 031 J, ,.., ! -i :z: X-i ,.., ~ ~ I .0 :z: c:: ,. -i r- :I: -~ -iV> 4 -< .., f 0'" ..,,. 31 -i ,.., :I: ,..,~ V> 0 or- n,.., c:: V> 31 V> ,.., zn ~ -i r- ,.., ,. '" -i :I: F' ,. :z: -i :I: - V> :z: 0 -i - n , ,.., . Jl r .J ').!..--j...:... 10 RECEIVED JUN I 6 1995 ASSIGNMENT OF SAVINGS CITY OF PORT ANGELES PUBUC WORKS THIS AGREEMENT is for the purpose of fulfilling the following requirements: Securing the cost of constructing certain improvements within the public right-of-way in accordance with ROW Permit No. 2.0 Ib The undersigned does hereby assign, transfer and set over unto the City of Port Angeles all right, title and interest in and to ONE HUNDRED NINE THOUSAND DOLLARS Dollars ($ 109,000.00) with full power and authority to demand, collect and receive said deposit and to give receipt and acquittance therefor, for the uses and purposes prescribed by said City of Port Angeles. If the owner(s) CATHY PALZER do (es) not perform the improvements wit~iq the public right-of-way as set forth in ROW Permit No. ___ ~~ as required by the City Engineer, then the City may withdraw from the savings account the amount necessary to complete the improvements up to and including the entire amount set forth in this assignment of savings. The City of Port Angeles shall give the owner's designated agent at least 24 hours' notice prior to commencing any work. The notice requirement is for the purpose of affording the owner an opportunity to perform the work; the notice requirement shall not apply in the event of an emergency as is determined in the sole discretion of the City Engineer. ' It is understood and agreed that SEAFTRS~ RANK holds the said savings account in its possession in account number Cl144'i-1?R and agrees to hold ONE HUNDRED NTNE ~HonS"ND dollars ($lnCl nnn nn ) until a release of this assignment is received from the City of Port Angeles. By.')j' Title CITY 'OF PORT ANGELES " ~. Jt( '- .:!~)'YJ/ ~""1 ;: t--b-l foo.J '~v-- i 'j BANK:, SEAFIRST BANK sn.~mie Branch , By,' ~.dJ T ~ tl - {;o/t--,.A>t- Date 1---1 Y- 'Is Account No. 93445-328 Address P.O. Box 2012 Snoqualmie, WA 98065 Telephone: (206) 888-2233 A;\AOS JUNE 1 2. 1 99 S ; ~ . "j;. I' ....\.;,. -~ / \ ! \ -.; \ ; ,..ga~:'.~~IJ~~Q~ ANTHONY A_ PALZER , TODD A. PALZER PORT AN ES 9636 Pay 10 the ord r 01 , . I. Jt~-. , .. AHDLC>>.N.lSSOQ..t; P.O. 80. 351 PorlAngollet A -llO56 ~ For_ -11 ~ ':3251.7081., ,f: Q~II~-"""~".. ~O"'Y "0""'.'" Ban. Note. 1001 -i=dfl 1976 - - 98-7084/3251 $g-~~I ~ CITY OF PORT ANGELES 321 E. FIFTH. P.o. Bo.X 1150 PHONE (360) 457-0411 PORT ANGELES, WASHINGTON 98362-3206 FAX, 1360) 452-0353 October 25, 1996 Pacific Ventures Limited 9721 45th Ave, N_E_ Seattle, WA 98115 RE: Utility fees for Eagle's Lair Subdivision Dear Mr. Bergsma Per our conversation I have compiled the utility fees associated with the Eagle's Lair Subdivision. Lts 1-6 along West 16th Street, All water service lines with boxes are to property line. Fees for drop in water meter $125.00 each lot. The water main was installed by private contractor. Sanitary sewer connection $80.00 + $410.00 sanitary system user fee each lot. Lts 7-13 along Butler Street: All water service lines with boxes are to property line. Fees for drop in water meter $442.86 each lot. The service lines were installed by City forces, partial payment previously made toward construction made by owner. Sanitary sewer connection $80.00 + $410.00 sanitary system user fee. Lts 14-26 Delores Place, All water meters are installed and paid. + $410_00_ Sanitary sewer connection $80.00 Lts 27-32 "0" Street: All lots will require new service lines / with meters. Existing lines on property do not have corp stops, so crew will need to go back to the main in "0" Street. Fees for each lot will be $550.00. Sanitary sewer connection $80_00 + $410.00. Because of previous quotes to the developer of this subdivision the sanitary system user fee mentioned above applies to this subdivision only, the fees have since been restructured and increased. Upon application for building public works permits please bring this information with you. If you have any additional questions, feel free to contact me at 417-4807. s~nCerelY," ., ~ i J~~, ~~CO,---, Trenia Funston Engineering Permit Specialist .. CITY OF PORT ANGELES A)~~ VllLle wo~ 321 E. FIFTH' Po. Bo.X 1150 PHo.NE (2061 457-0411 Po.RT ANGELES. WASHINGlDN 98362 FAK (206) 452-0353 August 9, 1994 Mr. Matt Petree 1726 West 7th Port Angeles, WA 98362 RE: Sanitary Sewer Peach Tree Estates Dear Matt, Field inspections and pressure testing for the sanitary sewer main installation at Peach Tree Estates Phase I, has been completed to satisfication of the City Engineering Division, Public Works Department. Proceedures for the installation were to code per City Specifications and Standards. Sincerely, ~ j) / I L---. ~ -Gary Ken rthy City Engineer GK/tf cc: Jack N. Pittis, P.E. Dir. file: 92-3-.10 / f<l:i;"tJ I n CITY OF PORT ANGELES A)~~ OI1l./c wo~ 321 E. FIFTH . Po. BOX 1150 PHONE 12061 457-0411 PORT ANGELES. WASHINGTON 98362 FAX, (2061 452-0353 August 3, 1994 Mr. Matt Petree 1726 West 7th street Port Angeles, WA 98362 RE: Building Permit Issuance, Phase I Peach Tree Estates Dear Matt, We are in receipt of your engineer's signed, stamped estimate. We have also received verification of the current balance in the assignment of savings, adequately covering the amount requir~d to . comp1eten the imprpvemEl~~-.f.or E.each,., Tree Estat.e.~ Phase ,I. C=;:1~ ~~ ""''''t;.~''--' M~-:;'~ ~ <> +Ci-\-"'''''''''.~ e..------p-~M...-.-f ~ 1-f'~QV<- DJ ..,-, "t-;- ;j'U/---f'L<, ""' .,....-~ ~"'-'e> Q"":"o-" z..., CJH. . Upon complet1onVof correct1ve reconstruc~1on .h~ ater serV1ce lines, bacteria and pressure testing and acceptance of the water mains, the City would allow conditional approval of the issuance of building p.,ermits for Phase 1. Per Subdivision regulations "J!9 ~~ Occupancy" of dwelling units will be allowed until all roadway;l'tand......-- / utility improvements have been completed and approved by the City Engineer. Sincer~~ \--~ . , J'-.., . Ridout . ector Public Wo Kenne Depu KDR/tf cc: Jack N. Pittis, P.E. Dir. City Attorney Planning Dept. Craig Miller Cathy Reppar/James Miller Seafirst Bank, Snoqualmie Branch file: 92-3-.10 . CITY OF PORT ANGELES .o~~ llLIC WO~ 321 E. FIFTH. P.O. BOX 1150 P.HONE (2061 457-0411 P.ORT ANGELE5. WASHINGlDN 98362 FAX: (2061 452-0353 July 29, 1994 Matt Petree 1726 W. 7th Street Port Angeles, W A 98362 RE: "0" Street Local Improvement [)istrict (LID) Dear Matt: In response to your request for information, we have the following probable schedule for the "0" Street LID. The City is in receipt of a valid petition for the improvement of "0" and 14th Streets by the LID method. The City Council has authorized the Public Works Department to proceed with plans, specifications and estimates (PS&E). We anticipate completion of the PS&E in the FalVWinter of 1994 with construction to be started in the Spring/Summer of 1995. If you need additional information, please contact me at 457-0411, Ext. 122. - , Very truly yours, \ Kenn h D. Ridout Dep ty Director cc: J. Pittis, Director KDR:pr Disk: [94-S] Petree.KDR File: 92-03 /l1ff-rT12-~ 7): \ ~p'^1:f\~lTqG;-::SC) 7/27/94 Memo to file: PEACHTREE ESTATES Met with Matt and Ken Ridout regarding the correction of the installation of water services on Peachtree Estates at " Delores Place". I asked if there has been any restrictions placed on his as to entry on to the project site due to the pending court date of August 12, 1994. He indicated that he not been restricted entry. Matt has requested a letter from the city regarding the issuance of building permits, reflecting building permits may be issued but occupancy of the structures will not be permitted until final subdivision plat approval. I indicated to Matt that prior to corrective reconstruction of the water service lines, he should contact me and I will arrange to have Ralph or Frank meet with him on site to assure materials used are to city standards. I have also made contact with Ralph to let him know that Matt will be working on the project shortly. I have reviewed file 92-30.10 which contains a letter from Gary Kenworthy to Matt, dated July 19, 1994 indicating the need for verification of the assignment of savings at Seafirst in the amount of $84,500 or greater. I showed Ken Ridout the letter and said I would call Matt and remind him of this requirement so we could proceed with his request for a letter on the issuance of building permits. If &>81- Uti) CherUlZ"-' PtU<.e NttVY-<<-"--' I t~ F~~q !/Jppr s ~r e:s-r/;11t'L7""8i'. if 71t::~~lfj S/f'/uP tL Cdr> '1 CITY OF PORT ANGELlES .o~"" . (Jl1l.lc WO~~ 321 EAST FIFTH sT, Po. BOX 1150 PORT ANGELES. WASHINGTON ')8362 PHONE (2061 457.0411 September 9,1993 PeachTree Estates Matt Petree 1726 W 7th Port Angeles, WA 98362 RE: Peachtree Estates Water service lines Dear Matt This is a follow up to our conversation regarding the previously installed water meters in the PeachTree Subdivision. Unfortunately, the service lines installed are not acceptable. The existing service lines are not City standard's copper tube size as called out on the approved plans. Each service line will need to be replaced back to the corp stop. Therefore as the developer/contractor, it is your responsibility for all labor, equipment, and materials supplied for this project. It is also the responsibility of the developer to correct any deficiences. If you or your contractor choose to have the City's water division replace the service installations on "Delores Place" and on "0" Street, they will be charged as one work order and billed to you separately. The Meters will be installed after all applicable fees have been paid and the final subdivision is approved. No additional water or sanitary sewer (SYSTEM USER FEES) will be charged for this subdivision, if it is completed within the time constraints and in accordance with the subdivision requirements. Issuance of building permits for new construction of single family residences within this subdivision will not occur until final subdivision plat approval. If you. have any questions regarding this, and want to schedule with the water division to complete this project, please feel free to contact me at 457-0411, ext 124. Sincerely, ~i:'Fu~ston Permit Technician ~ Gary Kenworthy City Engineer -- . ~ ,ORT ...~ . . "O~Q~ .~ (.A i) 'ijI ,.~~ , IM'.. " CITY OF PORT ANGELES ,o~C!I . 1I111./C 'NO~~ 321 EAST FIFTH ST, p.o. BOX 1150 PORT ANGELES, WASHINGTON 98362 PHONE (2061457,0411 June 7, 1993 Mr. Matt Petree 1726 W.1th st. Port Anqeles Wa. '98362 , Re: Peach Tree Estates, Assignment of Savings Revision Dear .Mr.Petree; , 9Z-'}:J, a We have reviewed the work completed as of June 4, 1993 covered by the assignment of savings dated January 28, 1993 for improvements required to develop lots 14 through 26 of Peach Tree Estates(Phase 1). The assignment of savings can be reduced by the following completed work: Water Mains (95% Complete) Water Laterals (Less setters & meter boxes) Sanitary Sewer site Grading/swales (50% $11,802.80 $ 2,133.00 $60,885.00 complete) $ 1.164.00 Subtotal $75,984.80 Contingencies $ 7.515.20 " Total $83,500..00 i.rhi'l' will result in a remaining balance in the assignment o.f savings for Phase I in the amount of $84,500.00... The time for completion will remain unchanged~ Please call if you have questions or need additional information. Sincerely, Jack N. Pitt1s,P.E. Oirectorof,Public Works Gary W. Kenworthy,P.E. City Engineer GWK/gwk , cc: Cathy Palzer Planning file: petreeb4.gwk {' . , .,,- . ! RECEIVED ---, LAKESIDE INDUSTRI~~~!~~[X /4/9.?3 1 / ,~',i,,;, :;1<;'>,~ I l ; I ,\}",-~,_\,,,,,,~,,,',.,,fA',,_. '. . _ ~.. M. 1@1'i~~~;::",,,,,, CITY OF'POm-.--J "li'" ''1;. b'''! -'. . j~Nc:,cl"S {::".. ;".. ...... ; ~..__ ~FU8L""" V'On ....... 1.: , . .~~f~f';~. ~ ~ ~."' ~,t " - ,; ~ 'i; <~~~f~<,;(' i~..._--1 ~.t}.,.,..r-'e6~';':":""" :.~ ,,~-"~'"'Yk'VI., t': ~tl. ~,;:~~;:::'f;,~1:~'~'~;:~,/~'", ~<;'"\.~~~<~J~~~' ,~~ 'J r;~~h ~~- . ''", 'l~,,-..f!"~"'i( l~~~'- .......... . . :~~:~,.,~~:9' \;/~~~~;.::;~ ,"- ~ii~ ~:.l.._.> ~~r"')i~~ I ..\:' ":':'1:-'flwrIr~_i.tioC.,iEa.Y ...~ "i. ~ .JIia(~ ~~.::..b ...'1,{, -.....;':' ~"icerrff;;t...;x!l)'.} ~ foMi' " ... j ic<. ~f.:'iNlrfrh~i't.f:>' X'i':':~ :fa.i~ t,''"lh. ~,,: ) '~ n:~) : subject: Peach Tree Estates street I ~ Dear Mr. Kenworthy: ~ i t~ Please be advised that seal coating of D~~Bres Place ari~~"the cul-de-sac within the Peach Tree Estates subdivision was,,, completed as of June 23, 1995. This surface treatment o~n~ the paved roadway will provide additional resistance to surface water penetration which was a concern due to the stress cracks in the pavement surface which were the result of soft sub grade conditions which existed at the time of paving. In addition to the seal coat, Lakeside Industries will extend the standard one year warranty for this roadway paving to one year from the date which the seal coat was completed, June 23, 1995. If any defects in the roadway occur during this warranty period, due to paving materials or workmanship, please contact me, and we will make any repairs necessary. If you have any concerns or questions, please let me know. Cordially, ~RJih- Project Manager PHONE: PORT ANGELES (206) 4.52.7803 PORT TOWNSEND (206) 38S.4.914. AN EQUAL OPPORTUNITY EMPLOYER WA ST. CONT. REG. NO. 223-01 LA.KE.SI.* 274.JD s. ~ /' .p,q..../ :.:e-ev- PUBLIC WORKS CONSTRUCTION and RIGHT-OF-WAY PERMITS City Phone: 206-457-0411, ext. 124 . ADDRESS OF JOB: ~eO-.-c. h {...-u:> . E.~IR---\€.~ PHONE LEGAL OF JOB: . D I V.::r:: LOTS 1-\3- . , PERMIT 00258 ......UC.~/OWNER: APPUCANT ADDRESS: WORK IS 0 OUTSIDE or 0 INSIDE OF TRAVELED ROAD VALUE OF WORK IS:$ (If work is outside roadway and is equal to or less than $2,000, then permit may be issued to other than licensed and bonded conlraclor.) PLANS REQUIRED 0 YES 0 NO CONTRACTOR: DATES FOR START & FINISH PERFORMANCE BOND REQUIRED 0 YES 0 NO AMOUNT: $ PROOF OF INSURANCE: 0 Worle $2,000 or leSs: $50,000 personal injury, $100,000 per incident, $20,000 propeny o Worle over $2,000: $200,000 personal injury, $500,000 per incident, $100,000 property o RighI of Way Use: $300,000 personal injury, $300,000 per incidenl, $100,000 property Penniueo undentmda that no street may be closed 10 traffic unless approved by the City Engineer and Chief of Police in advance of the closure; that there is a 24 hour minimum notice prior to inspection, and to call 48 hours before digging 10: 1-8oo424-55S5. ill . fII_.,.....fIIlWI.......ll..bIIIIr...."'d.~_..CIc)'oI....~_.,..ItI,~OI....."...eb&Ut.......~.tbI~'-.,.lIUiIb'_....ibi.lity 1W~~...CIl'.....IO..-or~, ~Of-..nac.u.~ IWIIbd&ft)' __\nima_.....,tisl&~dthil.~gtimoUlllli'c Pl'mJll orpetml~...tDdl~ '- ~ ialaClOfW u-...........uol.....LIIllUiti._.....,___"'_~. Sipd: --r: g, I~ /TF- DATE:~ ~3) -:c '" "n'D : """ FEE ...n'D PAID ITn FEE 'AID I , IUOKT OF' WA.Y ElCCAV. ....'" ~~ER'Sflll(O"\(lPIl.-6.... ...'" I -"'. SAN. SEWD .....n'. III ri ....00 <&<JUTTI:I( Sl2J.tXI SAN SEWER /'UFlll. .....00. UNIT "'" DtUVEWA Y Slum SAN SEWER 0THEJlS . loIiD-17j.tXt SO.lXl5I,1 104..._17" laUIDI!i1O.lXl'25 a_ D9t'Y CULyaT ~" ......, SEWD.. TAP. BY CTTY 1'10 S I25JD'SlOO.CO 0- WYElMANHOLETAP m.EEI' CtJT . IlMcnaiaa. SllXl'" SEWER CMfWATER METEll. $223.00 REMOVAL amD.lJGKt' OP WA'( WOax. ......, ALTD.ATIONI ""'" REPAIR TO SEWER mJ! HYDOAI<T DEPOSIT ,-,I) STORM DRAIN TAP sm.oo RD. WATER SDVlCE 1& X "'. "".00 (ii\ 2Ii.ti. ..~ -'2Lit./.\-DJJ., CATCH BA.SlNS IN tOTS PER EACH 1<000 I '-'" Ii RD. WAT'D SDV!CE I. X 1/4& "".00 SECONDARY SEWEll ASSESS. SAIO.OO in 1613.00 o.aAoOI: RES. WAT'D. S"""V1CE ,& Y I" "".00 SEWEll SYS. DEV. CHARGE 1124.00 fEWM I COMW. WAT'D. SD.VJCE '" . '.,000 MILWAUKEE DR. SEWER ASSESS. SlXUXI iEWM ~"':-l~~ WATER SB.V1CE. 0T1ID. EmMA"" JUOKT OF WAY USE PERMITS VARIES S,. Sloo WATER tvS. DEV. CHAKGE S7~.OO IEWM TaT ALS I I~VU\ Ot-I llliI..ut..u.au.......-.t....... ~1bI..._lOdolbl_.~_IDLIlll forlbl ~~ ID u.~ Ead:lpemul io a...-.- 1Olh:..,...... oili'c .1_QOIUInlCI mUll: _1..1"''''''' ~o~MENTs7C0';D~TI'0'N;-...~~~-:;-.~~-:7:;d:.s-;:;:;j ~~oP";;::; ~""l~b~X '~:.~;- CJ Inst&lI 0 Repair "( ,I ) [ _ n ~ CJ Wa/ermain 11\& TA-l A:~ \J" I e f-.CA<.JA- T' 01., - b/'I'1::.x="-, II <4-c) o.pel) o Sanilary S- #'Q... c'<?Y"P s<-lv,? @ eke..,... """G--~ '" c:L\'\<L gt=Te1 honelElectrical CLc..+\v(A..{~ ~~ Se..y\)Ic...e.., \\h~. '- lJ .otOOTTOTALS $ep -:? {jQ').!d2- RECEIPT # '1.3-f ISSUED BY: 11loAfff~TE:?illtJ- INSPECI10N FEES $ PW.0209.03 (12m] INSPI!CI'OR'S cOPY - WHITE APPUCANI"S COPY - PINK WORK ORDER No, OFFICE COPY .. CANARY PERMIT 0 0 258 ~ 0<<: ~ORT 4,vG' ...4. ~~.~ iJ~~' t> ..~~~~ ;rt '~~~1 ~_~,)lil' - ..0... -~ ~ ,0(/ ~'" 1Jt./c wo<<- January 31, 1995 .'--; 1~( -~.- ...,...... CH) IS / ::) ?~ ~ \ ;- ...-, "(\0. CITY OF PORT ANGELES 321 E. FIFTH. PO BOX 1150 PHONE (206) 457.0411 PORT ANGELES. WASHINGTON 98362 FAX, (206) 452.0353 Mr. Tony Palzer 403 S. 305th st. Federal Way Wa.98003 Re: Completion of Improvements Peach Tree Estates (Phase I) and Receipt of Required Maintenance Bond Dear Mr. Palzer: We are in receipt of the new assignment of savings agreement signed in the amount of $35,000.00 and, by copy of this letter to Seafirst Bank, authorize release of the original assignment of savings signed January 28, 1993. copies of the new and to be released agreements are enclosed to avoid confusion since both are held in savings account 93445-328. The storm, water, and. sewer improvements required for phase 1 of Peach Tree Estates have been completed and have been accepted by the city. The roadway improvements, due to the condition of the saturated subgrade when paved and the observed finish surface failures, were conditionally accepted with the provided one year maintenance bond in the amount of $35,000.00 to cover all necessary roadway repairs as well as current and future erosion control and drainage repairs. As discussed, Delores Place will remain closed for the time being to avoid further damage. Once it appears that weather and subsurface conditions will allow traffic without pavement damage and the road surface is not hazardous we will open the road. I checked with the water department regarding the 13 meter setters that were not installed for phase 1. The city proposed to install these at an estimated cost of $265.00 each when service is requested. This price includes the setter, meter box, meter installation, and excavation and backfill necessary to open the corporation stop at the main and activate the service line. This estimated cost was developed for phase 1 water services only. New estimates will be required for any phase 2 water service work you wish performed by the city. The only other phase 1 work remaining beyond the pavement repairs and erosion maintenance is final grading/cleanup of the drainage detention swales at the back of the lots. The plans prepared by Clark and Associates include all improvements required for Peach Tree Estates. Additional plans the will / / / / , . --not be required for phase 2. Following completion of Phase 2 the City will require Mylar "as-built" improvement plans for Peach Tree Estates to be provided by Clark and Associates for our records prior to final acceptance. I hope this covers all items requested at our January 30, 1995 meeting. Please call if you need additional information. sin erely, ~- , L Kenw rt y, P. . ineer GWK/gk cc: Jack N. Pittis, P.E." Dir. City Attorney Planning Cathy Reppar James Miller Seafirst Bank, Snoqualmie Branch disc: pvngbnd5.gwk file: 92-30.10 .< / ,. ~ ~ ~ORT "I.... 4. 0 . Q~ ......~.<..... ~ _r -~ '~ "~4 L- .- '~ ~=-l'-' IA;. F'--I I ~ - CITY OF PORT ANGELES ..o~c., Vl1Lle WO~~ June 2, 1995 Mr. Tony Palzer 403 S. 305th St. Federal Way Wa. 98003 321 E. FIFTH' P.o. BOX 1150 PHONE (360) 457.0411 PORT ANGELES. WASHINGmN 98362.3206 FAX: (360) 452.0353 RE: Bonding/Assignment of Savings for Peach Tree Estates Ph)e 2. _ 0- -€'''-''l ~.I' -l..:::, ~o ':)) O~ Dear Mr. Palzer: . CP !Jt~ We have reviewed and engineers estimate for improvements associated with the referenced su rformance and payment bond or assignment of savings in the amount of $ ) ill be required for a right of way permit to construct the improvements in the street right of way. A performance and payment bond form is enclosed along with an assignment of savings form for your use.. Very truly yours, b. L 1/ -- . ~ Gary W. enworthy P.E. - City Engineer GWK:gk ene Copies: J. Pittis. Oir. Reppar ~ 'Z-L'C--"=" Disk: OIwp\pelree,!>h2bnd.gwk File: 94-20.10 JaekPrttis, Otrec:torleJCt 120J Gary Kenworthy, City Engineer lext 129] Ralph E1'-orth, W" Supenntendent 1eJlt. 247] Mike Robeftaon, W........... Supenntendenl: {eXl 1631 ~ Ken Ridout. Deputy DIrector fert 122] Larry Romig, Builcling Official text. 121) Tim Smith, CorltnIdlI ,AdminIStrator fen 226J PtlyIhs Rillsl." Adminlllit1ati-.. AurstantleJlt. 120} Dale Warner Street Superintendent 'exl. 164J Bob Jones, Solid Waste Superintendent len 228J Pete Surrett, Equip, 5M:s. Supenntendent le>.t 155] CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date "1 ~ t7 -'is- Time 1: 3 0 A-w1 Received by r::telWL W. (phone, person) Location of Work to be inspected .;$. t.v. CCI/e/..)/:;VI... 0+ / to -(Jt- I;' 13<.<-fLc:/I... Name of person requesting inspection p. Bl=v~",,-4.e1\ ! II,.. . "n"r ) /- Address of person requesting inspection "1:,>>>--...; to ..c':.ot:),l.hH<.fJ Phone No. ~) Type of Inspection (circle appropriate one): Permit No, 0/33 Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other lJw. ZSt 1 INSPECTION NOTES: Inspected: Date 1-1 \'""r 4.:) Remarks: f3 'I- tJ, \J." + -n.,..p Time 6 \ ~o in'vt By ~. B"'''U.........~~ ..... . "Bl,d'~ l-~~r ~ / I., lit ~f- "!'-3/ _L --------- .. - - - ~ RESTORATION REQUIRED YES NO vi SURFACE RESTORATION: SURFACE TYPE: ~ Unimproved 0 Gravel 0 Asphalt o Repaired by City o Repaired by Permittee o No Damage Found OPCC o Other 3e"?;, Work Order # 0' COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) . CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date 7) -{<j- q s- ..... .,. Time Received by (phone. person) Location of Work to be inspected D-e )0 Jr -<- 5 r / c2 c ~ Name of person requesting inspection 7 W / I CO x: Address of person requesting inspection ) t+lt ~!3 Phone No. Type of Inspection (circle appropriate one): Permit No. Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other uJ t:!l.~f-e1, INSPECTION NOTES: Inspected: Date r;- -)"? - q 5" Time Remarks: ::;: AJ S it'( If J J 1> VJJt <--.f.----c/}__ . ~- () W - 2f/O( By T W ; / Cd )< WA..+er .s~r U/~'5 SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved DGravel rAsPhalt 0 PCC 0 Other Work Order # 3 ~ ./ ~COMPLETE).0 5" J(- r5 !ZJ-INeOMPLETE fjeJ_ ck /d~ /1bOV: ~y g'~ . 11+ .en) () C- u / d'€ ' ck r"""h r;; ee-+ sll'./;;.115 _ _ __(Continue~n reverse side if necessaryl STREET SUPERINTENDENT (DATEl RESTORATION REQUIRED E. . .. YES NO -s:.. "" c.\. \" '" ~ -- {) '" -.- - - ~ ~ ....,. ~<i' "0 "cP _ ~ <E- <f'c:\ ~ '<p -< ~,p~~ ~ :> '9 I cI 5,)- -I. Q r~d \ \. ?J-. <;.- D_ <...... J1. c\ c'- .......</ <'",.- o Repaired by City o Repaired by Permittee o No Damage Found ~ "* :f cr - APPLICATION FOR WATER City Water Department Port Angeles, Wash. 'zit , 191:;: I hereby apply for water to be furnished in accordonc.e with rates and rules of the City for the following premises: . . ...--1 ,Nome of Applicant /, ?,4--/ t!-er /72--'-1 De/oR~ j?~ct'!- __~-- 'Renewal 0 New Servic,e ~. Blk~ LOL4- A, dd~dr.A #",~F...s,T' ~ :::/..:' P II' 0-' Size of Service 7fJ J / ' Meter Number --3. q 11 cUi S- Service Left On 0 Service Left Off rJl Signed..:j'r; '-f-' I r. ' f~?~M~ " Address Installed by Remorks: 'Perh1IT-,!;I z.58 ---;<e.c.-:it- 0 ~~ ,4(0 oq 4V(2-0 " \, l' - rN........ , ~ ~. , " " 11 ~i>" .!~ ~ w vJ \ 81''''- E ----~ . s --- --~..------ APPLICATlOH FOR WATER City Water Department Port Angeles, Wash. 7-1? ,ilS- I hereby apply for water to be furnished in accordance with rates and rules of the City for the following premises:' . Nom'e of Applicant ---r-:? rr-!-ee...v Address /I'f-l1 -Pt5UJ~PLJ4CE ;. Renewal 0 New Se;~ic~,BI~t... Lot n-Add~",,~/,.-~ ~Z5, , I( ::>--z.. "I'l . -<- Size of Service--f'zY-1 Meter Number 3~ ! ,?>q 1.!:f.--5- Service Left On 0 Service Left ~gned.I?-".J,~. D CtlOJ<.t2-_ Installed by ?ern1/-r -# 258 I€~ t5~:if4? tZCo'5DO Remarks: 11(0 OQ4Q I 0 . ., - _._- --\,. N .,", -,"', I 4~~ iW ) 7th E ------ . s , , APPLICATION FOR WATER City Water Department z::--. / cI Port Angeles, Wash. i 0 , lfl~- I.hereby ,apply for water to be furnished in accordance with rates and rules of the City for the following premises: ," , NomeofApplicont~- ~ ?#~ /~/'? 7>CZ-Ol?c-S 'pLfICE Rene~ol 0 New Servi.....B-BIk-7: Lot&12.- Add?iM~!ree.,4Z5- ''s-z. " 6 u . <) ~ ~ \ Size of Service------'1.? i '/. Meter Number ~J3 Service L~ft On 0 Service Left O~Signed_T~J~Ql212 Address Instolled by Remorks:ffrffll'f"# Z~ " / ::::>e- e-=IV O'7~ IZfdJ -0 () '. rr -; qlG~ ; ~ . .' \ ~ w ~/ )~}1 E ~-- '. '" APPLICATION FOR WATER City Water Department Port Angeles, Wash. 2--)L-~, lcfi~ I hereby apply for water to be furni shed in accordance with rates and rules of the City for the following premises: ," -- Nome 6f Applicant I,? ~?!:e/ Address /~/S- ~~ '~flc:e- Renewal D. NewService8B~'~' Lot~ Addb<<d~ea13 II II 'I . . ~z:f9L Size of Service S ../ Meter Number J q I '3LLi.- Service Left On Service Left ~Signed~r Il.~ 01900 /!7f) Insto! led by - .Remarks: s'--~-oo ~/v oct4Q00 -;-erl-H/~ ~ ~ O'7~' rr \ <- -' A.. '" '" ~ ~ w \ J~{'I\ E ---------- s ". <Of -~ ---- - APPLICATION FOR WATER City Water Department PorI Angeles, Wash. .~IR ,1r/1J I "hereby apply for water to be furnjshed in accordance with rates anq rules of the City for the following premises: .',. ~ Name of Appl i cant _--1--" ~ker. /1 OLI', Pe~'Res ?/ace.-- -- Renewal 0 New ServiceG-BIi<--/- Lot /,ff Addii4rJIr~e E ~ . ,,;:;/_11 f ''ill . / II :<... . Size of Service~~ MeIer Number 3 r J 3-'l!---2-! Service Left On 0 Service Left Offg-Signed t ~l,1u_QQJ;>~-"':o> . ( or . Address Ins,lalled by Remarks~Y'fJ1/~ z:--.5i8 ~e -C-=If O~ 1~6{; . . . q / & otl4Q/7.-;- " "\"\ N ~ ",'" ,'1\ '" .. ~. "r!) 'Y 1 "\ \ l~ r- E w ------- . 5 ~;.. , , , , \ ; {. iW i\ I ~~ '. APPLICATION FOR WATER City Water Department' .~ ~ Port Angeles, Wosh.~~ ,1~5:- I ' I hereby apply for w,ater to be furni shed in accordance . for. the ,[ollowing premises: ___ 9..L_ . ~ 1A-7e-er' Name of Applicant " with rates and rules of the City " ., i'7()'S' l/CL-O~~ ?~ ,;,..., [J "5r~. Bd- Lotz;2 Ad~dk.BT5 . . . 2> V / . 91'8 Q, . S,ze of Service' 1'. Meter Number. ,.LiillL5!2 Service Left On 0 Service Left'~Signed p, 0 ~J I~ (> 00060 r2&~-OO Address Insfalled by ~YJ1,fI--!L Z~ Remarks: / ~ / ~ ~ .~~~ 1; ~Ic" OQ410 I' \ N ~ -\. 1.- I" /g-+k\ E 5 \ ".! ----..- ---- -~- APPLICATION FOR WATER . City Water Department -" ~ Port Angeles, Wosh,~--, lW:::- I her'eby apply for water to be furni~hed in accordance with rat~s and rules of the City for the following premises: , ,~~/.- Nome 01 Applicont I" , /I-'T~ 'Addres~ /~ '7-" ~re5 Pkc-e.-- , Renewol 0 New Servi~ B~ LOLB Add ft4di~elZI lId "Y'tr/./I 'lq\"'1iO TlIf,G Size 01 Service /0 ' /I I Meter Number "} .)"~lJ \ Service Left On 0 Service Left 01M:::r Signed 1f- P,.Q~ulL-~-- Instolled by IVo?-2- Remarks: jDer~;?-$ ~ {/7~ .4/& OQ4'1/1 ~._- ._~~~--- -f':;~ " \ w W\~ E --------- s '. <'r. ~ APPLICATION FOR WATER City Water Department -"7 / Port Angeles, Wash._~-g--, 19_~S I t . I ne~eby apply for water to be furnished in accordance wj'th rates and rules of the City for' the following premises: N.ame of Appl i cant -r:?A-f~v 1'7 ( k 7/e./O Ji?e5' ?~'-E- . 'A~'dress 'Ren~w~1 0 New S.erviceB-. Blk~Lot~ Add""L1:.M)..-I-rIf:..e..-f:q; I'd.. " " "7tl?V. , Size of Service~J?' f .I /I. . Meter Numbe, ~ ~ ~r ;)..6~_ Service Lell On 0 Service LeltOH. BSigned-={"F ~ocroo Installed by' Remarks: --re.- r Yk-I ri' -;:ze-c--:::# 2-~ Cn~ ;f~ 41& ot14Vi I Y '. , , ~', I . , \il " W , ;, \ -r.~ \.. /2-f1 E i L_.___. ~/- s. . . ee APPLICATION FOR WATER City Water Department _ //'.1 P,ort Angeles, Wosh,~#_____, 19ctj_ I hereby apply for water to be furnished in accordance with rates and rules of the City for the following premises: ....-r' 'If} /, _rl};-I~r / 7-LO ;z>elb A:e;; f? ~L e.- 'Renewal 0 New Service ~~LotP Ad~~ee.. &z:; IS'1.u ./'II/,t, 13 qi, Size of Service It'" /1' , Meter Number~3i1-J33.L[).-2 --- Service Left On 0 Service Left Ol~ Signed~!{..R" J "'''~A--e-e Na,nie'.ol Appl i cant '> Address Installed by Rern.arks: --;z:::erl'1-'1 n ./.I- Z-~ ~ -r> ~ r_-#- O?~ ~ 2-6J-.22 , , '; (i\v 0041'/tt '\ r N ~-. \ "" 2 ") w. ~ \~-r- E ..------ " s -----.--- ~-------- ---- APPLICATION FOR WATER City Water Department Port Angeles, Wash. :?//~ _, 19qr .I.hereby apply for water to be furnished ;n accordance with rates and rules of the City for the following premises: Renewal o -J: ?~/:u;y /1(/ ~7<'E5 .p~,- Ne::Jervi~~ Lo~ ,iifrA/r{'e 8/3 11 t./ , MeterNumber_~~l33L2L o Service Left~gned-,-~~ If? ~~ZI_ Nome of Appl i cant Address '> '. " Size of Service Service Left On Installed by -;PerYn'T* 268 pc _c.:;::# '?~ tz&s>--O 0 Remarks: '({Iv 00q.t!IS ,. . " ~\N k~ ~~ , rt:~1;, w I <]}1 E -------' 5 .'-"~-'- ". -----.-- . ._-- ---~ APPLICATION FOR WATER I City Water Deportment Port A~geles, Wash. ~'___'l{jl . '. .I,her.eby apply for water to be furnished in accordance with roleS and rules of the (it'.' . far't.oe.fallawing premises: / . . Name of Applicant. L PMce:.j/ " . Address / 12-Z-- =:l2e,.0 X es.P lac f' - ~enewal 0 New se:viceG}-Bik.::z:::..- Lot~ Add~a...cf.:.I:.~r'!:..,F~p .' ~"'. t . . D ;L .;;> .-L- Size of ser~ice~~1 Meter Number_:LU :Y!I C( 7 . Service Left On 0 Service Left Off ~gned_~ )"1 () C> r'1 !'rj) \5 ::!--z-h S" ~ . tdu d14ftl \ Installed by Remarks: ~~""",~z6g _ .-I/~ ~ Cf7?4 ~----~- " ~ ~."'. I, w )~+1 E \ , : ------ ----. s '. APPLICATION FOR WATER . City Water Department ~ / Port Angeles, Wash,~Z----1 lff~_ . I hereby apply for water to be furni shed in accordance for the following premises: /( with rateS and rules of the City Name ~I Appl i cant ?;?Ieer /1/1 l?&Z-O.e€S 7'~~ ~enewal 0 New serviceG-::. B1k::z:::-- Lot-ZS-Ad~&.4-r-f7e-Pt5 ,,'Si~~ 01 Service----$- 'I. / Meter Number_'3-c;;$m~?---- Service Left ~n 0 Service Left ~ Signed_tR.~ 6 Cl 0 DC:> . . . -Address ~ Installed by Remarks: 7-e;.. rWlI T -i:I ~~ .~ ~:y(,p :fzif~ "~\v 0014/11\ " --~_._---_.- _._----~ -- ~------_._.- ------._----_._--~ ----_..__.--~---_._-- \ N . ~-- ';L ,.i '" -t 4'"' ~"tb . p ,...... :-lL E w l~~' ---------~- s ." ~-_._-_._.-- ... APPLICATION FOR WA TER City Water Depa'rtment Port Angeles, Wash. ~~__, 1~ I hereby apply for water to be furnished in accordance with rates and rules of the City . for. the following premises'; ~_F#~r- Address 1'723 DE7-DiCp PL_~ . Renewal 0 . New Servic2- B;~ L~ Addffid/~e fu ,'.' . . (1 r' / -3~' !.': '7/ "i:i . . . 'Size..af Serv; ce -fj-!-I---- Meter Number 7 (J ;?,C ___n.__ Service Left On 0 Servic'e Left o+rB- 'Signed . Name of Appl i cant -. "t' Installed by n, ter- "''-'--''''''''1 .~~...." V rer~/T-:Ji ZC8 2h:J~ /::>p,....~ 7~ / . Remarks: , " 0'lL- 0t14A ri 'r -~---_. \,."-- - --------- ~ N v" 'r' .,-.. .r.. '0 , , \ / 2}~ \ W E \ /~ ~-:~/ s. . CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . . . INSPECTION REPORT. . . . . . . . . . . REQUEST: Date Time Received by (phone, person) Location of Work to be inspected Name of person requesting inspection Address of person requesting inspection Type of Inspection (circle appropriate one): ?Cae-A/'re-e. b5~'\ Phone No. Permit No. Sewer Foundation Framing Chimney Plumbing Final Sewer Excav. Other INSPECTION NOTES: Inspected: Date ::J--15-<1-1 Remarks: Time FfJ1 . By ~. RESTORATION REQUIRED . . . . .. YES NO ~- L I f/O "/ S L f-:1- 5:z.~- tl ~ ""\ 1'" P j. !.... ;u~ €- - , aD'"'' I -'47 -,,"",4t. tI1_....... , h - .01 [ t ,- ~ l .. - . -..! , ' 0 :z -" ~ ( , I ~ 1" - 00 - '- ' \1 0\ ~< , e E \~ , XI- , ~ J SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved 0 Gravel 0 Asphalt 0 PCC o Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE (Continue on reverse side if necessary) STREET SUPERINTENDENT (DATE) N~ 04472 ,'1. APPLICATION FOR PERMIT OWNER /J1 (j If toe fr'€- e.... LOT;>b. :eez,'I; BLOCK SL 100 (Print Name) S "0" JOB ADDRESS /7 GO 0 .s T SUBDIVISION "Te"c.J, ~"'- EST".+'''-S J hereby makes application for the following 1. Work to be completed by 2. Location of work: Outside Value of work to be performed 3. Contractor name 4. Performance Bond Amount 5. Proof of insurance Work $2,000, and less: $50,000 personal injury, $100.000 per incident, $20,000 property Work $2,000 and more: $200,000 personal injury, $500,000 per incident, $100.000 property 6. Permittee understands that no street may be closed to traffic unless approved by the City Engineer and Chief of Police and notifications given to the Chief of Fire Department. may be closed to traffic from to Inside (date) traveled roadway (if within traveled roadway, complete items 3, 4 & 5) (If over $2,000, complete item 6) OR ~ N o (street) ~ c) ': City Engineer Chief of Police Fire Chief COMMENTS/CONDITIONS PERMIT WATER MAIN SANITARY SEWER STORM DRAIN TELECABLE TELEPHONE UG UTILITY POLE AIW Sidewalk Curb/Gutter Driveway . Dwy/Culvert .... Sanita? Se~:~idential .. . .... ....................................( so.oo.) 2. Commercial 3. Alter, Repair. 4. Tap.... 5. Cap.. (includes W/M removal) 6. Secondary Sewer Treatment Assessment........ Storm Drain 1. Tap 2. C.B. .... Water Meter 1. 5'8w..... 2. 314M ........... 3. Commercial deposit (Based on estimate 1M=$1.000.00 deposit) ..... 4. Hol tap ........................ ....................250.00 5. Fire Hydrant install (deposit) .... ....... ..................... $40.00 .....60.00 .................... .60.00 ...................60.00 .......................................................40.00 xO ...... ..................... .........30.00 .....125.00 ... .....................225.00 410 ~ ....................... ...125.00 ............ ............... ................40.00 In conaidermion of the gnlnting of thla permit, it ia further agreed by the appllamt that the City of Port Angelea and any of tt. officers or employees ahall be..ved harmleu to the applicant from any liability or roaponslbility for any accident, 10M or damage to persona or property, happening or occurring aa the proximate result of any work undertaken undor the terms thla application and the petmh or permits which may be granted in /'Hponae the , and that all of lei Ilabilltlea are hereby aaaumed by tho applicanl c:!,:of'/i) .............~ ..........:.. 500.00 /25 Signed Telephone No. Mailing Address RESTORA nON DEPOSIT Permanent ...................................................................... 325.00 Gravel ...........................160.00 Non-traveled ...................160.00 Curb removal ........................ .......................... 160.00 Thi..certifi_ lhllh. ~ nam..:l applicant i. grant..! th. permitl. to do lhe...oo. dnabed in and for IhI. P\'poH Iohown in lh. -wlication. E.ch perm~ i. grane.d 5Ubj.ct to lh. term. 01 tie .greMnent contained in III. Mid eppIicetion end eWiect 10 III. pavilion. 0111I. code 0111I. City of Port An~_. and nothing permittedhereuno. lIheIl be deemed 10 overricle III. povi,.;ons 01 lilY eppIieeblI.s.w 01 th. City. Slate 0/1 FederalGo\lerJm&'ll Permit total ............... Restoration total TOTAL .. Receipt No. D' 24 HOUR MINIMUM NOTICE REQUIRED PRIOR TO SERVICE OR INSPECTION Call 48 Hours Before You Dig: 1.800.424.5555 Rnance - Amount deposited ..................................... $ Cost of repair (W/O #) ............................... $ Refund amount due ................................... $ Additional amount due City ....................... $ INSPECTOR'S COpy - white APPUCANT'S COPY - pink Pen Print, Inc. 5/92 Work Order No. P.O. No. Warrant No. Receipt No. PUBLIC WORKS WORK ORDER # PERMIT N~ 04472 OFFICE COPY - canary v . ;-", ., CITY OF PORT ANGELES DEPARTMENT OF PUBLIC WORKS . . . . INSPECTION REPORT. . . . . . REQUEST: Date +1 _ 9 -3 Time /z..- Received by -r-r- (phone. person) t ,/ Location of Work to be inspected / 7Z0 ~ {/ Name of person requesting inspection IVI Mr PZ.cTK&..2:- Address of person requesting inspection Phone No. Type of Inspection (circle appropriate one): Permit No. 4st70 C-Se~ Foundation Framing Chimney Plumbing Final Sewer Excav. Other INSPECTION NOTES: Inspected: Date 1-/-93 Time /." 7"-"- Remarks: d?'.c 70 I&J4.e.C /1 L-L- By f$.,/ J~.:>ZhV RESTORATION REQUiRED...... YES /" NO /' ~'tl ,~ ~ Ic,\ I 0-\ \J ,," ,,\: '" .~ '>- '" <S" "" - ~... ~ ~ 1-.. >( ~ ~~ 5 lj 1/ dtl \\~ 0 J""C 0, Y IJ ~" \ I\t ~ f\l ;;r- ) ~ 'vi :~ SURFACE RESTORATION: SURFACE TYPE: 0 Unimproved OGravel o Asphalt OPCC o Other o Repaired by City o Repaired by Permittee o No Damage Found Work Order # o COMPLETE o INCOMPLETE ~ --IC:",ntinl'A.on.reverse.side.iJ o~c;~~~~_~Yl STREET SUPERINTENDENT (DATE)