HomeMy WebLinkAboutWTR2700251(4) ROLLING HILLS TIE LINE W251A
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CITY OF RENTON
ENGINEERING DEPARTW Nt
DESIGN_EL _ DATE_
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PROJECT 110. UTILITIES D17ARIVM
CITY OF WITON
WOfiK ORDER :CIO. _ WASHINGTON
DATE SU,9MITTFD
DATE COMFLETFii _ DEPARTMENT
"r�ON OF 1"JRK
"ECSSSI:Y WORK TO DE DONE BY:
City Forces p
Contract p
Othor❑ [_1
ITEM QUANTI UNIJ COST I AMOUNT
I o.. G.I. Pipe 2140 1 LF 7. 00 !S, IZ0,00
I NSrALL Ar'o KI 2 'b0 LF^ 2. 5"0 :a00 ,oU
r AfE IA(VC- Gp0„. S, 100,0
10 O O U
35j920 0
oaca coo S',
400 liv
TAX .o
4.2Y. � + S
4-2 ,8LO,
TOTAL COST
SUPT. OF UTILITIES DATE APPRO'JED
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... , _ ...
10. The required "PRESSURE TEST' has been taken by
At a pressure of PSI , for _ minutes, on
The test: Failed Passed Comments
11 . The required "PURITY TEST" has been taken by
On Date of Rep Failed
Passed Comments
12. :s there an Easement required? If so, give dates for:
Preliminary Submitted Recorded
And Recorded Number
I;. This Project included LF of Waterinain
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11
And Gate Valves G„te Valves
Gate Valves and Gate Valves,
And all miscellaneous accessories for a total value of $
Y
Also, Size Make type Fire Hydrants 'or a
:oral value of 5
14. The transfer or "Bill of Sale" is in; Preliminary
Submitted �ecorded form.The recor4ed number
15. This project information was sent to the Utility Dept. for recording on
and taken into "plant" on
16. What drawings does the Water Shop have on File.
Preliminary As-Built
.r. ..
j
Form Completed on
City of Renton
Utility Department Project Form
1. Water Project N 41,2-51 A __Date Project No. given
2. Project Cescription and location pwoer Do we raor, -c46 6c'NaaN RbAO
'TO THE OULurvG dtL.LS [2."-k9oyt[Z St Tr6
3. Developer's Name ''f City check )
Address
Phone N
Engineer's Name (if City check ✓ )
Address
Phone N
Contractor's Name (If City check )
Address
Phone N
4. Is there an ACTIVE Late-Comers Agreement in the project areal NO
If sc, give File Name
Recording Date And Number
5. The Utility Department Work Order Numbers on thisproject are as follows:
6. What tans have been submitted? Preliminary ✓/ As-Built
7. Has an Estimate been Prepa-ed for Froject VCR. _If so, y: .y Jate Prep,
N 19407 And Total Amount of Estimate fAQ
B. Is there to be a Late-Comers Agreement on this project _ If so, give
dates for; Preliminary Submitted Recorded
and Recorded Number
9. Date of ''Start of Construction" Date of "completion"
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