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HomeMy WebLinkAboutWTR2700823i � � � l • CITY OF RENTON UTILITY ENGINEERING • • E00 HILL AVENUE SMITH '-No,_.Ti' ` RENTON. WA 9RD55 -- 1' PNOWF 155�zG71 ORDER FOR WATER SERVICE INSTALLATION A.cpunl No �� Reter CFa.ge S Wyk Order Np. Lau Sab Spvin Crepit S.od'v Sala No, Di.H P ,vFk,t In City Yu SYStee Dev.InPeAn ge t Char . ❑ Np� late-Co.en LCItYI On Sarver Y..❑ A, (OtMn) WAY., UOga: RU ltlential ❑ Cneei"PI ❑ IMuftri.l p TOTAL FEE S Other AN ter Site INSTALLATION: Temppr.1, NYtlgnt Net., Y.f❑ Np❑ SIR. S.rv;ce Hear Wake_ Sawpe Eas.Pt ART., Y.,❑ Np❑ Hear W. r lie Protactien Service VA.❑ No❑ GAIN Inf blletl Sarvice Add.... CcHrenu Le9.1 Da url,tion gnP Ae CROSS CONNECTION CONTROL Ackflo Protection Device Aapuirap Yes Q WE] If Yet, Ty" of Uevla: RtHl..0 Fir..wr. Backfl.CAA I,.❑ Double Check Valk. Asfembl `Wk. of Dark. Y❑ Ali or ,.nu.e V.c beaker❑ -- Nodal Serl al No. $ 1Fe Date 6evice Int alleC Neer Mp. . Np. OMner'. Marne Add.... --- Pho.e Conti.<tor'� ease --- L� v Srate __ ?T. Add..ff _ PMna 1 City � State _ ilp Are, Saved by Renton WAY., Seettle War ❑ ❑ SaaRie Mat er Code An TanpparY Servic. Apr,de nt Yu❑ de If Y.t, A, .vent Recording W. Servic. to be Lo:u.d on .n Essemeet Yes❑ Np❑ II Y.Y. EVaement Recording No, ub Is There an L.Rting St Servic. VAR Mo❑ ❑ IF Yes, Wtar Protect b V- [Aifting Late-;omer. Ag.eenent V.,In quo. ❑ ANY[3 e r It Yef, A,Nm. t Np. of City Stay Addns. -" Iip CNI rBR $ Svs an Development F.. Yu❑ Np❑ Ir qt, SYster, Oa re tepee nt Fee ReSt. on $puare Feel THE ]NOERS14NXD SUBSCRIBER REQVESTE THE CITY OF RkHTON TO SUPPLY WATER AT THE PREMISE, NOTED HEREON AMID PROM SES TO PURCHASE THE WATER AND PAY THE CITY OF RENTON THEREFORE I6 ACC THE WITH NOT CITY OI RENTON'S SCHEDULE OF RATES WHICH SHALL FROM TIME TO TIME BE LEGALLY IN EFFECT FOR THE PURPOSE FOR WHICH RESUMAT[ONSS INO BE USED NOTL�'FORCE. RELATING OE THE µRCHASE AND SALE OF AND ABIDE NATE R. BTHIS THE ISCITY IN ACCORDANClSNITH RULES [ITYAND O! RENTON CODE, CMAPTER ], SECTION f-EY7. is Y<ility milling lgntl tc f Nci fn in eElw - EIgineerllp IeR It, Shp, Id - Cst tmer _ L y a en on rutug en �Te hr 3/4t66 Nkw tin - W F Uufl - A. I .dy %nvc - waft. steam srcreh M•923 j s s1i i U)d1Ei �n�-Ve1+r-'Mc1`vtt�cie^t � atlr+MMb*ula. �6rk aft _nh+` Main 3 {� s+e�oU_�RiSkN[_q.dt -i-.i>►�1�'-•.,sp1� �•Ilsfku^ . n 1 . 1 � � ,� IRYrdwr_sps.lk- 6 .. DCO (a1u 6� Ceovirt SMk- eerh+fA twh✓ t seef nFwV iv 6uwk Ew1! ekte tAo. wjp. w ah uFil f%' Ite' A. kft 6). eeu "lOw I.tit.Unl r ,I ` K, � nh noT_„dio.Ael.-vai9l. . L1. (ltaw /e6»3 ewi .�, Jd.e. Sep av $F. 2aa(0 an P. `laUw� 'Ro.d A in (yrdC, �e �+1- 3alb 1W, a1e kk JnU.._a,ab .� ( - """ �•• , Uhwer � cas. ke+�eelary ARas• e�. 'ti nedtirad✓ Mme+ � Y11a..� __--� yausoJr o a els.A fia1c1 areas whore uel vrle Woad w P.UolloJ maa/ kMf Sul Q/mr~ � rWen lln�el+a.. kMFrd 6y $1wh CFrr� rd 4ws. ' ��r4� %d flaw&- 1v biiay my lwt\\ . l V I Strwa i » ':a•+ ;. :�' t.wi �a: i.. tt� .ry+y • 19: AL^h+l . tw.y •v,r, . ',pi �.•1, ... .et Wdwy qr� p.. .� �.rr •.wq W -+.. ..y �.•.P,ywY w c .14,u 4W, `111\QU S�'I?� Q1CJvly liefr ll(LI•�1Gr�e1R. Iq � �a.� y �bf."'�;' v. wok 4 .41N k1 .r•5r en!► ,•. 'clw.a' .( ���. j���( 1brw.rti dclo✓ 1�n. 3?� E �Y..� "2A. q � Y Wlb WWI gr.atdr R00%. Ajti*wa dik% NOVA * r.prk� pe.- WSDo'r K" 1 kt m,e.nm1� C �r�N 1• Judea `wm Shk ie 6--,- rr Auceb..Y) M ' U,�e � V ♦ 1 .\M �y O 6 �, ) VWM 4 SnwiNa"r NNa- s?".w b \' y Gau �„ (�_;Y,Q,.b;,,, Cass-u�,� w�•• r +4 .� ��,z i n'S,..q memo to mCo.at t w pAM- N ftw TNY bl f CYV1 wse.,.a rnu VNvo Valid lot Recoed at ILpuss:W NtGit.:u 'tl. DAT r �.� n_•nr.1 T° jjCLU1y p•'aphMNKfYM� __ . \ �10�31 R1882 0 RECD F 5.00 rim NA M!1 CRSHSL **a S.00 11 swr c na BILL OF SALE ~ C.R.Koarna DSA Monarch Motor Inn C LNOW ALL MEN NY TH&cE PRESENTS 7121 r Renton 94 Cpmty of King ,SWe o1 Wash V. tM path M do ant pan to la and m masidtnefm of tba sum of One and no/300'8 Douses lawfd moot) of the Vatted State;of Aawlu,to them la hosd Pad by th. .ity ,,,,ton the Pam of the rased pefe, tM nmpt .be is bmb, actausiodaed, da,.,, by tlee presets greet eaRaio, tell and editor sa%do atdd pan. of the teed pan, net f1HD tA& dearibed pt.-t p" Y ass located at MC rA-t Valley Poe: Is Qe City of Renton .Carty of Y,ing sed Statt of Watliepm, wart, Wr 823 Approximately 860 LF of B" ductile iron pipe and one fire hydrant assembly, and 6 each 8" sate "1"s. 2 each 6" Sato "lees and 2 each 2" (gets valves •nd all appureesnneaa pertaining to said rater main, expressly warranting said water min Wimt any expenses, costs or lien hereto incurred thereon by, through or under seller herein. TO RAVL AND TO HOLD tee teed to tee mud pan v of the eased ►sin. estrutun admmismalan and smut fweet And vd pan' of t1w ant pan. for th._r hair tescutora a�iatatnton,covenant` and"m a to and with tee ted r,y of the eased pan, its tefa n uto , odmmaustor, sod amgw that sad pan v of tee err pan a t`.e o.rt of the srd property,gw&sad Jattels sad ba . good right sad full autbonty to fall the asme and that he win sa>mnt and defend the tok `eroby made mto the ssid P►"v of the osmed pan, its arvton,odettwatitum sad asrgee splmt all and rtwy primmo w parmst, wh®Yrver,lawfully chunitag of to cL`the ter, IN WITNESS WHEILEOF,The lad pa-1 of the afar part ha r 118 =to eve has had sad awl that ;a .. do) of ;yl:. (awe) STATE OF N'4SHINC.TON Y Cousty of Os UN dry pemlly ippsand bolas tee to ate ►nowt to be the ladletdusl 6onS6wd is ad who nommad the seam ud kwelomt .satntaum and -kemeWmed that dpmd do sates Y Mt and .htuatary an and deed fw the sate sad purpose thorn srabosed. GRMQ ado say head and o0cal sal Saw of N'Yasgsos. t UTILITIES /l E A 5 E V E N T THIS INSTRUMENT, made thiS_day Of by and betweenwAdiow,4/4.eee1Casaand and and and hereinafter called "Grantor(s)", and the CITY Of RENTON, a municipal Corporatior of King Ol County, Washington, hereinafter called "Grantee". V4 WITNESSETH: e4 Hs M That said Grantor(s), for and in consideration of the sum of S/_ C paid by Grantee, and other valuable cons.dera a on, Oo by {per these presents, grant, bargain, sell , convey, and warrant u.,to the said Grantee, its iD successors and asstgos, an easement for public utilities (including water end Sawar) with necessary appurtenances over, through, across and upon the following described property In King County, Washington, Tore particularly described as follows: :EGA:. DESCR:PT:ON A strip of :and 15.00 feet in vridth, the margins of which lie 7.50 feet on each side and parallel with the following described centerline: Beginning at centerline Static, 1923.50 on the East Valley Highway, lo- cated in Section 30. Tounship 23 North, Range 5 East, W.M. , City of Renton, King County, Washington, thence South 88'03 41" East 357.50 feet: thence North O1°51 "o" East 45.50 feet: thence 'North 88°56'L5" West 35'.54 feet to the centerline of East Valley Highway at Station 2083.50 and end of easement; AND coe>mencing at said Station 923.50; thence South 88°08'41" East 305.00 feet to the Point of Beginning; thence South 0:•51'19" West :2.50 feet to the terminus of centerline ease=ent; AND cotmt,encing at said Station 1922.50; thence South 88'08'41" East 357.50 feet to the Point of Beginning; thence South 01'51' 19" West to the South- erly line of Lot 2 of City of Renton Short Plat No. 0:4-81 and the terminus of centerline easement; AND cottapencinp at said Station :923.5D; thence South 88'08'4 " East 357.50 feet; thence "orth Ol`S ' 19" East 145.50 feet to the Point of BeginninC, thence North 01'51 '19" East to the Northerly line of Lot 2, City of Renton Short Plat No. 0:.-81 and the terminus of centerline easement; TOGETHER W:TH a strip cf land 31.00 feet in width, the margins of which lie 15.00 feet on each side and parallel vith the fo:loving described Center- line: Comrencing at said Station 1923.50; thence South 88'OB' :" Eas,, 107.00 feet to the Point of Beginning; thence Nort.: C:'L' 19" man. .3.�J :eat to the terminus of centerline of easement. EXCISE TAX NOT REQU i;;Enj i OR RECORD AZ ii�ilii przt,F x!AE Crtf QfIN ea-E eEcO E- nuh multapAL kX r- r u? ?K Nill tfE.S8. CAStlil .•a a�,OC 0:W,NA M UEIfI-I = _ W- 9,13 Said heretofore mentioned grantee, its successors or assigns, shall have t.ie right, without prior notice or proceeding at law, at such tines as may be necessary to enter upon said above described property for the purpose of construct- ing, maintaining, repairing, altering or reconstructing said roadway and utilities, or making any connections therewith, without incurring any legal obligations or liability therefore, provided, that such construction, maintaining, repairing, altering or reconstruction of said roadway and utilities shall be accomplished in •uch a manner that the private inprovements existing in the rights)-of-way shall Oi not be disturbed or damaged, they will be replaced in as good a condition as they ;,,, were immediately before the property was entered upon by the Grantee. �r The Grantor shall fully use and enjoy the aforedescribed premises, including j the right to retain the right to use the surface of said right-of-way if such use does not interfere with installation and main enance Of the roadway or utilities. tzHowever, the grantor shall not erect buildi s or structure r, under or across the right-of-way during the existence of s rh roadway and tilt ties. This easement, shall be a covenant ru ing with a and and shall nd- ing an the Grantor, his successors, heirs a assi Gr tors cove t that they are the lawful owners -if the above propertie an at t ey ve a od and lawful right to execute this agreement, f an d and _ STATE OF WASHINGTON ) COIMTY OF KING ) SS 1 I, the undersigned, :,notary public i• and for the State of Washington, hereby certify that on this day of _19 fj�, personally appeared before me H"ml'Y'.n wM. He, < i— and and nd and to Re nwnTc to be lnndivi ua 1 sL_R ed in anT_ o exwh ecute7 th_e foreqo.ng ins rurent, and acknowledged that }Y� signed and sealed the same as L��g free and volmtary act and deed o--1—r the and purooses therein mentioned. o ary Pub I I c in ancf or the Washington, residing at -�Lil� s �_ COST DRIN ANp-ERYE Jog SUBJECT; Monarnh Motor Inn CITY PROJECT NUMBERS: w- 5700 6natta VVa11*7 Rood — a TO: CITY OF RENTON FROM; E.M. RolmberF Conntruotton Co. UTILITIES DIVISION . 200 MILL AVE. SO. 3?(M 43rd Plaoe ts'a RENTON WA 98055 vederal 'way, WA 927-8v01 DATE; 4 dune 1986 Per your request, the following information is furnished concerning costs for improve- ments installed for the above referenced project. WTER STSTLN; Length Size Type L.F, Of ._ B -I WATERMAIN L.F. OF - --• -- WATERMAIN L.F. OF "—_ WATERMAIN L.F. OF WATERMAIN EACH OF ._" __" IJJ— __. SATE VALVES A EACH OF 6 ^ Lhd*L_ GATE VALVES EACH Of 2_ GATE VALVES Size Type SUBTOTAL $ 32.215.00 EACH OF _3)t — _jowa FIRE HYDRANT ASSEMBLIES S 1,500.00 (COST OF FIRE HYDRANTS MUST BE LISTED SEPARATELY). ' TOTAL COST FOR WATER SYSTEM S 53,715.00 SANITARY SLIER SYSTEM: Length Size Type __.. 6 L.F. OF 8 PVC SEWER MAIN , ._ L.F. OF —"— SEWER MAIN L.F. OF - - ""—'- SEWER MAIN 1 EACH OF DIAK1EN MANHOLLS TOTAL COST FOR SANITARY SEVEN SYSTEN S���,0p SIORN DRAINAGE SYSTLM: Length Sim Type a63 L.F. OF Z2 t70 STONA LINE L.F. OF STOM LINE 190 L.F. OF __ STOOK LINE - L.F. OF ._ STOW LINE TOTAL COST FOR STORM ORAIRAOE SYSTEM S 19,950.00 S1RECf IIWROYENEMTS: (Including Curb. Gutter, Sidewalk) each TOTAL COST FOR SIREET IIP t.KNIS ' BUILDING A ZONING DEPARTMENT W_ 97) � PRE—OCCUPANCY INSPECTION REPORT DATE Mini 10, wet ®DESIGN ENGINEERING UIVISION BUILDING FINAL UTILITY ENGINEERING DIVISION FIRE DEPARTMENT TRAFFIC ENGMEEQvJG DIVISION aLANDSCAPE/PARKING OM: BUILDING 6 ZONING DEPARTMENT EJECT: 'DY Mnhocn. I rM,Lb4A1�1Yr M PERMITNO. B , 1I345 h. 3100 E 1`+ TYPE BUSINESS 1pCMrCit tk, inA The subject protect Is nearing completion. Pleasc Investigate your area of responsibility and Indicate below e116e1' your acceptance or corrections necessary by �_ In order that a Certificate of Occupancy may be issued. Certificate wilt be Issued. II nu are recelvetl by the above dale, the BUILDING 6/' I1Z-ON14G/DEPARTMENT DATE _5/70I1t OM: i,�rlll b`lWl l.lYl\lLl�w Ih�pY{t✓ This Project is approved by this department sublect to the following correch,,: " SE Piz AeYlco Patina u�� onTFn s J I5��1,. DO YOU HAVE ANY OBJECTION TO ISSUANCE OF TEMPORARY CERTIFICATE OF OCCUPANCY9 ❑YES �NO Authorh��_.Si.wturc __ •!cat •Sy41L r Ia4.,++01 Two 1!� 4a01a I*" p nD ayyK, "4,ol /+'�• �/ `"h.1� .++aa)1 �avr1lY afa 1 W ac,l� `n0�rR11 /� pp 'A� ,0� iTMr 4aC1W(•Y, a\vp -1.0e1 Vu.. nD-M"$ W�UK Avo% Lvq\MR ♦ VA" o rid y''tro pros a�. 4°K •4!'9 TV"N»Y r, ss ,, � l n �— !0 7' +N^ ryr )e ta, e 1� (^_? ",4oft Y+ � J M A,-Svc(, • •Jr,rf 1, ��'6 J'�r•t~,IMr., xoC:(T, 44 tj&JmA 3° V1'aW ,ut� y,,lp ,+4k.. • VW11\7 • �!�'{acv � tT•\� Maa1 yT,�, n•Maul 4r0J 1a+^}vj• ! tq,•ao noyy 1••'M 1°1 `Y,q,oa o, Nov i1•yrlcr 11v •awwa Li ` 1 • y NTM1W • w�•i; ; . p+a}y,u >1�K "1 '�•,!�)' w,(TQ,T Wy�uaa w^a�- � aN.ap vn�Q i•4'I� paroy� �1.�.n 9 w u)•q .a\op Z •Mt �,y c•a. �• �\•yGY Q "•1� Yl•m j.al A pug ^V.w,a•A 1)9dG' P•„yc,p AMMV% ' Alw 1\02 L 7tL �'a0`A j Ya o7•oi •,� �• s•h ..!Yn Qy „H.� q,.> u,gc.9 � �ay,«1 �•\dol ► ,law)} �JaQ' ,�.� �1Y11 T'`�"/LS. M ,�a•aa, p"' �yaa�, M'�`!„J '1•MS "1 7•1(-} 4101 W"y ,Ivy .0414 AJ! U'alT •+ "f aatc V���II 141 1b •n11L v,w ! ► ,){+u atri w, WWI rklill y •m •w-aa. • rW� w►•n � •Dort + ua.1 .Qlpw Y...wN A+ t1yaan1 71%*Q& KG S 74�51�5; 4'i,•M y- ,'Miytl,� iG. ,wr �� � 4i..-3---s`v�►-� .,a_i���iwr.,wv+ Spiy6t�,Y .w � �y� ��_._u�..✓.� �' 'M.} w f S.�Od IV. Mt1\ w- u OF Aft w- 117 PUBLIC WORKS DEPARTMENT MAINTENANCE DIVISION t 3555 N E 1NC STREET RENTON, WA3hm1GT0N 96066 rED SEvIEoP BARBARA Y.SWO40CH MAYOR MEMORANDUM TO: Ron Olson FROM: Ray Sled DATE: July 11, 1986 SOBJU T: LOW FLOW TEST ON DOUBLE TECTOR CHECK VALVE METER. 1. 12:30 p.m. - Ron Druce and myself went to Monarch Inn on East Valley Highway to perform the low flow test. The meter started to register at 1 gallon/minute and was approved. 2. 2c30 p.m. - Ron Druce and I went out to 2 Renton Place for the same test for low flow. The meter started to register at 7 gallons/minute and was approved, but the douole det+ctor check valve needs to have the test cocks in tailed. Ray Sled T 1 Plx iM Y. r. - • '•9 fiR IP 1'0_1% tiArt_c SEkPI .;. IhKi A,,LATiI?fi 4cwn[ W. 1 TMT ��Ur EWfp. Dr.or W. -, 1Y Stup S.rvlu 4tM� + -S.l. Px,. t+ D.y.lapi 0.`P•In Utv Vas .] W❑ - U-C w ,..Y.tw Mo"- h.I~tI.I❑ CP. "i'lTAL { Otfly _ J M t.r SIU �� tf .��r4?��'� •yr � .. - 1, Tomoorary MY. . t Wl,r "..rp❑ WIII.�s(.i�J1WII����_--_�.�.—.--.. sa"sW EAoApt FOL w r Vos Cl W p 1• "Y_Pit* rI•. Prat Ktlwn l.rrlu T V..❑ W❑ jtr /� •OPU Fn.ta11W._ _....�__�, Loy.{ Dow i ft Un � n// CROSS EONNECTIDN CONTROL: Muffo,r ProUetlon psPlu Rpwl r.0 ra.r N, 11"n. ,rr of p.xlc.: Mauch PrU%.r. losPf bw O..Ic.❑ i O Qr.0 Vsly. OuwC It❑ A., or PruwrP V. Sruur p.r. No"of W. It.d.l' i.w.�y.J�—_ ertd W.. 51.0 pal, ".it. �n.u14. WUr'No '� 1 rl4 No. aP.r.r•. AYr '•N; v , , !.� ! T 1 ...:r: .. Plwvr. -} u ContrKtor's PLRf " A,.. Lrv.d Sr Wnton Your �'r s.attlsy.*r[D• S..ttU r CINIR,ho. 1o.puorr Sar.iP. Ayr.oa.at V..❑ W C2' R V... hors t Ycof/lrp Ns. •_ S.r.ip to 0. LPuud on on b..NRnt VU(Z W Q If g.a, ER..R.I.a AUFWdin NP. Is TWr. an E—Itlny Scut.S✓Pil, V..❑ NO aeIPLV. Y Tr11JKt W. V' n 1 W.{inp E.ar Corn Ay r.um.nt VU❑ W W'_ if V.R. Qpr.000t N•. �_______ In qn, or _ Aaar... ...�- fltY st.0 AIR Cp.•gs t —_. I� { Ew:1*,Tnt fr T.s L']. W❑ If TO$. l.aN NE�OE■SIGNED SuasplNt. AEQOE STS THEE ' MT WPYTYAT6R AT T+t �xt MtilS,��11OTFp`-so" "014;SES TO PEMCNASF THE .ATFR AND PAY TNIXI OE 6IIORE 9M.AC,ORDAN.t MIT1r1[ME lry SEk[OWS SCNEWN.E Of RATES PINION SW O A Y N,&,,ELT rug. 4t1L INEpSE PW THE VAT ER IS'TN RE UMD ACTED-HEREON, M E IT CITY OR RENTOyIj•EIA.Ef r"`•.ELN1iM1 OBOE•�ff�YPTG#. EE r , OiiTY RFGWATN Cf I SIMON ) 14{ A . T.II.w p S..rirp PI nP V. t Snpp m So11 +darr - 2• � t� 4 1 A+e r._._.. ...•.ice+ s,`. .r� - � � _ �k r Yr 0:11 TY /Wd1NElAiA1. li -•LIV AYEMWE S'.A.rtN E RE IRON.SIA Iwwc n ,lr MVE: 215.1611 JHGER Work Ord.r ko. 'ram^ p a Sun.ry S.,1. ro. L.- TOTAL ICE S M p ' }NtIN� Lo�.r dRl a Ethel, INpor.,V NYdr.mt (Ml.r' YN 1 W1 .l D mitr.P .A. S.. . E.rWt hot", p�}N' IMtK11M°' .^tom_' F I r. Prot.p t;upS.rvlc., Y.�//N, Da.MH11N 'r Cp~t.; LNFI 41 iptim� CWff CDIN,ECTIOW CAIITRUtJ A.cNfl.r, Prot"00h OVWIc.fN.irNtl '1'N WC3 If Y... : F.of D.plcRi wd. nd Pnuur. A.cEf law E.v I'F - pe.,Rl. O.era WIV.AA.A.AIV O Air .r brwn YAc Arr.k., .JA1 of w.io Nodes _ S.rt.l Ao. O.c. O.,)[. INIHI.d New M,. Addrw,Y-. 7 ^i!. P f! IT r ,.b [Ilv suu -zip AddrNN .' .•�— - [It Y•-•!•. SI.t. Zip nT• A,.. S..e.0 nv A.nlon bur LL:^ SNTt I.W.t.r`� W.tt W WAt.r Cea. Ad. Trepou.r Sr.4. Ayrewnt Y.,L] w0 IP Y... Apr.rMAt wc.rd by w. Sr.vic. to o. tec.trd on an Easement V..Gi ' yq.p If Y..' war'rnt R.cerdinp Ny. IT TMre .d Ewl.t INq_St.V S.rYic. Y..n IIalm 16RN.A.l1 Ppl.ct Ind- V- (¢ i A w E.latf^.y L.te-[oi..n-Ay..wrnl YN w[P iqr YR., Apt.r..Pt Np: _„_„ i sti In F.wr of Aden.. _ City -- St.N Zip ch." S ' SY.c OPM11 op il.t N v ,l� moo If r.al',ff{tP l.�.plopMt PM E.s.d oA +G 4r. 11"t SILDEI"011D tUs S IE46A REOUISTS YWE jCITY 9/,11ENTOM TO SVIPLYONATER A* Tn: Plt Nt aEY NOTID'NIRe P<'111ton .[ 'PUR tUE!}TNE WATER NID MT THE Cirl OF ILEE1SON TNIRPFORE IN ACC"' ! �11TN 'WcDITT Of § A( SCNRp1yt OFIRAVES WHICH [MALL sROn TtNL TO TjM"11E LEGALLY IN Et'PECT POA TNE PSIREOse FDA ' TNI WATER ]$.Toler UfEO NOTED'WERION,.AND TO E E+ YME CITY OF RENTONI!S RULES ANp Re it ONS FORCE R LATING TO TN q" 'WATER. YmUS IS IN AC.QRAANCE Wvm CITY. ,f1 L�E.t ►Tuz.4sfcrlq�is-=q T.11 - INit 1.WWVlp W.t.r Slpt ♦ ._�_:etc .. BUILDOO ♦< ZONING DEPARTMENO S- ;q} e PRE—OCCUPANCY INSPECTION REPORT N DATE r IAi 70, 11A DESIGN ENGINEERING DIVISION BUILDING FINAL UTILITY ENGINEERING DIVISION ❑FIRE DEPARTMENT TRAFFIC ENGINEERING DNISION ❑LANDSCAPE/PARKING tit: BUILDING 6 ZONING DEPARTMENT �IJECT: W x6trich• Lim ^ 111f PERMIT NO. B II�45 ,1�1. le r y TYPE BUSIIEIa 400hirlll MIND' km The subject project Is nearing completion. Please Investigate your area of responsibility and Indicate below ellher your acceptance or corrections necesssry by In order that a Certificate of Occupancy may be issued. I no comments are recolved by the above date, the Certificate w1: be Issued. 3UILDING& ZONING DEPARTMENT DATE S I2611 r.JM: lu +1- 601t tl.CGrn In yalk.i This project h approved by this department subject to the following corrections: � SEE Al"tAft1ED PuT+M Lhf OPTFO S'I5,$6y _ DO YOU HAVE ANY OBJECTION TO ISSUANCE OF TEMPORARY CERTIFICATE OF OCCUPANCY? 13 YES �NO Aulhont a urc 41.015 7jr5�dl Qea� Tmthl) �. Non•.t4 H I n a W atta _ I,n.lol� �,,,th 1... �n mrlte � 1 ,n<n 'Dt.ol. 1! !6. ?•DCvA 'T"/.tr., �tt,nRlee,3��.ren, e1e,t. holt, "OC,11, , ba A6 G.t,et..l '1f11gI ♦ S„,Q rt(O& h, lzwon u�V� E.3e J♦ack- 1 ers+t, s rtplkm 1 ?00'en e� bah.+, r..b 2.k." 6� W" kv :r V1 2�•� to E Ito,y ul _ kr"+ota o�1d wn�x , Yawa.� e.,�#,nq •,Pbtr 1+�M•nr nod w`w+•� v„16, 16s, '0 nth.k� AV mt%$ 6) l6 Z ')44' 64� M, E J+W,t 'Re•A [it,, vwlk dtu,a 4,r srk-e total 6a V564 fe.l�•A to mn\tr t. sr k S1MA , hv,tu 1 Il 'Rt"Oy aU ASTWE an•s ,n Parb+r? b� i.el• boa enthi .fa.W.♦- • rO&M UIM) nw.r CM,% 'E M% 6WI - ill • �1,�),1„!' � !L Gty A P*Ahm. �7 jt\W 1 etT, ,I Vft kthtr Qi tE A: hviF (#am, ct.1+� ,� M� a P.,�,nw•,l Fn�•.•r k \ AL ulnkvn.0 y\tntn 'k ]entYntq Wwv bX,1a., �„nm ♦ 'A q,�l.� )town ytptd+•, 0 i �(1 ,(✓ rr,ny.tt{Jn •asw, aU. 1 a - ��.� 1vt,. Men fp,,.rtrol. 2`,5. 4.�t• nn Shoe £ >j.lt„� "Rwd . "Qa,►.a W.. a aiMN 7 In>Fall 1<n<n 1�.e. Pyx mrtr. ♦ \ ,n.n Mtvlk q4 (n. S� DcvA .¢t airs 3lr,nkkl Sy�hv,. 11ow 6 Vl' -U(.JA *'A.A $I S'\b Cai+a vf.,+a, Ijlsos f ,r bell. n Strn Nc ♦ fc Piaa �iurfirn brab... ;r.b . .�,k•.,r !;a Y♦4,. 4w St. 20.0 n i uaur� OQA .. 4eMora fold .w,V o Sawc v Nnh nr, a�PL,lt �.r...nY e.,r1 rr.+•h w,4'n lax b ++tfwnit• .y aaa.y kI) kA. 2 Ya4ve ba+.+ on F d.Yti 'Rs.d . li,a pcV+ tkv,tt liar la.x ;�,h•r syare. tao4.1 yk 1< ..,,;¢.d {rsta • Sr.rt ttpsrt b a. U+ ';P"4 +�� Fnat. �•rt. PRv,a• 11 renow all ay�flalE as♦y •r P]rll�n� 1.4 innk tihou cr.cka r) .tail..•a • rr�laa %,Ih ttrw Cb» $ n Ph It Lfitan ♦ Ire,m N+rF l.++a mkt, i. yaSfnt ku 6 Qlnba e"r a,, % "1, .( a[u�+na. `,kha Sk.b C' snob tukth. �aS.n.F iv Nr G6l # '12nntn, 1,lkti�y tr,.�t btpY 1h. .�aUw. AybadF �ans, t..h�.i tiny a � l Cvgrnw , AL eMkam� t Atnrn Suntka,y vow i .k.-Q Arlk Ua•M, ;*- ♦ '.AW44.y Scw.t ytpCc«, 9 taU . e v4.",u4« �w ntl a1... ;ton.y 64- 2�5. 2at. f TICE OF NEW FIRE HYDRANT IN—S iCE e NAME OF DEVELOPMENT —" 7fe• ADDRESS i" i''• ' - _. INSTALLATION CONTRACTOR WATER PROJECT NO. i i NUMER OF HYDRANTS 4 HYDRANT LOCATIONS (FOR FIRE DEPT. USE ONLY) HYDRANT W. 1. 2. 4. � z 6. INSPECTOR . c 6 •ILDING & ZONING DEPAR•ENT. PRE—OCCUPANCY INSPECTION REPORT w- a s•sp DATE F hr,nrn' 24. 1R6 fl TO: C�'}' _ DESIGN ENGINEERING DIVISION EI BUILDING FINAL �UTILITY ENGINEERING DMSION 13 FIRE DEPARTMENT TRAFFIC ENGINEERING DMSION ❑LANDSCAPE'PARKING FROM: BUILDING a ZONING DEPARTMENT SUBJECT: Dr. Allenbach PERMIT NO. 1111345 37nn FAtt Vatler RA TYPE BUSINESS Monarch Motor Inn The subject project Is nearing complaflon, Plea" Invesllgate your area at raonelb111y and Indicate .a below ORher your Accep' nce at Corrections necessary by Marih 3,198g6 In order that a CUW "fe of Occupancy may be Issued. 1 no comment$ are received by the above dale, the Certificate will be Issued. TO: BUILDING 6 ZONING DEPARTMENT DATE -3�'I if FROM: A9,vhUW (4Fn1A - Pf5,6v I j1"I C Tan This project Is approved by Inn department subject Ic the following conectlons: i �7E6 ATTkfHt'p PbdiHLiST � .' sh�l I I !I DO YOU HAVE ANY OBJECTION TO ISSUANCE OF TEMPORARY CERTIFICATE OF OCCUPANCY? I ❑YES ONO QL i Authorized Signstme. fOF4 4 1'M Th. ?i14 D6 4*(R* IM Nowrch Nay✓ Inn 1ppteQ - SE+att. y1DRw 375rrrn y'F2.1 1 s ;1� U.1Q'(Ft. In�lall Ua\ae- muY atkns+.ny ,�'+ <ill llalte muh }kwf are m,.•l[. lh.n 3 1� St1aU �nc�\rd gpdt . • rnstAU va\�. +nnt�m trueF ,ntw h.�t0e1' Laid, one ceak e� Pnu+vak,+c Pw.t. �n h,nanen a( ytuw pN �ztn+e. Sett �u nr euir .�r. Midwv vault . howl Dcvk 'tth.�:<a kWha "Ir- rePrrY +u lth4q Fn aetYO. Naha xg4cahon a!- I64i fnr Ite. )b h(kro- 6) ItWIt a..tev ,natick f .AL TLVO, \ofa �adlocl. 4V t+E Ind:aalw uwl+e. . vltmn Aebris 64 . Ja1«. Ser ar S!a 20+(0 as P. JaU r,a •Read -{ in OrdA kb 44- Valle 1@ty .nl0 A4 Jn\Je. I1 � 1R" al.dc 1tuvaA Qtwd'. J�� SQwrael� • aSwh•Or b4{el. o,✓tas k&V*t ultV .far welt nnaA. en F VnUt12`+ad, Uaab hul�w Q►a:r. ,�+ "lwn �rri�dlm AaY.I 6� Siw4 [ere4nrd thw-" stwi RS oM to Uli4ry F.y 5k.ntty IIMMd ti rmtrd mew SawrYa,.� lewrn rnawh.la 0« �d 8,a. et 6wlQ;� SFmtt- 5'fct7 Qvw,Q ouY 04 takk �W*n j (baba m.aah+Q a et.nta- &e IIS In CcAck baey, ;EWHL 4nhnr COO, 6,0-s al•- Fk.. 2 Ttw am"Wa.,r atE. Ilolloa Q••tl 1 n1\alA !\-(se are,•& Mt✓�uw 1\+.chn't in 6%,m6t r"Q, P.. 4 Setwel 1}- Mankd UQLI 4 .61 _ESa yb � tIM.4 (lahh.. . 3/411 c� IVW len. 340. E �1a 4d. 'T a~ ee'Mwt,Y fa~ Ci grcaedr . �tx au yalw a%t6 1 «eu► ,w �ura.� 6F " b tllai► aw,Jwa C6k� bq9;M. LIB . ftS�Ke Vt; w' a:hti ewe* A k�Wremenll C rt � G �Jw,w S hL ie 6vws. Dr /YJtwbw,A� 4w nowt 4 smq*b-_ AO,- Nett dM> MJ e.s� 364r•, 6A � s$ , sI w1 A. `{-b t v4U .Iol rG-�1S Qa.G'on l 25S uN�) w9.w bu w4He j�..j AW-L c .✓ 1.,�... 3/•lrc. •IlOINO i 20NIN0 DEPAR�ENT PRE-OCCUPANCY INSPECTIOV REPORT DATE h,br, v 24, 1986 TO: DESIGN ENGINEERING DIVISION OBUILDING FINAL OUTILITY ENGN£ERNG DIVISION OFIRE DEPARTMENT 1 OL TRAFFIC ENGINEERING OTWVON LANDSCAPE/PARKING b�V II FROM: BUILDING#, ZONING DEPARTMENT SUBJECT: 1) All—eC= PERMIT NO. PI1345 T7IXI sl �' l lev Rd TYPE BUSINESS Monarch lbtor Inn The SUblect project is neannq compNtlom Pleaw e+vestlyala your ati of�Fenewmty end eldlute below anMr your acceptant* or corrections neceuery by Karrh ',.986 bi Cerllllule d Occupancy may be lesued, / ro comments we ncNkved Dy tha •cre duel, the er DWI a Cartdlule ertA De mowed. 70: BUQONG NS ZONING DEPARTMENT DATE FROM; This project IS Wk tov*d by this department sublet, to the tollowlnq conecllons: UTILITY ENGINEERING ,,l,vrMqc, ilia ' B Lae YVENf08Y AMILT "AD ON sTEf711r a M N*fif M OO F c p—M SUBJECT TO REID INSPECTION BY— N YOU HAVE ANY 03,/EC 110N TO ISSUANCE OF TEMPOAARS 7kRTIFiCATE OF OCCUPANCY' CIE, ONO Authptlt rd SIQr1elY/r Li.F a 1>0 PUBLIC WORKS DEPARTMENT �Q BUILDING DIVISION CITY OF RENTON, WASHINGTON APPLICATION ONLY - UNTIL VALIDATED PE me Amer Incatior, of Wcrk Address — INSPECTIONS FEES CONSTRUCTION _;ieSwer PERMIT 'light-of-Way Construction Sp. Utility Conn. Fee - Water Water Latecomer Fees (Public R>qht-of-way) Water Imp./Approval Fees Sp, Utility Conn. Fees - Sev, : Steer Latecmer Fees Server Inap./APprc+al Fces Late Issued Inspection Fees '+ Special Deposit - CASH BOND Expiration Data TOTAL. FEE Description of Bork and Number of Feet Contractor I Business License Address -- Bond Telephone IT IS I:NDERST000 THAT THE CITY OF RENTON SHALL BE HELL HARMLESS OF ANY AND ALL LIABILITY, DAMA,;L JR IMIURY ARISING F" THE PEFF'CRMANCE OF SAID WORK. ANY WORK PERFORMED WITHIN THE RIGHT-OF-WAY OR ON SEWER PAIN MUST BE DONE BY A LICENSED, BONDED CONTRACTOR. LOCATE UTILITIES BEFORE EXCAVATING. CALL 235-2631 FOR INSPECTION. Call between B AM and y AN for APPLICANT inspection in afternoon: call before 12 Noon the day before for inspection in morninq. Pt-RLIC WORKS DIRECTOR SPECIFY TINE FOR INSPECTION. CALL 235-262C for street signs CALL BEFORE YOU U16 BY and lighting. 48-HOUR LOCATORS 1-600-424-5555 *CITY OF RENTON WATER OEPARTMENO o Pressure Test L Purification Test Form PROJECT Nr. W-o et .46C9 NAME rr PROJECT: lowltIN 'M t(dl - 3700 C 'Jil kcal PRESSURE TEST TAKEN Bt g14%l . (y,1S'4' ON IC fll AT A PRESSURE OF 2$G PSI, FOR ��`i MINUTES TEST ACCEPTED ON td��(P`I Lp E. PURIFICATION TEST TAKEN BY AEd,.. (r l.' ../ ON PUR1iICA710N TEST RESULTS, SAMPLE ♦1�'d {I SAMPLE 02 lc a A..6 rv: .j Y•r. SAMPLE A3 yA"., ' PRESSURE COMPLETE AND PURITY COMPLETE Q N0 connections to mains or meter permits issued until above box is chechtd by Inspector. REMARKS: SIATF W WA"Ne"N'l I w j Fall W WASNBK i•-• OEFARTYFNI Or SOCIAL AND Rfa1 a.h ') EVw:W BOCW RPO MEYIM WYIpEB WATER BACTERIOLOGICAL. ANALYSIS I WATER BACTERIOLOGICAL ANALYSIS SAMPLE COLLEOIfIN READ INSIKU:"DRS UN BACK OF UOLDENPD COPY SAMRfE COLLECIWAl REAL INSINUCTIONS ON BACK OF DULDLNFPD COPE 11 In«Fuo\Wn[ere nw folww ,MMPM wUl 0e nl"A" It In«fucllonA are not followed,Aarnple will W nk"Cg6 PATE COLLECTED TIME COLLECTED j COUI NAME I DATE COLLECTED IIMOtot,41EVED I COUNTY NAYIE yLy11N DAV .4P /.A - MON W. V[aR 1 L 10 10 f AM ❑JPM- K Elfb IO 40 $ 1—A-M 0 PM KIM4 FYPE Of SV61EM rt PUBLIC SYSTEM COMPLETE 1YPE OF SYSTEM IF PUBLIC SYSTEM OVMKF TE ❑ INDIVIDUAL.L 1NgVYUWL I.D.D.NO. ••� I a 5 0 L 7 D E T❑ LD.N0. 8 J O L ©2 7 i NAME W SYSTEM O MJM♦E OF 8Y8YEM^ 1 CI'EY Of z0filo F/ _bMB6LR&CYN�:;C I.e OEµC AY!KNIDtXr✓wEM«•'MRYA ES.Y+LYyAc.I fN CpUL IFCIE S+SRY•R O MMV:)P YQEN 3SL;f D TFMO q.pfA ,Wf CSILi IF S"SQM A YA lPShur LAf aom,W !4fRsNAR" M 25- NfA.In RAO U06 2,io AD rS li 1Lab F SAMPLE COLLECTED bI INwIN: SAMPLE COLLECTED BY I. Isubj 61. An.% ke I(LAeF iFAI., SOURCE TYPE T T EOYMCE TYPE .. 1, C SURFACE ❑WELL El SPRIPA, ❑PURCNASED (�LOMBINATIpN ❑SURFACE ❑WELL ❑SPEUIq OOTHER 'IURCM45EU COMBINATION l�ur MPINA 1 C OTHER BINA SEND REPORT lO IN•nl f n i; I a4Kw.ra is C,,, SEND REPORT TO.:FI`nI f E Y eF BCKA AlF 1MN.FL _ ir� E he E_-I+-I Wn1FM YL Ef NE pa' Sn NC 2`1 SC-- 1 w.,n~oN Q�7� 1Y r%�11W SANI'LY 1Y I%-{�IOF AAMPL[ 1.Ll DWNRINO WAIEN ❑CNIgN41N IRNWWI._TPMI��FNMI 1_LJ LftO0UNOWAIER ❑CNIp:MIM IRBS iuRI_IOW -frNl EMLa P.Ein en1-.BY ❑ F:IIMW ❑ winke1W W DRW ❑ u.n.Nnl w On., 2 CRAW SOURCE WATER 2. RAW SOURCE WATER 3, NEW CONSTRUCTION ur OUAfBS 3. O NEW CONSTRUCTON n JAIMWS 4 OTHEFISpeC:IY: __ 4 a OTREP RDwNY, _ COMPLETE IF THIS SAMPLE IS A CHECK SAMPLE COMPLETE IF IN*SAMPLE IS A CHECK SAMpaE m l`Ouy I"lnl W1 YP,U.I atl AY PYIEVIOLW SAMPLE COLLECTION UAIE PREVIpU$SAMPLE COLLECTION DATE__ REMARKS --- REMARKS __kv0 LAEORIAT011Y RESIHTE Rw LM WE WILYI LASCRATORY RMLTS LAB WE ONLY, MI`N COIIFONM STp PlaiE COUNT $AMPLE NOT TESTED MPN COLIFORIF STD PLATE dOUNT SAMPIt NOT TESTEU •{ BECAUSE BECAUSkEl 1 ,Q KS.....•.• .... gym.. Q�D:r P:... Imp I�., MPH DILUTION TEST UPI $R W T.OM ` MPH DILUTION 1L5I UNSUITABLE L: S.InPIn Twl Ow { ❑ Gonnunl Ol..In ❑ NPI In wuN•CPnlun« V�W nu T Gun!Iuanl Orw U Tapl:n qup.r CnnIwINI ,LJf1 MF COLIFW W MF COLIFORM AVI 2. 1N1C 1nw111c Nnt In1OnMLron 2. TNTC. ❑ P,ENW*k-I ....Rev^ mak /4 F-t ❑ ROY:UW-PIAnPn, ` ' Pa"Er'I -%NNR14Y 3 LJ ENPN OFOI`0 In\{fYC1WR\OIIFMII 3, y E.C\N MOn4 PNNµNWN JI fMn: .1. FECAL COMFO FECAL GOLITOR u MPN ❑Mf ❑ MPN 0 r 4. Cl ❑ / 4 L7 — q,•----- FOR DEIWILREO WATER SAMPLES ONLY THESE RESULTS ARE PON DRNIKEHO WATER SAMPLES ONLY 9kRfSUL IS ARE IK SATTBFACTORv Cl "SATISFACTORY �SATgFACTORY �ISATISFACIOfIv SEE,REVERSE SIDE OF 0I(1 N COPY FON EXPLANATION OF RESULTS Ski REVf NSE SIDE OF 4RkkN C,IpY F(IRgAPIANATIL`N OF RE5ui TS Lwe No DATE.IIMS%CMVfD- RECEIVED BV II 41R NP. WYf I., wCf:VE RYEE�Vk4 M. L 1J ti]L_ �I \ L/ L4_ —I W IA M. -I I. W kRkMR 11W4•in. MwARNY n /� �y. RkMPM6 /y"'faE/Ej/ I WATER SWPLIER COPY AI gy WATER SUPPLIER COPY RY ll OF u aEAaw"cut cut BFIamum 'm • ! �11VMiUEF11 OF ao me NEM WATER BACTERIOLOGICAL ANALYSIS SAMPLE CULLECUON %AC,NSINUCIIDN$ If Inalrucl"ere n01 tdlgeeG, ON WCF DE WILDLIACE,COY, Eemple WIN pa rslaclao GATE COII ECTED TIME COLL D F COUNTY NAME — wxrR oAr EAF. +M PM k 1N 4 IYKG8Y8TEM 6PUauC STSTEY,WMPUTE �O W E.D.No. y p 5 0 (, l„M> Ewa YanM Ot ! • r �1 tx "$eFr:ca• nFEanMC W��-0N WMM SAYRf'.OLIECt! wn ..Wna wry VSIEY ueR[R,LIT FRIA Mp— Wlla- ME...a MAlat 1ZAY SLED i ' Nq/YIW p% '�- 1 SAMPLE COLLECTED a SOEMCE HK • G ❑SURFACE ❑WE" t•J SPM —1 ND ❑! NASED R�OMYINAi10N 1 SEND REPGFIT TOrPrml Fwr NWr� OTHER AyFraL% Cuyr • E �' F- - �elhl arllL 1_ UMNNINOWA,Efl ❑CNwInrIW IReAgwl; 1F to rNlmynl�� ❑ F.,w, ��IOYI��Fgy: j1. ElUnIYFNM Or 011yr 3 NEW NSTRUCT W CORAW SOURCE TER I ION a Miyleg A OTHER ISPeoryl1_ COMPLETE IF THIS SAMPLE IS A C —MECK SAMPIE -- rN1 V'.IWS rAE MO RPERME WAROOaS SAMRLE COLLECTION ---��_3,t._3 _ _ LMOIIATpl1r --'--__-= MPN GOLIFORM 6T0 P Ts IF Wa OMIn UTE COUNT SAMRLf NOtr 9ECAUSEEStEU ; MPN tWYiToR `"" I T TEST UNSUrtAa\E ❑ SFm I t PF oc OM MF COUFORM G'oel F-eRYel in PrnPW CwrMrMl u Z_ ❑ TNTC Q In%unrCNM Inro.nYlr:.N1 FLCAL COLIF •a.Q ErteEe GNnF IMhKRpnad FarTFO MAN O RIF 4.O D" FOR CRINKINIQ WA -- T�fiAMPlfb ONLr. SE RE9y113 ARE I m FADTORY dWSATRFACTWY j SEE EF 11e WEtIaE atOE DF GREEN COPY F 1 W rl0 wn DRI%PLANA}ION Of NESUFIS nME AE.eN _ I \ RECEroE_per � V1n pF ua"l 7 tORr Alum" �. .WATER iUKLon CO►r ' al CITY OF BLHM 200 !STEM AV&M SOl ip R'Tfinp NA 9lOSS L ATTOTION: MUMS MIGHT ,� p Sv$ncTz PROJECT 'nnn: W_ Dear Ms. Haight: ton an MreM authorised to he" t nc= p he Tlnae �eWrteant bills Addremee city: b ion: r D Xc^�flRr-�.c for time acd flare. `—"d-Z--��1 Prolaat, The ork Uldfa the related Ater wrk cc the above referenced mmcr%ed ee follaee2. Pegg truly voura, WATER AND SEVER PROJECTS PRESENTLY UNDER CONSTRUCTION IN THE CITY OF RENTON WATER PROJECT P 6Y S'z SRTIER PROJECT 0 ' JA:i. WATER PROJECT TITLE /it^tAtt! ( /Yf.c rr PROJECT LOCATION _ -iZ tt. DEVEIOPIP ADDRE:S PHONE EMERGENCi PHONE CONTRACTOR + !' - ADDRESS !- PHONE EMERGENCY PHONE FOREMAN cn •iE _ EMERGENCY PHONE City of Renton Insneetar ,� . �r1S�2,(i) Other Insnector__`_. ( � �w1� /2Cn�R•.e�1,[w� c 4// r r+ PHONE CALL ATI °18i4tR- w�kiE:uL•s+a — fu vo✓. 1 PUBLIC WORKS CEPARTMEr BUILDING DIVISIIIN CITY OF RENTON, WASHI%TON PERMIT APPLICATION ONLY - UNTIL VALIDATED NUMBER Omner ; :neat ion of Work Address INSPECTIONS FEES CONSTRUCTION "de sever Storm Sever PERMIT Rlght-of-Way Construction Sp, Utility Conn. Fee - Water (Pvhlic Rrghtrof-Way) Water Latecomer Fees Water Inap./Approval Fees Sp. Utillty Conn. Fees - Sever Sewer Latecomer Fees Sever Insp./Approval Fens Date Issued Inspection Fees Special DePoalt - CASH BOND _ Espiratlon LLeto TOTAL FEF i Description of Work and Number cf Feet Contractor a_�m - Nus loess Address License _-__— Bon . I jTelephone 1 iT IS :NDERSTOOD THAT THE CITY OF RF4T-,N SHALL BF HELD HARMI&SS OF ANY AND ALL LIABILITY, DAMAGE OR INJURY ARISING FROM THE PERFORMANCE OF SAID WORK. ANY WORK PERFORMED WITHIN THE RIGHT-OF-WAY OR ON SEVER MAIN MUST RE DONE BY A LICENSM, BONDED CONTRACTOR, LOCATE UTILITIES BEFORE EXCAVATING. CALL :25-2631 FOR INSPECTION. Call "t"We R AM and v AM for APPLICANT Inspection in afternoon: call before 12 soon the day refore for inspsation in morning. P;.BLIC WORKS DIRECTOR SPECIFY TIME FOR INSPECTION. CALL 215-2620 for street sign, CALL BEFORE YOU OIG by and lighting. 48-HOUR LOCATORS 1.800-424-5555 ENDING OF FILE FILETITU WT