HomeMy WebLinkAboutWWP2703373PROJECT REQUEST FORM
PLANNING/BUILDING/PUBLIC WORKS
DATE: �/ Q CONTACT- EXT.
FILE STATUS 1 ❑ NEW OR ❑ EXISTING: FILE CODE (PRl-roc-xXcx):
LOCATION 1 ❑ My Work Space: 1 ❑ File Bay Shelf #: 10Other:
PROJECT NAME/ FILE TITLE: \l klob'' fY? Re4
(70 characters max)
I
UTILITY PERMIT # U Q (Q 606 �-2 LUA# 0 J - n (t) c WO#
ADDRESS / STREET NAME(S):
DEVffh 9r i»'IT
OTHER ALIASES:L��1 � j ',- lh , A Qf4+
Circle Size of Waterline: 8" 10" 12" Circle One: New / Replace / Extension
Circle Size of Sewerline: ' 10" 12" Circle One: New / Replace / Extension
Circle Size of Stormline: 12) 18" 24" Circle One New / Replace / Extension
CHECK EACH DISCIPLINE INVOLVED IN PROJECT
Ltr
Drwg # of sheets
1� TED
❑
❑
(off site improvements)
(include TESC)
TRO
❑
❑
(Signalization, Channelization, Lighting)
V WWP
❑
❑
(sanitary sewer main, include basin name)
[ / WTR
❑
❑
(Mains, Valves, Hydrants)
(inc. composite & HorizontalCtrl)
f� SWP
❑
❑
(CIP onlyxinclude basin name)
8/PLR
(For Developer Files Only)
❑ (letter only)
PLEASE CIRCLE THE DISCIPLINES WHICH NEED TO SIGN MYLARS
WATER WASTEWATER SURFACE WATER TRANSPORTATION FIRE
FOR FII.F MAINTAWANCF, I1SF ONLY
File Codes
File Alias
Date Entered and Labels Made
Pro -Vac Tele-Scan
6622 112th Street East
Puyallup, WA 98373
Phone: (206) 242-5452
Cellular: (206) 949-9185
Cellular: (206) 423-2445
Fax: (206) 244-8398
Customer
HWH VALLEY
imam
VIDEO INSPECTION REPORT
ALL REPORTS ARE SUBJECT TO OWNERS ENGINEERING APPROVAL
Project Location
L _ 3819 NE 19TH ST
Starting MH Ending MH Flow Joint Type Pipe Size _ Pipe Type
MH 3 MH 4 ] Against R, GASKET 8" _; PVC
Tape Number Start Tape Counte End Tape Counter Date Camera Directio Invoice #
[ 7] F- 14/24/2008 1 U Stream_ _
Remarks
SHEET 1
40
A
Ftg. Observation
-0.0 Downstream Manhole
-85.6 Service Connection Left
* 155.6 Service Connection Left
184 0 Service Connection Lett
268.2 Service Connection Left
-282.6 Service Connection Left
-290.5 Upstream Manhole
Category Position Comments
Structure
Structure 9
Structure 9
Structure 9
Structure
Structure
Structure
9
9
Page 1 of 1 Generated on 4/24/2008 at 8 48 AM by the PipeTech` TV inspection system
Pro -Vac Tele-Scan
6622 112th Street East
Puyallup, WA 98373 low
Phone: (206) 242-5452
Cellular: (206) 949-9185 VIDEO INSPECTION REPORT
Cellular: (206) 423-2445 ALL REPORTS ARE SUBJECT TO OWNERS ENGINEERING APPROVAL
Fax: (206) 244-8398
Customer Project Location
HWH VALLEY _ 3819 NE 19TH ST
Starting MH Ending MH Flow Joint Type Pipe Size _ Pipe Type
MH 3 11 MH 2 With R, GASKET j 1 8" I PVC
Tape Number Start Tape Counte End Tape Counter Date Camera Directio Invoice #
1 1241 1418 1 4/23/2008 1 F DownStream
Remarks _
SHEET 2
Ftg. Observation Category Position Comments
wr <0.0 Upstream Manhole Structure
r
1
I
I
I
I
I
1
I
Page 1 of 1 Generated on 4/23/2008 at 8 49 AM by the PipeTeche TV inspection system. I
Pro -Vac Scan
6622 112th th Street East
Puyallup, WA 98373 1"M
Phone: (206) 242-5452
Cellular: (206) 949-9185 VIDEO INSPECTION REPORT
Cellular: (206) 423-2445 ALL REPORTS ARE SUBJECT TO OWNERS ENGINEERING APPROVAL
Fax: (206) 244-8398
Customer Project Location
HWH VALLEY 3819 NE 19TH ST
Starting MH Ending MH Flow Joint Type Pipe Size Pipe Type
MH 2 11 CO ] j Against R, GASKET 8" _ [ PVC
Tape Number Start Tape Counte End Tape Counter Date Camera Directio Invoice #
1 1418 ] 8102 [ ] [ 4/23/2008 UpStream ]
Remarks _
SHEET 3
Ftg. Observation Category Position Comments
f�
°0.0 Downstream Manhole Structure
zzd58.1 Service Connection Left Structure 9
r
102.0 Upstream Manhole Structure
Page 1 of 1 Generated on 4/23/2008 at 9:07 AM by the PipeTechc TV inspection system.
Pro -Vac Tele-Scan
6622 112th Street East low
Puyallup, WA 98373
Phone: (206) 242-5452
Cellular: (206) 949-9185 VIDEO INSPECTION REPORT
Cellular: (206) 423-2445 ALL REPORTS ARE SUBJECT TO OWNERS ENGINEERING APPROVAL
Fax: (206) 244-8398
Customer Project Location
HWH VALLEY j — 3819 NE 19TH ST
Starting MH Ending MH Flow Joint Type Pipe Size Pipe Type
MH 2 1 L MH 1 ] I With R, GASKET 8" ] PVC
Tape Number Start Tape Counte End Tape Counter Date Camera Directio Invoice #
1 1802 ] 2229 ] L4/ 3 02/2 08 DownStream I L
Remarks
SHEET 4 ---
Ftg. Observation Category Position Comments
�0.0 Upstream Manhole Structure
r
., 91.7 Service Connection Right Structure
,94.5 Service Connection Left Structure
<,118.5 Downstream Manhole Structure
3
9
I
I
I
1
Page 1 of 1 Generated on 4/23/2008 at 9 21 AM by the PipeTech' TV inspection system
SANITARY SEWER SYSTEM LOW
PROJECTt��6d� �uf
DATE
PRESSURE AIR TEST
I N P rTnD �-►�
LOCATION
LENGTH
K
C
r _
I E
RESULT
OA
--�1—
—M
12 c
IM Z
4
p$
_r
_y
1
"
Return Address:
City Clerk's Office
City of Renton
1055 South Grady Way
Renton, WA 98055
11111111111111111111111111111
20110209001262
CITY OF RENTON BS 63.00
PAGE-001 OF 002
02/09/2011 14:14
KING COUNTY, (JA
BILL OF SALE
Proj Name: VaoyIgL Jr Sig Property Tax Parcel Number: o Y23o - 923 d
Project File #:�j9 , Cq dS8 Street Intersection: Ait /71" STWCGT' Address:
060^^9WO cr^.* 81"1 a!F i9a''-STRC£r
(Reference Number(s) of Documents assigned or released: Additional reference numbers are on page
Grantor(s): Grantee s:
of
1. City Renton, a Municipal Corporation
2.
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: LL Size Tvoe
-7 �_ L.F. of S Dt Water Main
33 / 3 L.F. of Water Main
L.F. of Water Main
each of Is Gate Valves
each of Gate Valves
1 each of Fire Hydrant Assemblies
SANITARY SEWER SYSTEM: Length Size Tyye
L.F. of Pv Sewer Main
L.F. of Sewer Main
L.F. of Sewer Main
each of Y8 Diameter Manholes
each of Diameter Manholes
each of ' Lift Stations
STORM DRAINAGE SYSTEM: L_e�n�th Size IyVe
cP
n L.F. of f2 Storm Main
i1�J 33 7J L.F. of ;' Storm Main
Y \ L.F. of Storm Main
each of Storm Inlet/Outlet
cc?each of ;' 7 yam- Storm Catch Basin
each of T)(P TZ Manhole
STREET IMPROVMENTS: (Including Curb, Gutter, Sidewalk, Asphalt Pavement)
Curb, Gutter, Sidewalk WO L.F.
Asphalt Pavement: 2179 SY or L. F. of Width
STREET LIGHTING:
# of Poles y
1�6 N -' 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.
0:\Fomns\PBPW\BILLSALE2.D0C\bh Page 1
4
IN WITNESS WBE F, said Grantor has caused this instrument to be executed this LL day of , � 20 J I
G-.�47V a1S ME$
INDIVIDUAL FORM OFACKNOWLEDGMENT
Notary Seal must be within box STATE OF WASHINGTON) 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 OFACIOVOWLEDGMENT
Notary Seal must be within box STATE OF WASHINGTON ) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that
Notary Seal must be within box
signed this instrument, on oath
stated that he/she/they was/were authorized to execute the instrument and
acknowledged it as the and _
of to be the free and voluntary act of such
party/parties for the uses and purposes mentioned in the instrument.
Notary Public in and for the State of Washington
Notary (Print)
My appointment expires:
Dated:
CORPORATE FORM OF ACKNOWLEDGMENT
STATE OF WASHINGTON ) SS
COUNTY OF KING )
On this ) I +h day of �GY1�, 20 , before me personally appeared
ina nG bp n rie- f - to me known to
be P S IC12 r \4- _ _ 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 he/she 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) It � . V, UCW o,Ce-
My appointment expires: aW- 5.2o • Z.-p►4
Dated: t• i t• Z-0 t 1
0:\Forms\PBPW\BILLSALE2.DOC1bh Page 2
- — COST DATA AND INVENTORY
CITY WTR-
PROJECT WWP-
NUMBERS: SWP-
�EL !2 `��Gc // _.S c�>z r Rz-A -r TRO
NAME OF PROJECT: TED-
TO: City of Renton FROM: ,10EjeF4 64AJ41"5
�Ey �E•g�snb�tn.�, LC-C
Plan Review Section dZrV
Planning/Building/Public Works
1055 South Grady Way 61" floor DATE: rL Zot�
Renton, WA 98055
Per the request of the City of Renton, the following information is furnished concerning costs for improvements proposed
to be installed for the above referenced project.
WATER SYSTEM CONSTRUCTION COSTS:
Length Size
B_
Type
WATERMAIN
L.F. of
WATERMAIN
_ L.F. of
L.F. of
WATERMAIN
_
_ L.F. of
EACH $
WATERMAIN
[.,t GATE VALVES
/ 9 00 2e
Z, of
EACH of
GATE VALVES
EACH of
GATE VALVES
FIRE HYDRANT ASSEMBLIES $ 3(�o •�
_
EACH of
(Cos Hydrants must be listed separately)
$ / -.,— U,a ,
Engineering Design Costs
$ ZZ•o o.. c"
City Permit Fees
TOTAL COST FOR WATER SYSTEM $ 3 l 197.
Washington State Sales Tax
STORM DRAINAGE SYSTEM:
SANITARY SEWER SYSTEM:
Type 3Sy (4Z.�
Size YP �
Length Size
S
Type
�L SEWER MAIN
Length
L.F. of %Z C PE STORM LINE
�� STORM LINE
S•913 L.F. of
L.F. of
SEWER MAIN
L.F. of
L.F. of STORM LINE
L.F. of
SEWER MAIN
STORM INLET
EA of
e_ EA of DIAMETER MANHOLES
Engineering Design Costs $ yew
EA of T YPE= STORM CAT CHBASIN
¢ STORM CATCHBASIN
City Permit Fees $ /.SAD P
_ EA of c18 Engineering Yt Design Costs $ y/70V-cIO
Washington State
Sales Tax $ Z t'TO
• aO
City Permit Fees $ f Lae
(Sewer Stub - line between sewer main and
$ ZZ,83Z. do
Washington State Sales Tax $ 3 °'11 '-
private property line)
TOTAL COST FOR SANITARY SEWER
SYSTEM $ 3 l,?j02 .
TOTAL COST FOR STORM DRAINAGE SYSTEM $ yS 2Sco.
STREET IMPROVEMENTS: (Including Curb, Gutter, Sidewalk, Asphalt Pavement and Street Lighting)
7y0 GF of C/64T = �/7 /Z3 .
Z! 7 -5� of /10oJ = 430, �3Z
n
SIGNALIZATION: (Including Eng. Design Costs, City Permit Fees, WA St Sales Tax)
STREET LIGHTING: (Including Eng. Design Costs, City Permit Fees, WA St Sales Tax)
7l9 0
�c✓ ,rZ �pyJ�4124j <�LS' y�S /S9� "'� (SIGNATURE)
(day phone#)
Print signatory name (Signatory must be authorized agent
or owner of subject development)
forms/COSTDATA . D O C/bh
Return Address:
City Clerk's Office
City of Renton
1055 South Grady Way
Renton, WA 98057
:5- 3373
1111' 11111111111111 11111�111 1111111
20110316000665
CITY OF RENTON EAS 66.00
PAGE-001 OF 005
03/16/2011 13:51
KING COUNTY, WA
Title: Public Utilities Easement
Property Tax Parcel Number: 042305-9231
Project File #: LUA-09-058-SHPL
Street Intersection or Project Name:
Grantor(s): Grantee(s):
1. Langley Meadows Homes, LLC 1. City of Renton, a Municipal Corporation
Legal Description:
The East 155 feet of the Southwest quarter of the Northeast quarter of the Southeast quarter of Section 4, Township 23,
Range 5 East, W.M., in King County Washington;
EXCEPT the East 22 feet of the West 75 feet of the North 228 feet thereof; EXCEPT the West 53 feet of the North 262 feet
thereof, AND EXCEPT portion of the North 15 feet thereof East of the West 75 feet; AND EXCEPT that portion quieted to
Lawrence A. Haugen in King County Superior Court Cause Number 08-2-37589-7 and Recorded under Recording Number
20090115000345. Situate in the County of King, State of Washington.
That said Grantors, for and in consideration of mutual benefits, do by these presents, grant, bargain, sell, convey,
and warrant unto the said Grantee, its successors and assigns, a Public Utilities Easement (including water,
wastewater, and surface water) with necessary appurtenances over, under, through, across and upon the property
described on attached Exhibit A and illustrated on attached Exhibit Map in King County, Washington.
For the purpose of constructing, reconstructing, installing, repairing, replacing, enlarging, operating and
maintaining access and utilities and utility pipelines, including, but not limited to, water, sewer and storm
drainage lines, together with the right of ingress and egress thereto without prior institution of any suit or
proceedings of law and without incurring any legal obligation or liability therefor. Following the initial
construction of its facilities, Grantee may from time to time construct such additional facilities as it may require.
This easement is granted subject to the following terms and conditions:
1. The Grantee shall, upon completion of any work within the property covered by the easement, restore the surface of
the easement, and any private improvements disturbed or destroyed during execution of the work, as nearly as
practicable to the condition they were in immediately before commencement of the work or entry by the Grantee.
2. Grantors shall retain the right to use the surface of the easement as long as such use does not interfere with the
easement rights granted to the Grantee.
Grantors shall not, however, have the right to:
a_ Erect or maintain any buildings or structures within the easement; or
b. Plant trees, shrubs or vegetation having deep root patterns which may cause damage to or interfere with the
utilities to be placed within the easement by the Grantee; or
C. Develop, landscape, or beautify the easement area in any way which would unreasonably increase the costs to
the Grantee of restoring the easement area and any private improvements therein.
d. Dig, tunnel or perform other forms of construction activities on the property which would disturb the
compaction or unearth Grantee's facilities on the right-of-way, or endanger the lateral support facilities.
e. Blast within fifteen (15) feet of the right-of-way.
This easement shall run with the land described herein, and shall be binding upon the parties, their heirs,
successors in interest and assigns. Grantors covenant that they are the lawful owner of the above property and
that they have a good and lawful right to execute this agreement
By this conveyance, Grantors 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.
IN WITNESS WUREOF, said Grantors have caused this instrument to be executed this 17day of /'�Cl 20 If
NE,t MEs� OttiLS' tl0 1.LC
Si SVT: 'Z 0ip s
Notary Seal must be within box
STATE OF WASHINGTON ) SS
COUNTY OF KING _ )
On this 12L day of retAA.aCA]r: - 2011, before me personally appeared
2a(aVv— I-,. , to me known to be
WA Oo\LAB of the Company that executed the within instrument and
acknowledged the said instrument to be the free and voluntary act and deed of said
Company for the uses and purposes herein mentioned, and stated on oath that he/she
was authorized to execute said instrument.
Notary (Sign)
Notary
My appointment expires: S 2y 14
S "M—V ' 3 c
A PORTION OF THE SOUTHWEST QUARTER OF THE NORTHEAST QUARTER
OF THE SOUTHEAST QUARTER OF SECTION 4, TOWNSHIP 23 NORTH,
RANGE 5 EAST, W.M., IN KING COUNTY, WASHINGTON, DESCRIBED AS, -
COMMENCING AT THE SOUTHEAST CORNER OF THE NORTH 15 FEET OF THE SOUTHWEST
QUARTER OF THE NORTHEAST QUARTER OF THE SOUTHEAST QUARTER OF SECTION 4,
TOWNSHIP 23 NORTH, RANGE 5 EAST, W.M., 1N THE CITY OF RENTON, KING COUNTY,
WASHINGTON;
THENCE SOUTH 01'03'12" WEST, A DISTANCE OF 640.35 FEET
TO THE SOUTH LINE OF THE SAID SOUTHWEST QUARTER OF THE
NORTHEAST QUARTER OF THE SOUTHEAST QUARTER OF SECTION 4;
THENCE NORTH 88'09'50" WEST, A DISTANCE OF 45.00 FEET
TO THE POINT OF BEGINNING;
THENCE CONTINUING NORTH 88'09'50" WEST, A DISTANCE OF 15.00
THENCE NORTH 01'03'12" EAST, A DISTANCE OF 91.57 FEET TO A
ON A NON -TANGENT CURVE, THE RADIUS POINT OF WHICH BEARS
NORTH 12'35'25" EAST,
THENCE ALONG SAID CURVE TO THE LEFT, CONCAVE TO THE NORTH
A RADIUS OF 50.00 FEET AND A CENTRAL ANGLE OF 17'16'34", AN
DISTANCE OF 15.08 FEET TO A POINT OF CUSP, THE RADIUS POINT
BEARS NORTH 04'41 '09" WEST;
THENCE SOUTH 01'03'12" WEST, A DISTANCE OF 91.01 FEET
TO THE POINT OF BEGINNING.
FEET,
POINT
HAVING
ARC
OF WHICH
SITUATE 1N THE CITY OF RENTON, COUNTY OF KING, STATE OF WASHINGTON.
OWEN B. HILLE, PLS
PLS NO. 40016
11Lel:r[om
SHEET: 4 OF 5
EXHIBIT MAP
A PORTION OF:
N.E. 1 /4, S.E. 1 /4, SEC. 4, T. 23 NORTH, R. 5 EAST, W.M.
N.E. 19TH STREET
N. LN., S. W.
1/4, N. E.
1/4, S. E. 1/4
P.O. C.
-------------------------
S.E. COR., N. 15',
SOUTH LINE N 15'
S.W. 1/4, N.E. 1/4,
S.W. 1/4, N.E. 1/4'
S•E. 1/4
S.E. 1/4
1
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SCALE: 1'=100'
;can w
I�
N
In
I�
to
Iti
to
I�
I11
3
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moo¢ I
Cl: Rad=50.00' A 17'16'34" Arc=15.OB'
1,
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15' PUBLIC UTILITY EASEWNT
C1I_
w
� I
I
}�
45.00 '
NBB '09 50'W 15.00
' y
SOUTH LINE, S. W. 1 1A,
N.E. 1/4, S.E.
1/4
SHEET: 5 OF 5