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tiw REVISED
CITY or
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Z &TONN AND LOGAN AVE 56
10. The reyui red "PRESSURE TEST" has bfer, taken by
At a pressure of PSI , for minutes, on
The test: Failea Passed Comments
e 11 . The required "PURITY TEST" has been taken by
On Date of Reply Failed
Passed Coa,ents
lz. Is there an Easr,.ent required! If so, give dates for:
Preliminary Submitted '"-` Recorded
And Recorded Number
13. This Project included ^2 9 3 LF of � U,r Watermain
And Gate Valves Gate Valves
Gate Valves and Gate Valves,
And all misce! laneous accasscries for a total value of $_*no
o
Als, Size Make type lire Hydrants for a
t. �l value of $
14, The transfer or "Rill of Sale" is in; Preliminary
Submitted --7ecorded - form.'he rocorded number p ;.N
15. This project information was sent to the Utility Dept. for record;ng on
and taken into "plant" on
16. What drawings does the Water Shop hale on File.
Preliminary As-Built
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i
Form Completed on
City of Renton
Utility Department Project Form
1. Water Project V ', Date Project No. givmi
'. Project Description and location
3. Developer's Name (If City check )
Address
Phone q
Engineer's Name {�,sti (� LSiGPJ (If City check )
Address
Phone k
Contractor's Name If City check )
Address
Phone d
4. Is there an ACTIVE Late-Comcis 4greement in the Prujec. area?
If so, give File Name
Recording Dat- "'- And Number
5. The Utility Department Work Order Numbers on this project a-e as follows:
;�- 27 3 ! -
6. ghat plans have been submitted? Preliminary ✓ As-Built I,--
7. Has an Estimate been Prepared for Project ✓ If so, give Date Prepared
And Total Amount of Estimate
l3. 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" p �•
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Moss Construction Inc.
3A CR GENERAL CONTRACTORS
>✓ POST OFFICE BOX 97
ZENITH. WASHINGTON 9618E
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10. The required "PRESSURE TEST' has been taken by
At a pressure of PSI , $or minutes, on
The test: Failed Passed Comments
il . The required "PURITY TEST' has been taken by
On Date of Reply Failed
Passed Comments
12. Is there an Easement required? f,' If so, give dates for:
Preliminary - Submitted Recorded
And Recorded Number
13. This Project included 8 Q LF cf 12 /_�I.e/n Watermain
And — 12. ,j: Gate Valves Gate Valves
Gate Valves and Gate Valves,
And all miscellaneous accessories for a total value of
Also, Size Make type Fire Hydrants for a
total value of $
14. The transfer or "Bill of Sale" is in; Preliminary —
Submitted .7ecorded form.The recorded 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.
Pi eliminary As-Built
i
e
Form Completed on
r ,
,.lk1eX,
d
City of Renton
Utility Department Project Form p�
I / 1
1 . Water Project # ry �;>5 '� Date Project No. given
2. Project Description and location Md ncs .C ^ e
3. Developer's Name (If City check )
Address
_ Phone # ✓
Engineer's Name (If City check )
Address
/'� // Phone #
Contractor's Name /nn ]C (2,. mC?Y.-t�rdY (If City check ) p
Address f7_ U �r{ 2 7
Phone #
4. Is there an ACTIVE Late-Comers Agreement in the
t/ project area?
If so, give File Name /f
Recording Date Pr, lumber
5. The Utility Department Work Order Numbers on this project are as follows:
.'* !� 6P70
6. What plans have been submitted? Preliminary � As-Built
7. Has an Estimate been Prepared for Project ✓ If so, give Date Prepared _17 z,
And Total .+mount of Estimate /D� 1`/�i.. O0
8. Is there to be a Late-Come rs Agreement on this project tJ 0 If so, give
dates for; Preliminary t, milted carded
and Recorded Number
9. Date of "Start of Construction" ) /O�]z Date of "Completion"
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