HomeMy WebLinkAboutWTR2703113Short Plat (SHPL # )
REQUEST FOR PROJECT 4 Prelim. Plat (PP# )
To: Technical Services Date 6-) I-S-1 C _�) WO#
From: Plan Review/Project Manager
,iUIUA-r\3A
Project Name C 4ATeA,\) VA_t r-q C t--N I_K—_
(70 characters max)
Green#
Description of Project: , i s ���! tN iaC- i L tTY l �� _ CH M V M lam'
N��� ��� �q,� M� ► � EX � SUS: O � . �iI�1- ; ► `,Tc) i_t'-k "-L?/� i2 -
Circle Size of Waterline:
Circle Size of Sewerline:
Circle Size of Stormline
Address or Street Name(s)
Developer/Contractor/Owner:
8" 101, 12" Circle One: New or Extension
8" 10" 12" Circle One: New or Extension
8" 10" 12" 14" Circle One: New or Extension
�6ipr i .,_Oz C.(
Check each discipline involved in Project
Nsri UC-T t O r i /
(70 characters max)
f Trans -Storm
(Roadway/Drainage) (off site improvementsxinclude basin name)
O Transportation
9- Wastewater
(Signalization, Channelization, Lighting)
(Sanitary Sewer Main) (include basin name)
Ltr Drwg # of sheets per discipline
✓ ✓
(include TESC sheets)
Water (Mains, valves, Hydrants)
(Include composite &Horizontal Ctr] Sheets)
E�-�o-3���� 3i 13
TS Use Only �11
w -- _�>\ �
Approved by TSM
fomis/misc/92-090.130C /CD/bh
Date: -
i
Return Address:
City Clerk's Office
City of Renton
1055 South Grady Way
Renton, WA 98055
kkA V-y (14'V1+f-q'
20050316000021
CITY OF RENTON BS
PAGE001 OF 002
KING6COUNTY/2005 08WA;
20050113000570
CITY OF RENTON OT 27-00
PAGE001 OF 008
KING3/2005 COUNTY09UA4
BILL OF SALE
I Property Tax Parcel Number: 6391800010
Project File#:3113
Ra lst71n45th Street
Oft:Davis Avenue South
Reference Number(s) of Documents assigned or released: Additional reference numbers are on page
Granter(s): Grantee(s):
1. Public Hospital District No. 1 of 1. City of Renton, a Municipal Corporation
wKing County
The Grantor, as named above, for, and in consideration of mutual benefits, hereby grants, bargains, sells and delivers to
the Grantee, as named above, the following described personal property:
WATER SYSTEM: Length Size Type
270 L.F. of 12 DI Water Main
L.F. of Water Main
L.F. of Water Main
each of Gate Valves
each of Gate Valves
2 each of Fire Hydrant Assemblies
SANITARY SEWER SYSTEM: Length Size Type
L.F. of Sewer Main
L.F. of Sewer Main
L.F. of Sewer Main
each of Diameter Manholes
each of Diameter Manholes
each of Diameter Manholes
STORM DRAINAGE SYSTEM: Length Size Type
L.F. of Storm Line
L.F. of Storm Line
L.F. of Storm Line
each of Storm Inlet/Outlet
each of Storm Catch Basin
each of Manbole
STREET IMPROVEMENTS: (Including Curb, Gutter, Sidewalk, Asphalt Pavement)
Curb, Gutter, Sidewalk 253 L.F.
Asphalt Pavement: SY or L.F. of Width
STREET LIGHTING:
# of Poles -0-
By this conveyance, Grantor will warrant and defend the sale hereby made unto the Grantee against all and every person
or persons, whomsoever, lawfully claiming or to claim the same. This conveyance shall bind the heirs, executors,
administrators and assigns forever.
H:\FILE.SYS\FRM\84ID41DOUMILMALE.DOCVAAB
Page 1
IN WITNESS WHEREOF, I have hereunto set my hand and seal the day and year as written below.
_ INDIVIDUAL FORM OFACKNOWLEDGMEIYT
Notary Seal must be within box STATE OF WASIIINGTON ) SS
COUNTY OF KING ).
I certify that I know or have satisfactory evidence that
signed this instrument and
acknowledged it to be his/her/their free and voluntary act for the uses and purposes
mentioned in the instrument
Notary Public in and for the State of Washington
Notary (Print)
My appointment expires:
Dated:
REPRESENTATIVE FORM OF ACKNOWLEDGMENT
M,Lu y .;cal must be within box STATE OF WASHINGTON ) SS
COUNTY OF KING )
certify that I know or have satisfactory evidence that
y %L_ HQ signed this instrument, on oath
stated that ®'she/they ere authorized to execute the instrument and
acknowledged it as the i L41 wand
of y4.1)" yV>cd �., _ to be e free and voluntary act of such
11 RY pan
�/parh�x for the uses d purposesmnntioned in the instrument.
j �� �0:�� Notary Public in and for the State of Washington
qr O`19" �+ Notary
4F v F \t. ASS My appointment expires: i o
Dated: i a/ is /o
CORPORATE FORM OFACKNOWLEDGMENT
Notary Seal must be within box STATE OF WASHINGTON ) SS
COUNTY OF KING )
On this day of , 19 before me personally appeared
to me known to
be of the corporation that
executed the within instrument, and acknowledge the said instrument to be the free
and voluntary act and deed of said corporation, for the uses and purposes therein
mentioned, and each on oath stated that helshe was authorized to execute said
instrument and that the seal affixed is the corporate seal of said corporation.
Notary Public in and for the State of Washington
Notary (Print)
My appointment expires:
Dated:
rayu
PROJECT CLOSING
FINAL COST DATA AND INVENTORY
SUBJECT: 3113 CITY PROJECT NUMBERS: WTR-
WWP-
_Chateau at Valley Center SWP-
Name of project TRO-
TED-
/#4 Final Cost Data
and Inventory
TO: City of Renton FROM: Roland Persson 1 Constar motion Manager
�
Plan Review Section Stratton onstructors, LLC
Planning/BuildingJPublic Works PO Box 907
200 Mill Avenue South Woodinville,
Renton, WA 98055 DATE: 10 04
Per the request of the City of Renton, the following information is furnished concerning final costs for improvements
installed for the above referenced project.
WATER SYSTEM CONSTRUCTION COSTS:
Length Size Type
__270 L.F. of _ 12 _DI -
L.F. of
L.F. of
L.F. of
EACH of
EACH of
EACH of
—_ EACH of — — — —
(Cost of Fire Hydrants must be listed separately)
(Include Engineering and Sales Tax if applicable
Length Size
WATERMAIN
WATERMAIN
WATERMAIN
WATERMAIN
GATE VALVES
GATE VALVES
GATE VALVES
FIRE HYDRANT ASSEMBLIES $ 2,600.00
$18,040.00
TOTAL COST FOR WATER SYSTEM $ 20 , 640.00
1vi-f�
Type
L.F. of SEWER MAIN
L.F. of SEWER MAIN
L.F. of SEWER MAIN
EA of DIAMETER MANHOLES
EA of DIAMETER MANHOLES
(Including Engineering and Sales Tax
if applicable) $
TOTAL COST FOR SANITARY SEWER SYSTEM $
Length Size Type
L.F. of STORM LINE
L.F. of STORM LINE
L.F. of STORM LINE
EA of STORM INLET/OUTLET
EA of STORM CATCHBASIN
EA of STORM CATCHBASIN
(Including Engineering and Sales Tax
if applicable) $
TOTAL COST FOR STORM DRAINAGE SYSTEM $
STREET IMPROVEMENTS: (Including Curb, Gutter, Sidewalk, Asphalt Pavement and Street Lighting)
Sidewalk 253' $4,010.00
(Including Eng. Design Costs, City Permit Fees, WA St Sales Tax)
STET-tje-TJN6:• (Including Eng. Design Costs, City Permit Fees, WA St Sales Tax)
Roland Persson
Print signatory name
fomis/COSTDAT2.DO C/bit
425 488 2400 ext 228 -
- day phone #
(SIGNATURE)
(Signatory must be authorized agent
or owner of subject development)
Laucks Testing Laboratories, Inc.
940 S. Harney Seattle, WA 98108
WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COLLECTION: READ INSTRUCTIONS ON BACK OF GOLDENROD COPY
If instructions are not followed, sample will be rejected.
DATE COLLECTED I TIME COLLECTED I COUNTY NAME
MONTH , DAY .YEAR
❑ AM ❑ PM
TYPE OF SYSTEM IF PUBLIC SYSTEM, COMPLETE:
❑ PUBLIC
❑ INDIVIDUAL I.D. N0. CIRCLE GROUP
(serves only 1 residence( I I
A B
NAME OF SYSTEM
SPECIFIC LOCATION WHERE SAMPLE COLLECTED TELEPHONE NO.
DAY ( )
EVENING ( )
SAMPLE COLLECTED BY: (Name) SYSTEM OWNER/MGR.: (Name)
SOURCE TYPE ❑ GROUNDWATER UNDER SURFACE INFLUENCE
❑ SURFACE []WELL or ❑ SPRING ❑ PURCHASED or ❑ COMBINATION
WELL FIELD INTERTIE or OTHER
SEND REPORT TO: (Print Full Name. Address and Zip Code)
WASHINGTON
TYPE OF SAMPLE (check only one in this column)
❑ ROUTINE ❑ Chlorinated (Residual: Total _Free)
DRINKING WATER —
check treatment ❑ Filtered
❑ Untre/�f
❑ REPEAT SAMPLE F1 LMyy
Previous coliform presence Lab #
Date Mir 1 /
n�� ENTON
❑ RAW SOURCE WATER Source # A ILI YS[fgI&I Coliform
❑ NEW CONSTRUCTION or REPAIRS ❑ Fecal Coliform
❑ pecl
REMA S:
ONLY) DRINKING WATER RESULTS
❑ UNSATISFACTORY, Coliforms present
❑ SATISFACTORY,
REPEAT ❑ E. Coli present ❑ E. Coli absent
Coliforms absent
SAMPLES
REQUIRED ❑ present Fecal absent Fecal prese❑
OTHER LABORATORY RESULTS
TOTAL COLIFORM /100 ml E. COLI /100 ML
FECAL COLIFORM /100 m) PLATE COUNT /ml
ANOTHER SAMPLE REQUIRED
SAMPLE NOT TESTED BECAUSE: TEST UNSUITABLE BECAUSE:
❑ Sample too old ❑ Confluent growth
❑ Wrong container ❑ TNTC
❑ Incomplete form ❑ Turbid culture
❑ ❑ Excess debris
SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS
LAB NO. (7 DIGITS) DATE, TIME RECEIVED RECEIVED BY
DATE REPORTED LABORATORY:
REMARKS
DOH 305 002 (REV. 4/92)
WATER SUPPLIER COPY
INTERPRETATION OF RESULTS
FOR DRINKING WATER
The analysis performed on this drinking water sample is an examina-
tion for the presence of coliform organisms in the water and indicates
the bacteriological quality of the sample. The presence of coliform
organisms is used by health organizations worldwide as an indicator
for the possible presence of other disease causing organisms.
REPORTING OF RESULTS:
Group A Public Water Systems must report the results of Drinking
Water Analysis to the State as specified in WAC 246-290-480.
SATISFACTORY RESULTS:
The absence of coliforms from any sample is satisfactory. Proper
system maintenance and bacteriological monitoring should be con-
tinued routinely to insure the safety of the water supply.
UNSATISFACTORY RESULTS:
Any coliform presence is unsatisfactory.
The presence of coliforms indicates the system is not properly
protected against contamination and may be unsafe for human con-
sumption. Unsatisfactory samples should be investigated IMMEDI-
ATELY and repeat samples submitted. Contact your local health
department or DOH Regional Office for assistance in determining
the source of contamination and corrective procedures.
When fecal coliforms or E.coli are reported present in a sample, the
IMMEDIATE ACTION REQUIRED by a Public System is:
1. Investigate to determine the cause and correct the situation.
Your local health department or DOH Regional Office can
assist you.
2. Submit repeat samples as specified in WAC 246-290-480.
3. Publicly notify the users of the public water systems as
specified in WAC 246-290-480.
4. Contact your local health department or DOH Regional
Office as specified in WAC 246-290-480.
TEST UNSUITABLE: Resample Immediately
"Confluent Growth" means bacteria have grown into a continuous
mass which makes counting impossible. "TNTC" means bacteria are
too numerous to count. "Excess Debris" means that particulates in
the water interfere with the interpretation of test results. "Turbid
Culture" means an overgrowth of other bacteria can interfere with
coliform analysis. If any box indicating an unsuitable test is checked,
the presence of coliform bacteria could not be determined and a new
sample must be obtained for testing.
RESAMPLE:
Sample too old. (Sample to be tested must be received within 30 hours).
Not in proper container. (Bottle to be used for testing must be
purchased from a certified lab within 6 months.)
Insufficient volume. (Sample must be at least 100 ml)
If not tested, a new sample must be submitted for analysis.
FOR ADDITIONAL INFORMATION:
Contact your local health department OR the laboratory where this
sample was tested OR the Department of Health, Drinking Water
Program Regional Office.
' Laucks Testing Laboratories, Inc.
940 S. Harney Seattle. WA 98108
WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COLLECTION: READ INSTRUCTIONS ON BACK OF GOLDENROD COPY
If instructions are not followed, sample will be rejected.
DATE COLLECTED I TIME COLLECTED I COUNTY NAME
MONTH , DAY ,YEAR
❑ AM n PM
TYPE OF SYSTEM IF PUBLIC SYSTEM, COMPLETE:
PUBLIC
❑ INDIVIDUAL I.D. N0. CIRCALE GB UP
(serves only 1 residence)
NAME OF SYSTEM
SPECIFIC LOCATION WHERE SAMPLE COLLECTED TELEPHONE NO.
DAY ( )
SAMPLE COLLECTED BY: (Name)
EVENING ( )
SYSTEM OWNER/MGR.: (Name)
SOURCE TYPE U GROUNDWATER UNDER SURFACE INFLUENCE
SURFACE 0 WELL or ❑ SPRING ❑ PURCHASED or ❑ COMBINATION
WELL FIELD INTERTIE or OTHER
SEND REPORT TO: (Print Full Name, Address and Zip Code)
TYPE OF SAMPLE (check only one in this column)
ROUTINE Chlorinated (ResidypM(: Total _Free)
DRINKING WATER check treatment Filtered 1
U�er
REPEAT SAMPLE vv q
Previous coliform presence Lab #
Date /CIE�.
or Sys.�rtii
RAW SOURCE WATER Source # S Total Coliform
NEW CONSTRUC or REPAIRS Fecal Coliform
❑ OTHER (Spey�N
REMARKS:
(L ONLY) DRINKING WATER RESULTS
UNSATISFACTORY, Coliforms present
SATISFACTORY,
Coliforms absent
REPEAT E. Coll present E. Coll absent
SAMPLES REQUIRED Fecal present Fecal absent
�
OTHER LABORATORY RESULTS
TOTAL COLIFORM /100 ml E. COLI A00 ML
FECAL COLIFORM /100 ml PLATE COUNT /ml
ANOTHER SAMPLE REQUIRED
SAMPLE NOT TESTED BECAUSE: TEST UNSUITABLE BECAUSE:
Sample too old Confluent growth
Wrong container TNTC
Incomplete form Turbid culture
❑ ❑ Excess debris
SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS
LAB NO. (7 DIGITS) DATE, TIME RECEIVED RECEIVED BY
DATE REPORTED LABORATORY:
REMARKS
DOH 305 002 (REV. 4192)
WATER SUPPLIER COPY
INTERPRETATION OF RESULTS
FOR DRINKING WATER
The analysis performed on this drinking water sample is an examina-
tion for the presence of coliform organisms in the water and indicates
the bacteriological quality of the sample. The presence of coliform
organisms is used by health organizations worldwide as an indicator
for the possible presence of other disease causing organisms.
REPORTING OF RESULTS:
Group A Public Water Systems must report the results of Drinking
Water Analysis to the State as specified in WAC 246-290-480.
SATISFACTORY RESULTS:
The absence of coliforms from any sample is satisfactory. Proper
system maintenance and bacteriological monitoring should be con-
tinued routinely to insure the safety of the water supply.
_UNSATISFACTORY RESULTS:
Any coliform presence is unsatisfactory.
The presence of coliforms indicates the system is not properly
protected against contamination and may be unsafe for human con-
sumption. Unsatisfactory samples should be investigated IMMEDI-
ATELY and repeat samples submitted. Contact your local health
department or DOH Regional Office for assistance in determining
the source of contamination and corrective procedures.
When fecal coliforms or E.coli are reported present in a sample. the
IMMEDIATE ACTION REQUIRED by a Public System is:
1. Investigate to determine the cause and correct the situation.
Your local health department or DOH Regional Office can
assist you.
2. Submit repeat samples as specified in WAC 246-290-480.
3. Publicly notify the users of the public water systems as
specified in WAC 246-290-480.
4. Contact your local health department or DOH Regional
Office as specified in WAC 246-290-480.
TEST UNSUITABLE: Resample Immediately
"Confluent Growth" means bacteria have grown into a continuous
mass which makes counting impossible. "TNTC" means bacteria are
too numerous to count. "Excess Debris" means that particulates in
the water interfere with the interpretation of test results. "Turbid
Culture" means an overgrowth of other bacteria can interfere with
coliform analysis. If any box indicating an unsuitable test is checked,
the presence of coliform bacteria could not be determined and a new
sample must be obtained for testing.
RESAMPLE:
Sample too old. (Sample to be tested must be received within 30 hours).
Not in proper container. (Bottle to be used for testing must be
purchased from a certified lab within 6 months.)
Insufficient volume. (Sample must be at least 100 ml)
If not tested, a new sample must be submitted for analysis.
FOR ADDITIONAL INFORMATION:
Contact your local health department OR the laboratory where this
sample was tested OR the Department of Health, Drinking Water
Program Regional Office.