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CALL 1-800-424-5555 FOR UG LOCATIONS TWO DAYS BEFORE CONSTRUCTION
'EJ lOCATES REQUIRW
FILENO ___
'-'0 SR REQUIRED
SR NO
'B TRENCH REQUIRED
PUGET POWER 170'
'E F"LAGGLHS REQutr~[O
CAL lED
r<)Q 6':\ 11.1t~
COMPLETED By _~__ lNSPEC1ION NO_
CALL ONE NUMBER FOR UNDERGROUND LOCATION ASSISTANCE PHONE
THIS SKETCH IS NOT TO BE RELIED UPON FOR EXACT LOC".TlON or POWER FACILITIES
CUSTOMER
I" .'
:;::::~ WORK ORDER NO 69038 /4 [ ..'
SCALE __I.:: L,~)~ WORK SKETCH SHEET or --'-- or ~ '.
~ . JOI~TFACIUTI:S ARRA~G~~~,~~S~~~~T~~~ UT_;~:~~ =~-_~~ ~~~S~~~~::~ON:::~~~:YIT~~OR_CHARGES ~~~~ C~ECK i....... :.', '. '.'
JiC NO -_'_..__ JfC NO t"" __~___~_____._____._____ ~'.', ',...
O1HER UTiLITY _\--_u OTHER UTILITY e __ t----
[NGINCER _. , 'U' ENGINEE" _____.:,.,.,-_ f iii~ff,k<i:TR-ANSfORME~~_M_OV'"NS2:^-'!o_ ~:+- " ..
i, \ f-.... ~~_~.!.-~~ANSrO~~~EMOV[/tNSTAl~_. 58405 " ,:'",\:,>~':":,':
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0994
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jelferson Stlllel
P.O Box 1220
PorI Townsend. WA 98368
(206)385.9160
N::
District Nu.
5
PERMIT
In accordance with all applicable Revised Codes of Washington and amcndrncl1ls thereto, and subject to all the terms, condi.
tions and provisions written O( printed below or 011 any pan of this form
PERMISSION IS HEREBY GRANTED TO U.S. West Crnmunications
611 6th St., Brenerton, WA 98310
lo Install a buried cable and a buried repeater on the North side of Paradise Bay Rd.
at mile JXlst 2.25.
R,Q. - 89-8-5540
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^,PR 1 i989
JEFFER::;UN CUUNTY
PUBLIC WORKS DEPT
County Road No. 503609
Franchise No.
Milepost 2.25
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
received instructions from
This permit shall be void unless the work herein contemplated shall have been completed hefore March 28
Dated at March 28 . 19 89
.1990
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CALL 48 I
HOURS
BEFORE
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GENEIlAL l'Il0VISIONS AI'I'L1CAIlLE TO ALL I'EHMITS
This permit b subject to <Ill applicable provisions of the RCVN:d Co...!c!> of Washillgton, c),ccpl lhal all} provlsiolllllllw. agreement not l.:oflslSlcflI '" ilh
such resolution shall be clII1lro]lillg.
A bond ill the amount of $
is rC4uircl.l for tile protectioll of tlie COUllt}' a~ set fonh ill the term" of the bond.
During the progress of the wUlk such barriers shall he crcclcJ alld Illailllailll:d U!> 1Il1l}' II\.' I1cccs\ary or as may he directed fur thc protection ulthe
truveling public; the barrier!> slmll he prupc'rly lighted .It night.
1/1 accepting this permit the p..:titiollcr, his Slll;!;c!>sors alllJ assigllS, agrees to protect Jclfc/sOll ('oum)' and save ill1arlTllcss from all cl<lims, lIt'liom and
damages of every kind allll description which may uccruc III or be suffered hy UlIY I:k:r!>on or perMIIl!>, curporatiou ur prOI:k:rl~' by rea,otl 01 the perfor-
mance of any such work. character of muteriab L1!>cd or mall/ler of il1!>tullalioll, lIluirllellarll.:c and uperation or oy lhe improper OCl,;UP,I/lq of right of
way or public placc or public stru<.:ture, and in case UlIY Mlil or :let ion i, brought uguillst said Jdfcrson Coullty for dUllluge!> arising out of or by rCUMJII of
any of the ahove causes, Ihe petitioner, hi!> SUc!;c!>!>ors or uMiign" will upon notice to him or thelll uf COlTllllem;ClIlerH of !>uch actiun, defcllu the ,\:JlIle ut
his or their own sole co!>! anu eXpell!>e anu will satisfy un~' judgment after the !>uiu suit or uetion shull ha\e fmally been deterlllined if ud\'erse'o th~ Jef.
ferson County.
Ellcept Wi herein <.IUlhoriZt'd, 1IU "XC/H'Il/iull shall he HI,lde (Jr ()h~ti.CIe placed wit/lit! IIle lirnit~ of a COUflCy nl:ul in SUdl a mamler as to intafere with
the travel over said road.
Except as herein authori/.ed, no e,\eav,llioll shall be mauc or uh,wcle placed wlIhill four 141 feet of the edge of tile pavelllelll.
If the work done L1IH.!er this permit interferes ill all)' w.ty wilh thedraillage of the county rO'-lJ, the grantee sllall wholly allu at Ill!> UWll expcllM: lIJu~e
such provision as the engineer llIay direct to luke care of said drainage.
On completion of said work herein cOlllemplaled all rubhi~h and debris shall be immediately removed and Ihe ruadway and roaJ~iJe shall be Icrt neat
and presentable and satisfactory to the engineer,
All of the work herein COlltemplateJ shall be done under the supervision al\ll to the sutisfactioll of Ihe Coullty Engineer ami the entire expense of said
supervision shall be borne by the party or parties 10 whom this permit is iSSUI.:J,
The Department of Public Works hereby reserves lhe right to onJer the change of location or the removal of any structure or structures uuthori/cd by
this permit at any time, said change or removullo be maJe at the sole expense of the party or partie!> 10 whollltl1is permit is isstled, or Iheir ~UCC"sor5
anJ assigns.
All such changes, reconstruction or rclc)(:atiOll by the grantees stml] be done in such manncr as will cau" the least interference with any of the Coun-
ty work. and the County of Jefferson shall in no wise be held liable for allY damage to lhe grantee by rcason of any such wmk by the Count)' of jeffer-
son, il agents or represematives, or by the exercise of any rights by the CounlY upon road~. streets, public pl:lces or structures in question,
This permil or privilege shall nut be deemeJ or held to be an exclusive one and shall nut prohibit the Coullty from granting other permits or franchi~e
rights of like or other nalure to other public or privale utilities, nor shall it prevent the Cnum)' from using any of its roads, strcets, or puhlic places, or af.
feel its right 10 full supervision and control over all or any pMt of them, nOlle of which i, herchy surrenJered.
The Dcpartment of Public Works m,lY re\'o~e, amend or cancel this permit or allY of the pruvi!>ion, thereof at un)' time by giving wrinen notice 10 thc
permittee, The permittee shall immcdiately remove all facilities rrol1ltllc right of way, AllY facilities rcmaining upon the right of way 30 days after writ.
ten notice of cancellation shall be removed by the County at the expeme or the permittce.
The party or partics to whom this permit is issued shall maintain lit his or their sole expense the structure or object ror which this permit isgrallled in
a condition satisfaCtory to the Derartl1lCllt of Public Works.
SPECIAL PROVISIONS,
1. Cable shall be a minimum of 30" below existing Jitch line.
2. ~PElatl'!l'""'s., \%'i~' \'i' buried outside of ditch line.
'1'li,nhLi~~I~ (",
3.' '~~~iC!ifftl ~ ifJw responsible for all damages to county road right--Qf-way.
In accepting this pcrmillhe gralllee, his successors and lIssigm, agree Ihut allY damage or injury done 10 the properly of the gruntee or uny cxpense
incurred by him through lhe operlltion of a contraClor, working for the Cuunty or lIny County employee shall he tit Ihe sole cxpense ofllle gmmee, his
successors and assigns.
j /! () " 1 ) , 1i "
;1..; lj TO, L/J(j..J"{'Q} {fir;; /)7 L/', tile undersigned, hereby accepls this permit subject tothe lerlllS
~11~ c!~~;~~;~:, herein :~~I' de ow
Dated this* 4. ouy or* !JfL\;'} ,11).:>;t81
>J< V/'-(c(,,~ e {~)?/ll..,l...Arcl___,
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fee Paid_ y~ _ No
la20 Jellerson Slreet
P.O. Bolt 1220
Pori Townsend, WA 98368
(206) 365-9160
R<<:e'l'l Nu
Addr~!>5 Requc!>t _ Yc!> _ No
Mile PO!>!
Al'I'L1CATION FOR "EltMIT
To Department of Public Works,
Jefferson County. Washington,
The ulldersiglled U S WEST Communi cati ons (PNB)
herebyappl_ /orpermis"jolllO dig pit to locate cable and place a buried repeater.
lAPP/II III" '"II,I""''''~'I''/I... ...hullH' ""'/11'" /"';0 I
Paradise Bay Road. (Please see attached sketch)
S'16
T -28N
R-l E Routi ne Order 89-8,5540 ?OITWOLD..U
Telephone Company Engineer, Jim Williams, 478-4404
SKETCH:
RECEIVED
SEE ATTACHED SKETCH
MAR 2 4 1989
JEFFERSON COUNTY
PUBLIC WORKS DEPT
011 Coullty Road:
bel ween
(-'>lIl1o""'II>I"lf""\-\/'''''/11f ,mlt'{HJlIl/)
and agree_ 10 do rhe work ill accordance with your rules alld regulations and subject to your inspection and approval.
Dare March 21 19~
~~~, ,e...."",""
(It IlpphCll1ll IS II coparlnerslllp, set fanh names of copartners)
A,hlfe\-\
Ad.1!e\\
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Jefferson Co.
DEPAnTMENT OF !'UUUC WOnKS
District No,
Ii'
Pet/lI/t No, c? 99-+
Supervisor's H.CIHut No,
Supervisor will make detailed report with his recommendation Oil Ihis applicatioll. Whenever possible show sketch of proposed
work. Supervisor will also make addilional repofls alld fillal repOrl gil'illg dale of completion of work 011 Ihis form.
Preliminary Itcport:
PA-f'..'l-\:o."',", ~".'I
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Si~ned:
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Dale:
Final Report:
PERMIT INSPECTION REPORT
. \ / Work covered by permit has been completed
satisfactorily,
Work is not completed.
Recommend permit be cancelled.
Traffic control.. adequate
. inadequate
REMARKS
Onle:
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jellelson Slreel
P,O, Box 1220
Port Townsend, WA 98368
(206) 385.9160
DiMricl No.
5
PERMIT
N~
0083
In accordance with all applicable Revised Codes of Washington and amendments thereto, and subject to all the terms, condi.
tions and provisions written or printed below or 011 any part of this form
PERMISSION IS HEREBY GRANTED TO Mike Thormil ey
28~O €, ma.-n-cWs.i"",,- ~, \ rfQ'{~\.o..,,~
to install a private driveway on the east side of the EAst Marrowstone Road
at r~. P. 2.8fj.
593909
County Road No,
Franchise No,
Milepost 2.86
No work shall be done under this permit until the party or panics to whom it is granted shall have communicated with and
received instructions from
This permit shall be void unless the work herein contemplated shall have been completed before
Dated at June 21 .19 89
~r:~
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CALL 48 I
HOURS
BEFORE
YOU DIG
By ~.,u:d- K-L
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1.800.424.5555
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GENEIlAI. I'IU)VISIONS AI'I'L1CAIII.E TO Al.l. I'EIlMITS
This permit is subject to all applicable pfOYisicJll.s of the Rcviscll Code!> or Wa!>hrnglOn, C.\CCPllhul all)' pro...i~jfJn ill Ihj~ agtcclIH:nt 1I011,;(m!>l~tl'rH with
such rC1Oolul;ol1 SIl.il1 be controlling.
A hond in the amount of $
is rcquircll for the prOICl:lioll of the count)' <1!> M.'I forth Ifl lhe terms of the bOlld.
During the pru~rcss of the WUI k such barriers shall be erected <lud llla;lIlaillt:d as lIlay he ncccs!>ar}' or as lIlay he Jircctcd for Ihe prul~.ctjUIl of the
traveling public; the barrier!; shall be properly lighted at night.
III accepting this permit Ihe petitioner, his successors ulld as!'iigns, agrees Iu protect Jeffcnoll ('oullIY and save it harmlcl>!'> from all claims, actiollS and
dallluges of every kind and dcscriJ11ion which Illay uccrue to or be suffered by any person or perSOns, corporation or property by rea!.un of Ibc perfor.
lIlancc of any such work, ehuraeter of TIIuterials used or IllUll/ler of installutiulI, maintenance und operation or by the improper OIXupancy of right of
way or public place or public structUle, and in case UllY suit or actioll is brought against said Jefferson County for damages arisillg out of or hy rt'asun of
any of the ubove causes, the petitioner, his successors or assigns, will upon notice to him or them of COnHl1ellCernent of such action. defend Ihe same.!l
his or their own sole cost and expense und will sUlisfy uny judgmcnt uflcr the suitl suil or action shull have finally I>t'Cfl determined if adverse In the Jef-
ferson County.
Except as herein uutlmrizcd, 110 excavation shall be made or ohstacle placed withitlthe limits of a county road ill such a manlier as 10 interfere with
the travel over said road.
Except as herein authoril.eJ, no excavation shall be made or obstacle place:j within four (4, feet of the edl?C of thc pavcment.
If the work donc under lhis permit inlcrferes in allY way with the druillage of the county toad. the grantee !:.hall wholly and at bi~ own expense make
such provision as the enginccr may direct to take care of said drainage.
On completion or said work herein contemplated all rubbish and debris shall be imlllcdiately rcmoved ulld Ihe roadway and roadside shall be Iert Ileal
and prcscntubre and satisfactory to the engineer.
All or the work herein cOlllemplated shall be done under the supervision and to the s.Hi~faction of the County Engineer and the entire expense of said
supervision shall be bornc by the party or panics to whom this permit is issued.
The Dcpartmellt of Public Works hereby rescrves the right to order the change or localion or the removal of any structure or struclures authorized by
this permit at any lime, said change or removal to be malic at the sole expense of the party or parties to whom thi.'> permit is issuell, or their successors
and assigns.
All such changes, reconstruction or relocation by the grantees shall he done in such manner as wiIJ cause the least interfcrcnce with any of tbe Coun-
IY work and thc CUUnl)' of Jefferson shall in no wise be held liable for any dum age to the grantec by re.lson of allY such work by thc Count~. of Jeffer.
son. it agents or represcntatives, or by the exercise of any rights by thc County upon roads, streets. public places or structures in question_
This permit or privilege shall not be deemed or held to be an exclusive one and shall not prohibit the COUnty from granting other permits or franchhoe
rights of like or other nalUre to other puhlic or privatc utili lies, nor shall it prevenl the County frolll using any of its roads. streets, or public places. or af.
feet its right to full supervision and control o\'er all or any part of them, nonc or which is herehy surrendered.
The Department of Public Works may revoke. amend or cancel this permit or any of tile provisions thercor at any time by giving written notice to lhe
permittce. The permittcc shall immediatcly remove all facilities from the right of wuy. Any facilities remaining UpOIl the righl or way 30 days after writ-
ten notice of canccllalion shall be removed by the COUnty at the cxpensc or the pcrmillce.
The party or panics to whom this permit is issued shall maintain at his or their solc expense thc MrllClUre or objecl for which this permit is gr<lnted in
a condilion satisfactory to the Dcpartment of Public Works.
SPECIAL PROVISIONS,
1) Gravel entrance so as not to track mud onto county road.
2) No culvert required.
3) Applicant shall be held responsible for all damages to the
county road right of way.
In acccPting this permit the grantee, his succcssors and assigns, agrec thlll .lIlY damage or injury done 10 the property of the granlee or an)' cxpcnM!
incurred by him tmroUgh c operatIon of a contractor, workmg for the CoulIlY or any COUnty cmployee shall be at the sole expense of lhe grantee, hiS
s~ri:')9assl
"11/Ju. (~ . the "nd"r"gn,d, herchy n",plS Ih" pcrnlll ",hJecllo th, tern"
and conditiOns as herem ~et fort~ -(,
Dated Ihi._ :;?? day of ;S--V?-;' t::.. , 1''i5(
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1620 Jellerson Streel
P.O. Boll. 1220
Pori Townsend, WA 98368
(206) 385-9160
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
AP"UCATION FOR PERMIT
To Department of Publie Works,
Jefferson County. Washington,
The undersigned M. 1 kIF '[\-1 () iR tJ. \ L t: Y ~!K .
hereby appl_ for permission to
~OA'D Ac:cI2'SJ To ?R.c P~R.\")I
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SKETCH:
E:'A'Sl G~A c.f::{
'i?ARK
On COUnty Road: -E:. WViAAOL..y~ {Do..t~ R \).
between
(.\'/Q/t'IlIVl"",alll"'IfI't'IU,mif<',N'illlJ
Nt l'k8 C.., RAve-::;
Phone No,
Phone No.
100% Recycled Paper
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Fee Paid--L Yes _ No
--..aII!-/O 4
Re<<'rl No
Addrt~!>!l RCljUC31 _ Yes _ No
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and agree_ /0 do the work in accordance with J'our rules and regulations and subject to your inspection and approval.
Dale ~/J~" :9.. \ J9~
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{~ Uf uppticUnI is a copartnership, set forth names of COpiHtners)
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JeHersun Co,
District No, 6"
DEI'ARTMENT OF PUBLIC WORKS
Perl"it No. c.o p, .::-S
SUIJcrvisorts ItclJOrl No.
Supervisor will make detailed report with his recommendation on this application. Whenf!\'er possible show sketch of proposed
work. Supervisor will also make additional reports and linal report giving date of completion of work all this/orm.
JJ.Q ..-......11/...<:.-'\ '?~'t.-..........j.
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'.rcliminllry n.cport:
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Dale:
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Final Repnrl:
PERMIT ~SPECTION REPORT
I. /' Work covered by permit has been compleled
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control - adequate
- inadequate
REMARKS
I>ale:
(<:r ',0,
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01.\ MI'U' I'IU~'" U~"', 1'liC',
Signed:
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DEPARTMENT OF PUBLIC WORKS
Fcc Paid_ Yes __ No
1820 JellerSOrl Streel
P.O. BOil 1220
PorI Townsend. WA 98368
(206) 385.9160
I(O:O:'PI No
Addn.:s.s.HcquCS1_ Yes_No
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AI'I'UCATION fOR 1'lmMIT
To Department of Publie Works,
Jefferson County. Washington.
77/e undersigned Po,.1 /(!J<O()/lCSC"dd Q ) <:J l,,/ Or'/-Jf
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SUIJcrvisur's 1~l'J)()rl No.
DEI'ARfMENT OF PUBLIC wonKS
Permit No, 0977
District No,
b
Supervisor will make detailed report with his recommendation Oil this application. IVlIenever possible show sketch of proposed
work. Supervisor will a/so make additional reports ami final report giving dale of completion of work olllhis form.
Preliminary Report:
If-R,I;)E';J ~ "r, r /<.01Vl
^/o D, f-c,d e$ / J1/H?RovJ
5-<;Jt &46 r
Date:
"J-I5'~')
Final Report:
PERMIT I!Y'PECTION ImpORT
. I / Work covered b)' permit has been completed
- satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control - adequate
- inadequate
REMARKS
Date:
s- ~ ,_ :5")
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JEFFERSON COUNTY
OEPARTMENT OF PUBLIC WORKS
Fcc Piliu_. Yes _ No
HCl.ClIJI No
1820 Jellerson Streel
P,O. Box 1220
Porllownsend. WA 98368
(206) 385.9160
Addrc!>S RequC:!o,t _ Ye~ _ No
Mile (10M
AI'PLlCATION J!()R p.mMIT
To Department of Public Works,
Jefferson County. Washington.
The undersigned Pn/lr 7?'l'..u,d,<Y,C-;lrI LG-Jof-",/, /)("',01
hereby applY--- for pmnissionlo OPe", .s I.cul'ld r>/' c' / C"'{j,L-r~ U
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.'J..~1 agree_ 10 do the work ill accordance with your rules and regulations ami subject 10 your inspection and approl'al.
Dale
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DEI'ARTMENT 01' I'UIILlC WORKS
Pellt/it No, 0 9 7 ?
Disrric/ No.
(,
Supervisor's ItclJUrt No.
Supervisor will make de/ailed report with his recommendatioll 011 this application. ~Vhefle\!er possible show sketch of proposed
work. Supervisor will also make additional reports and fillal report giving dalt! of completion of work all this form.
I)reliminary Report:
Eo C"'Je-Je. Sf'. I"1'P' 0,00 !o o.o'L.
~ Su-.rzFllce. (tSs?-,)
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Date:
3-/3- 99
,j) ~ nY:( KY ~
Signed:
Final Report:
PERMIT INSPECTION REPORT
Work covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control.. adequate
.. inadequate
REMARKS
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fec Paid_ Ye~ _ No
1820 Je1ferson Slftlal
P.O. Box 1220
Pori Townsend, WA 98368
(206) 385,9160
Rn;cll'l ""u
Addle',;!; Rtquc~t _ YClIo _ No
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AI'!'L1CATION FOlll'EltMIT
To Department of Public Works,
Jefferson County. Washington.
The undersigned -C.t.i;,. ('l f' P r.J tI I !;-) (,th"1 f'-, L n rI I J ) rt-It" J- D e;/-? '"
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DEl'AltTMENT OF l'UULlC WORKS
District No,
6
Permit No. I'lP9 S
SUI)Crvisur's JtC'f)ur. No.
Supervisor will make detailed Tepon with his recommendation on this application. Whe/Je\'er possible show sketch of proposed
work. Supervis'or will a/so make additional reports and /lnal repo,! giving date of completioll oj work 0/1 this/arm.
IJreJiminury ({cporl:
g\-\uo~ \)~, "",:\e t'O';'T 2,,0 0,", /:;151' s:pf _ /y1""~I<eT "7',
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1-1>4'" \lee" ~"Sr1l~ fRooM R~t>'o! \>K., -Ie doL""",... BIV\), ~'-fli " FtR<f:' /lyDl'!II",r
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Date:
/0-/7..-<:38
./\ ~ l!~
Signed:
Final Report:
PERMIT INSPECTION REPORT
.'><( Work covered b)' permit has heen completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control.. adequate
. inadequate
REMARKS
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1820 Jellerson Slreet
P,O, Box 1220
PorI Townsend, WA 98368
(206)3[,fJ.9160
AdJre!'.sl{~qucsl_ Yt:S_No
Mile PO'll
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fee PaiL_ Yes _ No
alld agree~~ do tile work ill accordance with your rules ami regulations and subject to your inspeclion and approval.
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To Department of Public Works,
Jefferson County, Washington,
The ullderslglled Fbl'7- 7~:n"-"rl-:S<'"ri C-UQI..f" O<'/jr-
hereby app/~ for permlssiolllO Ope" <ittl 6- ,<)1/<2 crl /7"0,/1<->// S/-;
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Jefferson Co.
I>EPAllTMENT 01' PUIlLlC WOnKS
District No.
;:,
Permit No. t? q 7 '8
SUfH..'rvisor's Ilcpor. No.
Supervisor will make detailed report with his recommendation 011 this app!iculiofl. IVlzenever pOs".iible show sketch of proposed
work. Supervisor will also make additional reports and Jillal report gillitlg date of completion of work all Ihis/arm.
J>>reliminury I{c,wrl:
4"'- ;:r::'.J/t::J2..:5 cC j'" ON oF' .>.t:C dA.JD /-4,R,.jc"..).. C" R.oSS ,',.J J !>- t::ff (J..-..I
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Date:
"fi; 3-/3-&3
..l) , ~..z;;f- J~
Signed:
,
Final ~~~~:
PER~NSPECTION REPORT
Work covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control.. adequate
- inadequate
REMARKS
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1820JellersonS1reel
P.O. Box 1220
Porl Townsend, WA 98368
/206} 385-9160
!,IT'-I-.
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
N:: 0907
DI'lrICI No.
6
PERMIT
'..,
In accordance with all applicable Revised CoJ~s of Washington and wncndmcllls thereto, and subject to all the terms, concH-
lions and provisions written or printed below or on any part of this form
PERMISSION IS HEREBY GRANTED TO CLly of FlJrt T(Mnscnd Water Dept,
540 l~ater 5t" Port TownsencJ, II!^. 98368
to Open cut 6th Ave. near LntersectLon of E. M:Ju:je 5t, to provLde water servLce to
Lot 1 of BLock 8 of 1 rondaLe ,
County Road No. 667109
Franchise No,
Milepost 0.18
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated Wilh and
received instructions from
This permit shall be void unless the work herein contemplated shall have been completed before NovOTber 9 ,19 89
Dated at t\bvOTber 9 ,19 88
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CALL 4B
HOURS
BEFORE
YOU DIG
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GENERAL I'I!OVISIONS AI'I'L1CAIILE TO ALl. l'EIlMITS
This permit hi subject to all applicubJc pruvbions of Ihe Kcvbcd Code!> of Washington. CXl,;Cpllhat an)' rruvl,'Otl i/1 thi.. agreement not COrl!\lslCllt .....lth
such resolution shall be COli trolling.
A bUild in the amoulll of S
is rCljuircd for the protection 01 the count)' as \CI forth III the telm" of the bom.!.
During the progrc!>S of the work sm.-II barriers shall be erected unu llIuinwincu as Ill:.!}' be I1CCC.....:.If} Of us may be duc(.;lcd for the prutectlon of the
lravcling public: the barriers shall be properlY lighted at night.
In accepting this permit the petitiuller, his ~Ul.:c.;e:.~urs and as~iglls, agree~ to ploteet Jcrfcr~lIll COUllty alld sa'le it harmless from all c1diJll~, .U,;tiOllS and
damages of every kind and description which may accrue to or be suffered hy allY per!.lJl1 01 pcr!.olls, corporation or property by reaS()Il of the perfor.
mance of any such work, character of materials lIsed or mamB.:r of illslllllatioll, lllailllenance and operation Of by the improper t.lCcupanC)' of right 01
way or public place or public structure. and ill case any suit or actioll is hrought ag<linst s<lid Jefferson Coullty for d<llllages <lrising out of or by reason of
any Df the <lbovc causes, the petitioller, his successors or assigns. will upon llotiec to him or them of COlllrllellCernellt of such actioll. defend the same at
his or their own sole cost <Iud expense and will s<llisfy any judgment after the said suit or action shall have finally been dctennilleU if ad,erse tu the Jef.
ferson County.
Except as herein authorized. no excavation shall be made or obstacle plai.:ed withill the lilllils of a C(lLlllt~ roall ill sucl. a manner as to interfere with
the travel over said road.
Except as herein authorized, no exc<lvation shall he made or oh:..tar.::le phll.:cd within four (41 feel or lhe edge of the pavement.
If the work done under tllis permit interferes in any wa~' wilh lhe drain:lge of the county road. the grantee slmll wholly and at hh own e....pensc rIl<lke
such provision as the engineer mOly direct to take C<lre of s.lid dwinagc.
On completion of said work herein contemplated all ruhhish and dehris shall be irnrm:diatcly removed and the roadway and roadside shall be left neat
and presentable and s<ltisf:lctory to the engincer.
All of the work herein contemplatcd shall be done under the supervision ami to the satisfaction of the CCJUlll~' Engineer <lnd the cntire expense of said
supervision shall be borne by the party or parties to whom this permit is issucd.
The Departlllent of Public Works herehy reserves the right to order the changc of location or the remuval of any structure or Structures authorizcd by
this permit at any time, S<lid change or rell1ovalto he Illude <ltthe sole expense of the parly or parties to whom this permit is issued. or their successors
and assigns.
All such changes, reconstruction or relocation by the grantec:> stmll be done in such mallner as will C.luse the least interference with any of the Coun-
ty work and the County of Jefferson slwll in no wise be held liuble for any damage 10 the gr:itltee hy reason of any such work by the County of Jeffer-
son, it agents or representatives, or by the exercise of any rights by the County upon road!.. streets. public places or structurcs in question.
This permit or privilege shall not be deemed or held to be an exclusive one and shall not prohihit the County from granting olher permit!> or franchi!>e
rights of like or other nature to other public or priv<lte utilities, nor shall it prevent the COUnty from using any of its rO<lds. streets, or public pl:ices, or af.
fect its right to full supervision and control over all or any part of them, none of which is hereby !>urrendercd.
The Department of Public Works may revoke. <llllend or cancel this permit or any of the rrovisions thereof at any time by giving written notice to the
permittee. The permiltee shall immediately removc:ill faeilitie~ from the right of way. Any facilities remaining UrMl the right ofw<lY 30 days after writ.
ten notice of cancellation sh.1I1 be remo'led by thc COllllty <It lhe expcme of thc pcrmillce.
The party or puTties to wholll this permit is isslled shnllmailltain at his or their sole expense the stru(.turc or object for which this permit is granted in
a condition satisfactory 10 the Department of Public Works.
SPECIAL PROVISIONS,
1.
I~ater LLne shall be a mi.ni.rrun of 30" below exi.sti.ng roadvay,
2,
ALL areas di.sturbed duri.ng oonstructi.on shalL be restored to ori.gi.nal condi.ti.on,
In uccepting this permit the gralllee, his successors and assigns, agrec tlmt any d.lnwge or injury done to the property of the grantee or any expcn!oiC
incurred hy him through the operation of u contractor, working for the County or uny County employee shall be at the sole CX[lCnse of the grantee. his
Sllccessors and assigns.
amI conditions as herein set forth.
, the undersigned, hereby accepts this permit subject to the terms
Daled this 10
7?ov
, 19"?;~
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Thil> permit is subjCCllouJl applicable provbjomof thf; Ih:\'i:-.cu l'odcsof W,LslllllgtOll, C:Xl:Cpllhal :Ill} prOVI~J(J1l ill thl.., a.\:rcclI1cllIllOI \.'lJrj~I...LCIll .....ith
such rCl>oJulioll shall be controlling.
A bOlld in lhe UUllllI1ll uf $
is IcquircJ for lhe pru[cl,:tlOJI of the coullt} as ',(."1 forth jn the tcrms of the bond,
During the prugrc...s of the work such barriClS 1>111111 he erected :lIlU nlallltalllcd U.!o Ill:.!)' he IICt.:C"'~H) ()f a... may be (hrcClcd fOJ Ihe Pfcltcction of the
traveling public; lhe barriers .'ihall he properl)' Iiglllcd at night.
In accepting thi~ permit the IlCtitioller. his ~uc~essors and assigns, agrees to prole!.'t Jefferson COUllty alld save it harrll!es!' from all c1airm, OJl,.:tJom, and
damages of cvery kind aud uc!,criptioll which may accrue to or he suffered by all}' person or per!'lollS. corporation or PrtlllCrt)' by rt~ason of the IlCrfor.
manee of any such work, character of lIIateriaL~ used or manner of inswllation, lIlaltltenance and opcriltioll or b}' the improper occupanC}' of right of
way or public place or public structure, and in caliC an}' suit or action is brought i1gainst said Jefferson Coullty for Jamages arbingoutofor hy reasc)II of
any of the above causes, the [lCtitiuner, hi!!. sUt:cessors or assigns, wiJIupolI IIolice to him or them of cOlllmcncement of sut:h action, defend the !.illllC at
his or their own sole COM and t:.\pemc ami will satisfy any judgment alter the !'uid suit or ac.:ti(Jfl shall havc finally been determined if aJ\er~e tu the Jef.
ferson Counly.
EXCCpl as herein allthori/ed. no excavation shall he made or ohstacle placcd wilttill the limits of a county H~ld in such a manlier as to illlerfere with
the tron'el mer said mad,
Excepl liS herein authorized, no excavation shalf be made or lJh.~tacle pla.:ed within four loll feet of the edge of the pavement.
If the work done undcr this permit interferes in any way with the drainage of the COUllty roud, the grarltec slwll wholl}' and lit hi~owtl e.\pen~c make
such provision as lhe engineer fila>' direct 10 take care of said drainage.
On completion of said work herein contemplated all rubhish and dehris shall he illllllcJiately removed and lhe roadway and roath-ide shall he lefl neal
and prescnlahle and satisfactory to the engineer.
All of the work herein contemplated shall be done under the supervision Ulld to tile sati~factiol1 of the COUIlIY Engineer and the en lire e.\]lCnliC of !oaid
supervision shall be borne by the party or parties to whol11 this permit is is!oued.
The Department of Public Works hereby reserves the right 10 order the l.:hange of location or the removal of allY structure or !!.truclures authorized hy
this permit at any time, said chunge or removal to be made at the !oole expense of the party or panics to whom this f'II:rrnit is is..ucd, or their ~uccessors
and assigns.
All such changes, reconstruction or reloclllion by lhe granlees shalf be done in such manner as will calise the least interferel1l.:e wilh allY of the Coun.
ty work and the COUnty of Jefferson shall in no wise be held lillble for any damage to the granlee hy reason of allY such work by the County of Jeffer.
son, it agents or representatives, or by the exercisc of any rights by tht: ('oumy upon roads, streets, public place:'. or structures in question,
This permit or privilege shall nOI be decmed or held to be an cllclusive one and !obllJl not prohibilthc County from granting olher pcrn1il~ or franchi~
rights of likc or other nature to other puhlic or privllte utililies, 11m shall it prevent tile County from using any of its roolds. streets, or puhlic pl.lces, or af.
fect its right to full supervision anll control over all ur all)' part of them, Ilonc of which is hereby surrendered.
The Department of Puhlic Works may revoke, amend or cancclthis permit or any of the provisions tht:rcof al any time by giving written notice to the
permiuee, Tht: permittee shall immediately relllm'e all facililies rrom lhe right of way. Any facilities rem.lining upon the right of way 30 days afler writ.
ten notice of cancellation shall he removed by the County al the exrensc of the permittce.
The party or parties to whom this permit is issued !ohaJlmaintain at his or their sole expensc the structure or objecl I'm which this ~rlllit is granled in
a condition salisfactory to the Departlllent of Public Works,
SPECIAL PROVISIONS,
1.
Water lLne shall be a mLnLm..m of 30" beLow extsti.ng: roadvay.
2.
All areas dLsbrbed cUrLng consi:ructLon shall be restored to orLgLnal condLtLon,
In licccpting this permit the grantce, his successors lIud lIs~igns, agrec th<1lllny dumage or injury dOlle to thc properly of the grantee or uny expense
incurred by him through lhe oPCffllion or II contractor, working for the County or Hny COllnty ernplo}'ce shall be lit the sole expense or the gr.lntee. his
Sllccessors and assigns.
lInd conditions as herein sct forth,
, the undersigned. hereby lIceepls lhis rcrmit suhjcctlO the terms
Outed this 10
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Ftc Paiu_ Yo __ Nu
1820 Jetlllrson Street
P.O. 801. 1220
Pori Townsend. WA 98368
(206)385.9160
Ito;o,;cir>! No
^ddrc~ Rcquc.!.t_ Yt:S_ No
Mile P~t _
AI'I'UCATION J:'()IlI'ERMIT
To Deparlment of Public Works,
Jefferson COUllty, Washington.
The undmlgned i:J,::>/'-f 7;,,..,,,, n~.r>f/rI {~},'i-~e,,o T-
hereby appl_ far permission fa (!> ~ e 17 (! tt' I;."""q;, "::-;;,~(,,, "",, ??:,,,,, "'~~;'~ 7'(-;//'
3/V LOct/el' Se/1yl[!,e. ~ ./.,../
SKETCH:
011 CoulllY Road:
A ~:r' ,1- P' ~.<< .sT
beMeen ~;bc'!de- 5 r
/Slc,,,,wmt'l/f'/Jl\\.\/ft'l'llIrlllil",,,lmIJ
and agree$- to do the work ill accordance with YOUf rules alld rel.;'ulations and subject (a ,\'our inspection and appr0l1ol.
Dale //-:::l -'i?<6- /9_
9~o~",~~L EL ~;~"tf(lrr
-1../ t> Le-..J cz.....;;t; Alica?:;:"~lPartncrshiP. SCt rorth name!i of corurSlJlcrSI '71 . 'r?
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',/
Jefferson Co.
DEI'AHTMENT 01' l'UIlLlC WO\(KS
District No.
(.,
Pert"ll No. 09 Of
SUIH~rvis()r's Ill'lwrt No.
Supervisor will make detailed report IvitII his recommendation on this applicatiofl. Whellel'er pOS!iible show sketch of proposed
work. Superl'isor will also make additional reports alld jinal report gil1illg dale of completio/l of work on this form.
Preliminary Ileporl:
b....!! ,4-\l ~ '
/lI1'l-R1L'\,4 'V~ <;l".. ~~
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",,:I-t-! A 13..-1 of
o.~.
o~o+t>e~ <r=~,4u..c...
Date:
/1-7- <;;,.E..>
/\./~K.~
Signed;..
Final Report:
PE&NSPECTION REPORT
. Work covered by permit has been completed
satisractorily.
Work is not completed.
Recommend permit be cancelled.
TrarFic control - adequate
- inadequate
REMARKS
no.te:
:5-- 3 ( -a~'1
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SIJ,tned:
CITY of PORT TOWNSEND
(Building Penni, AJlplicalion) WATER SERVICE PLAN
I.n Show streets surrounding hlock ill which lots arc IOl'ah.'d.
2.0 Show I1C~II'csl w:llcrlinc and size'.
2.1 Show I'OUll' of proposed wnterline to properly.
DlDC-[]
-.:;::,
DO CC~
DOEJOv i
D~O~OD tJ
D~D~DtJ D
The above proposed waterline will usc~fect oC&pipc._""""tecs. ::::::-crosses. ~lydrallts.
~inch saddles,~ tapping sleeves,-=--, inch valves. Ditching and backfilling will be
accomplished by (' do 1/ t,J" I-n- ,ripe and fittings will be installed by
. 'J (C&'nlractnf or City)
(1/,';'v ii' a"...p", '. I ( is cstim:llcd Ilmt the cost will he S to he borne
(CO~rllclOr or CiIY)
hy :lpplicnnt 0 assessment district D. The city has agreed ~ has not :1greed 0 to benr
S of the costs incLlrred.
date Or<! ~ ....e.
~Water Superiutel1 enl)
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(OWl er/Coutractor)
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JEFFERSON COUNTY
OEPARTMENT OF PUBLIC WORKS
1820 Jt:lIerson ShlH:l
P.O. Box 1220
Pori Townsend, WA 98368
(206) 385.9160
I)r'~' ~
N:: 0906
PERMIT
In acconlancc with all applicable Revised Codes of Washington and amcm..lmcllls thereto, i.JJld subject to all the terms, cOIH.Ji.
lions and provisions written or printed below or on any part of this form
PERMISSION IS HEREBY GRANTED TO CU,y of Port TOIM'lScnd Water Dept.
540 l'later St., Port TOllnscnd, I"" 98368
to Inst-aLL fere hydrant on South ~Le St. at the Intersecteon of IrondaLe Rd,
Milepost
County Road No. 638009
Franchise No.
0.01
No work shall be done under this permit uJ11illhe party or parties to whom it is granted shall have communicated wilh and
received instructions from
This permit shall be void unless the work herein contemplated shall have been completed before Novmber 9 . 19 89
Dated at Novcrrber 9 , 19 88
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CALL 48
HOURS
BEFORE
YOU DtG
1.800.424.5555
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GENEHAL I'ROVISIONS AI'I'L1CAJlI.E TO ALL I'EHMITS
This permit is subjccllO all applicable pro\'bion~ of the I{cvi~cJ CoJc~ uf Washillgtllll. c>.ccpt that i1J\~ pun l~lOJl III till'> agrccIllCIlIIlOIl.:o/I\\slcll( "lIh
such resolution shall be controlling.
A bunJ ill Ihe arnoullI uf 1;
h. requireJ fur the prutectioJl of the cuullty a.. S~'I fonh JlJ the term" of the hondo
During the progress of the work such harriers shall be crcclcJ and mailllaillcu a:-. IlliI)' he Ilccc\~ry u/ tiS may he utrCl'h.:d fur the protCl,;I!OI1 of the
tHlvcJing public; the barriers shall he properly lightcd <It night.
In acccpting this permit the petitioncr, his !.uccC!.SQl!. <I lid <lssigm, agree.!. to protcct Jeffersun COlllll)' :JIld ;.a VI.' It harrnle\s from <.Ill d<lII11\, al.tiutls and
d:ullages of every kind and dcscriptioll which may uccrue to or he suffereJ tw any person or rcfS(jJl~, cmporatiull ur property by rca..un of the pcrfor.
mancc of allY such work, charucter of materials u~d or rrmllller of imtalla\ioll. mainlenarll.:e aud upcnlllull or by the IInplOrl\:r nu;upancy of flght of
way or public place or public structure, and in c<.Ise any suit or action h bruu~ht ag,llll!.1 s,lid Jeffersun County for d,ulI<ll:\es urising out of (Jr by n:asol1 uf
any of the abm'e cause.'i, the petitiuner. his successors ur assigns. witlupollllmice to him or ltlclll OfCIJlIIllIerLcelllellt of sudl al.:tLml, dcfclld the .'i:lllle at
his or their own sole cost and expensc anJ will satisfy ,lilY judgmcnt aftcr thc said .'iuit or al.:tloll shall ha\e fjl1all~ lJ<.'crl dcterrnmcd il <Idvl.'rsc to the Jef,
ferson County.
Except liS t1t:rein authorized. 110 cxcavatiOll.'itlalJ be lIlaJe or ohsta(.'1c placed wilhinlhe limits of a coUnly road in !>uch a manner a!> 10 interfere with
the travel over said ruaJ.
except as herein aUlhurized, IlO excavalion ~hall be made or uhstuch: plat.:cd within four HI feet uf lhe edge of lhe pavement.
If the work done under this permit interfcres in allY way wilh the drainage uf the cOLLmy ruau, tile grantee shall wholly and at hj~ own expensc make
such provision as the engineer may dirct.:l to take carc of said drainage.
On complction of said work herein colllclllplatcJ all ruhbish anJ dehris shall be irnl11cJialcly rcmovcd and the roadway and roau!.idc slwll he left lIeat
and presentable allJ satisfactory 10 thc engineer.
All of lhe work herein contemplatcJ shall be done undcr the supervision anJ 10 the satbfactlon of the County Engillcer UllJ the cntire cxpense of said
supervision shall be borne by the party or panics to whom this permil is issued.
The Depanment of Ilublic Works hereby resef\'es lhe right \(J order the change of locatiol1 or the rcmoval of any structure Of Mructures authorized by
this permit at any time. said change or rernovallO he made at the !>olc expell!.C' uf the party or parties 10 Whollllhis permit is issued. or their successors
anJ assigns,
All such changes, reconstruction or relocation by the grarlleeS shall be done in sllch manner as will cause the least interference with an)' of the Coun-
ty work ,LOd the County of Jefferson shall in no wise be helJ liable for any damage to the granlee hy reas.on of any such work by the County of Jeffer.
son, it agenls or represcmatives, or by the exercise of uny rights by the CounlY upon nmd.<., streets. public places or .<.lrUctUres in question,
This permit or privilege shall not be deemed or held to be an exclusive ol:e and shall nul prohibit the County frolll grallling olhcr permits or franchise
righls of like or other nature to other public or private utilities, nor slwJ] it prevent the County from using any of its roads. strcets. or public places, ur af-
fect its right to full supervision and control over all or allY pan of thell!. none of which is hereby surrendered.
The Departmcnt of Public Works may revoke. amcnd Of cancel this permit Of any of the provisiollS thereuf al any time by giving \\ riuen noticc 10 lhe
permittec. The permittec shall inunediatcly rellloveall facilitie!> from the right of way, Any facililies remaining upoflthc right of way 30 day!> after writ-
ten notice of cancellation shall be removed by the ('numy at the expense Ill' the rcrllliuee.
The party or parties towholll this permit is issued ...hallll1ainlain at his or lheir sole expense the structure or objecl for which this permit is granted in
a condition satisfactory to thc Depurtlllent of Public Work....
SPECIAL PROVISIONS,
1, Hycrant to be LnstaLLed as near as possLbLe to the rLght-of-,^",y LLne,
2. ALL areas dLsb.rbed drLng cOnstrucHon sl-aLL be restored to orLgLnaL
condLtLon.
In accepting this permit the grantee, his !.uccessors <lnl! assigns. :lgree that any damage or injury done 10 the property of the grullIce or any expense
incurred by him through the operation 01':1 contractor, working for the County or any County empluyee shall be at the sole expense of the grantee. his
successors and assigns.
llnd conditions liS herein set forth,
1)",,11 "* It> lIay of 7;/' ce)
, the undersigned. hereby accepts this permit subject to the terms
,19~'G
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Mile P~I
JEFFERSON COUNTY
OEPARTMENT OF PUBLIC WORKS
Fcc Pai<1- Ye. _ No
1820 Jetlerson Street
P.O. Box. 1220
PorI Townsend, WA 98368
(206) 385.9160
1l~'l'lr-;o
AI'I'UCATION FOR PERMIT
To Department of Public Works,
Jefferson County, Washington,
The undersigned ./-bI'7T /rJco,ptsc-,nd (-f.JC1~f"~ ()r;o-r
hereby appJ~_ for permission to CJ'peVL Q t.( I- 'A""',,~~:f:::i::::""'...,s,,f /J,1a".o/e sr
q,/t l~fer.s""c..-f{~/1 U-J/I-A .2',;,o/1da/c Rei / ?O"",;/?f:/Ct//
Fire: Hyd.
SKETCH:
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On CaulIlY Road:
be/ween
(Slall'l''''''''\If''O\Hlrl~'I(''/IIil,'('''itl/)
and agree-X- to do the work in accordance with your rules and reb'Ulatiofls and subject to your inspection and approval.
Dale //- :2 _ 19~
/7~AifJ~ ",.~~~ --2ZT fA) CP,~t~:"", 0 PJp ;l-
V ..A- 1If applicant IS 1I copMtncrshlp. set fnuh n.lIl1CS of corMrtncrsl
&(j() LVG-Y,.IJ. 81" _
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DEPARTMENT OF I'UIlLlC WORKS
SU(Jl'n'lsor's UCllurl No.
Permit No, 0 '7 () f..
Supervisor will make detailed report with 11;.\> recommendalioll ofllhi.\" applicatio/l. JlIl1el1e~'er pO!Jsible show sketch of pruposed
work. Superllisor will also make additional reports ondfillal report gil'ing clate o!compleliofl afwork oll/his/orm.
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PERMIT NSPECTION REPORT
Work covered by permit has been completed
satisfactorily.
\Vork is not completed.
Recommend permit be cancelled.
Traffic control. adequate
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820JellersonSlret:1
P.O. Bo~ 1220
Porl Townsend, WA 9836B
(206)385.9160
N::
0908
PERMIT
In accordance with all applic<lblc Revised Codes of Washington and .HllclH..Imcllls thereto, and subject to all the terms. comjj.
tions and provisions written or printed below or 011 any part of this form
PERMISSION IS HEREBY GRANTED TO CLly of Port Towlsend l'bter Dept,
540 Water St" Port Townsend, LIlA 98368
10
InstaLL fLre hychmt on S, 7th Ave. at LntcrsectLon of Cora St,
County Road No, 635809
Franchise No,
0.13
Milepost
No work shall be done under this permit until the party or partics to whom it is granted shall have communicated with and
received instructions from
This permit shall be void unless the work herein contemplated shall have been completed before Novarber 9 ,19 89
Dated at Novarber 9 , 1988
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CALL 48 1
HOURS
BEFORE
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GENEltAL PROVISIONS Al"'UCAllLE TO ALL PEI(MITS
This permit is subjct:11O all applicable pro\'i~ioflS of the Rcvh.cJ Code), or Wuslllllgloll. C,\l;cpllhal all} pru\'i~I()1I III lhi~ ag.ICCIllClllIlOI con,>,Slcrlt .... ilh
such rc!.olution shall be controlling.
^ bond ill the allluunt of $
is rCljuircd for the plutccllO/l of Ih~' C(JUlll~ us M:t furth ill the tCftll\ ul the hO/lll
During the progress of the \~ork liuc.:h harriers shall he electeJ allJ lllaimaim:rJ as Ill"')" III: IlCCC.....H}" or as llIar III.: thrcctcJ fUl the pfOl~.(;tj()1I {,f the
traveling public; the barrierli shull be propl'rly lighted at night.
III accepting this pefmit the petitioner. his succeSSlHS amJ assigns, agrees to prolel:t Jefferson ('(}UI11~' <lmJ s.ne it harmless frulII all clailll', al:tiOI\~and
damages of every kind and deM:riptioll which may accrue to or he sufferctJ by any persol1 or pcrsol1.~. corporalion or propert~. b}' rea"ull uf the perfor-
mance of any such work, characler of IllUlerials used or mallller of imlaJJalioll, lIlainlell<lnCe <llld upcr<llioll or by the improper (X;eUp<lllcy of righl of
way or public pl<lcc or public struclure. ami in C<l1>C allY SUil or action b brought agaiml saki JdfcrsOII County for dalllage~ ansillg out of or by rra~oll of
any of the above causes, till: petiliOller. his succeM',ors or assigns. will UI>lJll llotke tl) hilll or lllem of CIJlnrrlellCefllent or !ouch action. defend the !>:JOle at
his or their own sole cost and expense and will satisfy allY judgmellt afler the said SUil or action ~tl<lll haw fiU:llJy been determined if <ldverse to the jef-
ferson County.
Except as herein aUlhorized, JllJ excavalion shall he made or obstacle placed wilhilllhe limits of a county road in such a manlier us to interferc with
the ua vel 0\'e1 said lImd.
Except as herein authoril.ed, no excavalion shall be made or obstacle pl<.lced within four 14) feet of the edge of the pavement.
If the work done under lhis permit interfcres in <IllY W;!y with the drain<lge of the CtJlIlll}' road,lhe gralllee ...hall whoJJ}' and at his own expense lIla~e
such provision as thc engineer Ill;!y direct to take care of said drainage.
On complction of said work herein contemplated all ruhbbh and dehris shall he immediately rcrnc)\'ed and the roadw<.lY and f(Jadsidc SIHil1 be left neat
and prescnlable and satisfactory to the engilleer.
All of the work herein contemplated shall be done under tlte superYi~ion and lu the satisfaction of lhe COLlnl}' Enginecr and lhc cntire c),pcnsc of said
supervision shall be borne by the party or p.lflies to whom litis permit is issued.
Thc Department of Public Wor~s hereby reserves the right to order the change of location or the rcmoval of any structure or structures authorized by
this permil at any time. sa.id ch<lnge or removal to he made :Hlhe sole c.\pcnsc of the party or parties to whom lhis permit b issued, or their sllccessors
and assigns,
All such changes, reconstruction or relocation by the grantees shaJJ be done in such manner as will cause the least inlerference with any of the Coun.
ty work and the County of Jefferson shall in no wise be heltJ liable for any damage to tlte grantee by rea SOIl of any such work by the County of Jeffer.
son, it agents or representatives, or by the exercise of any rights by lhe County uJ10n roalls. streets, J1ublic places or structures in question.
This permit or privilege shall nol be deemed or held to he an exclusive one .llld shall 1101 prohihilthc Count}' from granting other permils or franchise
rights of like or other nature to other puhlic or privale utilities, 1I0r sh.1I1 it prevel11the CounlY from using :lll}' of ilS roads. streels, or public places. or af-
fect its right to full supervision and control over all or any part of them. none of which is hereby surrendered.
The Departmem of Public Wor~s m<l}' revoke, amend or canecllhis permit or allY of the provisions thcrcofat any time by giving written notice 10 the
permittee. The permittee shall immedialely remove all facilities from the righl of way. Any fllcililics remaining lIpon the right of way 30 days afler writ-
len notice of cancellalion shall he removed by the CounlY at the expense of the permiltee.
The pany or parties 10 whom this permil is issued shall mainlain at his or their sole expense tltc structure or ohjecl fur which this permit is granted in
a condition satisfaclory to the Department of Public Wnr~s.
SPECIAL PROVISIONS,
1, Hydrant shall be LnstaLLed as near as possLble to the rLght-oi'-way lLne.
2. All areas dLSturbed cLrLng construct LOn shaLL be restored to orLgLn.'1l cordLtLon,
In accepling this permit the grantee. his Sllcccssors nntJ assign~. llgree lhat uny danlllge or injury done to the property of the gralllee or lIny expense
incurred by him through the operation of ,I conlrnClOr, working for lhe COUnty or any County employee shall he al the sole expense of the gramee, his
successors and assigns.
and conditions as herein Set fmth.
, lhe undersigned, hereby accepts this permit subject 10 the terms
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fee Paid___ Yo _ No
1820 Jelterson SHeet
P.O, Box 1220
PorI Townsend, WA 98368
(206)385-9160
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API'I.ICATION FOH /'EHMIT
To Department of Public Works,
Jefferson County. Washington.
l1/e undersigned PI') 1.1 JC:, t' ..} 14 q, ,.. /1 d 1..1 ) & 1(';- ~
hereb,~ app/~ for permission /0 0 'pen CCI,~"I",,,,:2,,1.'?,/f,l..7!/:t;,,,,,,,,'?, f )' ""X" st~
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DEI'AUTMENT OF I'UHLlC wonKS
Pennlt No, t'? 9 0 B
SUIJCrvisor's ItclJOrt No.
Supervisor will make detailed report willl his recommendation Oil/his application. Whenever po,\sible show sketch of proposed
work. Supervisor will also make additio/lal reports am' final report giving dale of complelioll of work Oil this form.
Preliminary Report:
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l'ERMI~CTION REPORT
Work covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control.. adequate
. inadequate
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N:: 0909
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
HI20 Jellerson SIre!)!
P,O. Box 1220
Port Townsend, WA 98368
(206) 385-9160
Dislricl Nu.
6
PERMIT
In accordance with all applicable Revised Codes of Washington unu amendments thereto. and subject to all the terms, condi-
tions and provisions written or printed below or 011 any part of this form
PERMISSION IS HEREBY GRANTED TO CLry of Port Tmlnsend l\ater Dept,
540 Water St., Port Townsend, 1\!A 98368
to InstaLL fLre hyc:rant On 7t-h Ave, Ln the north\Vest q,oncJrant of the LntersectLon
\Vi. th E, Moore St.
County Road No, 665709
Franchise No,
Milepost 0,18
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
received instructions from
This permit shall be void unless the work herein contemplated shall have been completed before Novamer 9
Dated at Novenber 9 ,19 88
,19 89
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HOURS
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GICNlCltAL PROVISIONS AI'I"L1CAIlLE TO ALL l'EllMITS
This permit is subject to all '*pplicablc pruvbiow. uf the Rcvi!<ocd Codc~ of WashillgllJll. c;\ccPI tbat <lilY Plll\ is 1011 in thh ;J.grccllIl'lll not (,;{)n~lstclll wllh
such resulution shall he controlling.
A bund in liLe all10ullt of $
is fe(IUlred for the protect lUll of Ihe l.:OUJlly a~ '><.:1 lorlh ill the terms ut the hOlld.
During the prugrc.'>!> of the w(Jr~ such barriers shall he erected and maintained as may he I1CCC"\<lry UI as Ill"")' he Jircl,;tct! for tile protcl:lion of the
traveling public; the harriers shall he properly lighted at llight.
III accepting this permit lhe pelitioner. his successors UIlJ assigns. agrees to protect Jcffcrsol1 CUUllty and sa\'c It harmless from all claims, <H;lium and
damages of every kind and descriptioJl which lIlay accrue tl) ur he suffered by any per!>on or persum, 'orporalioll ur property by rea.~tJll of th~ perfor.
mancc of allY such work, charactcr of lII:tteri:tls used or Ill:tnller of imt:tll:ttion, IIUltrltCll:tllce and upcn.ltiulI or br the improper (J(.:cup:tncy of ngl\( of
way or public place or publil.: structure, am! in case any suit or actiOl] is brought again!>! saiJ Jeffersoll ('uunty fur dalrmgcs arising uut of ur by rea..on of
any of the above causes, the petitioner, his successors or assigns, will upon notice to him or them uf cmmllelll::emelll of such action. Jdend the i>a/JIC at
his or thdr own sole co.';t and expense and will satisfy ;.lIlY judgmclll after the saiJ suit ur actioll ~hall have finally been determined If ad\'Crsc to the Jef.
ferson COUIllY,
Except as herein authori/.ed. no excavation shall be made or obstacle placed wilhin the limits of a county rmd in such a manner as to interfere with
the travel uver said road.
Except as herein authorized, no cxcu\'uliol\ shall be maJe or obstacle pl;u;:eJ wilhin four 141 feel III' Ihe cdge of the pa\ClI1Clll.
If the work done under Ihis permit interferes in any way with the drain:lge of the COUllty road. the grantee shall wholly and at IllS own expCll!.e ma"c
such provision as the engineer may direct to ta"e care uf said drainage.
On completion of said work herein cOlltemplated all rubbish and debris ~hall he irnmelJiatcly remo\led anJ the roadway and road!.ide shall be Idt lle.<Jt
and presefllablc and satisfaclory to the engineer,
All of the war" herein corllemplated shall be done under the supcrvi~ioll and to Ihc sati!.faction of the County Engineer and the entire expense of 1.aid
supervision shall he borne by the party or parties 10 whom this permit is iSMled.
The Department of Public Works hereby reserves the right to order the change of location or the removal of any structure or structures authorized by
this permit at any time, said change or relllO\lalto be rmu.lc at the ~ote expense or the party or partics to whom this permit is issued. or their successors
and assigns.
All such changes, reconstruction or relocation hy the grantees !>hall be done in sllch mallller as will cause the least illlerfcrellce with any of the Coun-
ty work and Ihe County of Jefferson shall in no wise he held liable for any damage to the gr,lntce by reason of any such work by the COUnty of Jeffer-
son, it Olgents or representatives, or by the exercise of any rights by the County upun roads. Weets, public places or structures in question.
This permit or privilege shall not be deemed or held to he an exclusive one and shalll10t prohibit the COUIIIY frolll granling uther permits or franchise
righls of like or other nature 10 other public or priv:'lte utilities. nor shall it prevent the Coullty frorTlusing any uf its roads, streets, or public plOlces. or af,
feet ils righl to full supervision and control over all or any part of them. nOlle of which is herehy sllrrendered.
The Department of Public Works may revoke. ,llllend or cancellhis permit or anyof the provisions thereoLtt any time by giVing writtcn nOlice to the
pcrmittee. The permittee shall immediately remove all facilities from the right of way. Any facililic!<l remaining upun the righl of way 30 days after writ-
ten notice of cancellation shall be removed by the County III Ihe eX!'lCnse of the permittee.
The pany or parties to whom this permit is iSSlled shall nHlintltin at his or their sole expcn!<le the structure or object for whicl1lhis permit is granled in
a condition satisfOlctory 10 the Departmenl of Public Works.
SPECIAL PROVISIONS,
1, May open cut ?i-h Ave. shall restore by placLng 6" of crushed su-facLng
(COITf"3Cted) and 6" of asphalt concrete,
2. ALL dLsturbed areas shall be restored to orLgLnal condi.tLon,
In accepling this permit the grantee, his sUcces~ors and assigns, llgrec that any damage or injury done to the properly of the grantee or any expense
incurred by him through the operation of a cOlllrnctor. working for Ihe County or any Coullty employee shall he lit the sole expense of Ihe grantee, his
successors nnd assigns.
? / ~ .EJ ~ ,Ihc "I1<lm;""cd, herehy ncccpts Ih;'pc'I1<;1 ,,,hjeCllllthc lerll"
and C()lIditiO=h~~1 fonh. .
Dnted Ih;, 10 Ih,y of ;;1'e>-c..J ,19 %"6
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1820 Jetlerson Slreel
P.O. BOll: 1220
Pori Townsend, WA 98368
(206) 385.9160
JEFFERSON COUNTY
OEPARTMENT OF PUBLIC WORKS
AI'I'UCATJON JlOI( I'ERMIT
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To Department of Public Works,
Jefferson County. Washington.
The undersigned /'::?-,,,f /;,r.,>-",,<;c-?2d -(~)t'}:ler Dr;,D ;.,
herebyapp/~ jorpermisslon /0 CJ~&n C!q'T""",,,,,,,;.!f!:,{;,q,,f,;!..,1.;:tv,,,,,,,'!., p ~'~V
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On CoulllY Road:
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13 U';1 "- e1l\.. <;, 6etween
rSIUlt' 1I1'tJ't','II'm'...'m~.1 '" mIl.. p/Jil/O
alld agree~ to do the work ill accordance with your rules and regulations and subject to your inspection and appro\'al.
Dale 1/- 2 , 19~
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t:/' (SIIlIlU1Urel~'hCU11l1 tC"ontruClnrl
_I Hf applicanl is a copartnership, set forth n:1lTIl.-=S of Copllrtners)
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Jefferson Co.
DEl'ARTMENT OF !'UIJLlC WORKS
District No,
,;
Permit No,..J2!lQ't--
SUIJcrvlsor's J{cllOrl No.
Supervisor will make derailed report Wilh his recommendation 011 this applicatio!l. Whenever pOS!J'ible show sketch of proposed
work. Supervisor will a/so make additional repurts ondjinal report giving dUle afculllpletion of work oll/his/orm.
I)rcliminary Itcporl:
X",J-eIU@c:'-"c...r of '/":!" ",?N,~,E'MOOR.e S'r'. ~'r' 0./8
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+i>-A--J U-eo \.O.v{) /lee b -10 ~~ ~ ;:r-: WI f/'-'i'l.
mer w; r/l" "',-,.., E;~ Ie, LYe. Dee' De D fr::J s; c (' /-/yD/:J.t.+N r-
''''' rle. NC7R.-.rf""esr Q'-'\It-P,2..-i-'r- <>F l1.e ;r::AJ""~I2S<::L:r-,o,J
Date:
11- 7 - B 'i? _
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Signed:
Final Report:
PERMIT INSPECTION REPORT
V
\Vork covered by permit has heen completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control.. adequate
.. inadequate
REMARKS
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0050
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1B20 Jef!tJfson SlrCI:!
P.O. Box 1220
Pori Townsend, WA 98368
l206) 385 9l{iO
Di>trlcl No, 5
PERMIT
In accordance with all applicable Revised Codes of Washington and umcndrncllls thereto, and subject to all the terms, condi-
tions and provisions written or printed below Of 011 any part of this form
PERMISSION IS HEREBY GRANTED TO Patten Paci.fi.c Northwest. I nc" 1 001 Hwy,
101 E" Sui.te 9, Sequi.m. WA 98382
to LnstaLL a cuLvert and prLvate dri..veway on the south sLde of Larson Lake
Road at m.p. 0,32
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County Road No, 503008
Franchise No,
Milepost 0,32
No work shall be done under this permit until (he party or panics (0 whom it is granted shall have communicated with and
received instructions from
This permit shall be void uniess the work herein contemplated shall have been completed before June 5 ,i9 90
Dated at June 5, 19 89
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CALL 48
HOURS
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By -!J~ K~
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In accepting this pcrmillhc grlllllCC. his StlCl;cssors IlIllI assigns. agree th:lI11llY darna~c or injury done 10 the property of the grantee or an~' expense
~~I~~~~~~r~Ya~~ma~~lrg~~~h ~ATT~~n (~ACC'~~lI~C ~N,pIf~(IiWE~OT'~ty oi'iSC:ounIY employee shall he <lIthe sole expense of the grantee. his
7J 0Jv1 t.v. ~ . the tlllucrsigncd. I1crchy <IeeeI'm this permit subject to lhe terms
lInd conditions liS herein set r~l,
Dilled Ihh (,11- day of ~
)j~ W. ~
.19 J 4
GENlmAL /'Il0VISJONS AI'I'I.ICAIlLE TO ALL /'EIlMITS
This permit is ~ubjcct wall applicable provisioll!.of the Revised ('odes of WasllillgIOI1.C>.l:cpllhat an} plunSlOlI illllll'!> agrcclllclll nOII.:UJISI"tCllt with
such resolution shall be COlllrollillg.
A bUill.! ill the amount or $
h. rC4uucu for the prutecLion ol the I:ounly as set funh ill the terms of tht: bond.
During the progre~s of the ....ork ~uch barrier~ shall he erected amJ m:.lilltailleJ us lIlay Ix: Ilecessur~' or as fila}' be dilcl.:teJ fllf the prutel.:tioll 01 the
traveling pubfic; the harriers shall be properly lighted utllighl.
In accepting this permit the petitioner, bis SUCl.:cssors alld a~signs, ugrces to prutect Jcffcr.son COUIlt)' and ~a\'e it harmless frurn all claims, uctiollS und
dmnagcs of every kind and description which II1U}' accrue to or be !iuffered hy un}' pcrsoll ur persons, corporatioll or property hy reuson of the perfor.
mancc of an)' !iuch wurk, l.:haracter of materials uscd ur manner of installation. ttlUlnteuam;e and oper:.ltioll or hy the irnprolx:r occupanq uf right of
way or public plact: or public structure, and in case any suit or action is hrought against said Jerferson Cllunty fin damages urh.iug out of ur b)' Ica..on of
any of the above C<luse~, the petitioner, hi~ sUcce~sors or assigll~, will upon notice 10 him or them of COfllmencelllt'nt or !ioch actioll, defend tht: '>ame at
his or their own sole cosl and eXpell~e and will satisfy any judgtllellt ufter the said ~uit OJ aellUII shall have finally bcen dctermlned if advcrse to the Jcf.
fersull Cuunty,
Exccpt as herein authorized, no excavation shall be lI1:.ldc or ohstaclc placcd within the limits of a coUI1lY road III such a manncr a.. to ilHerf'crc wilh
lhe travel over said road,
Except as herein authorizc<.l, no cxcavation shall he Ill<lde or ohstacle placed Wilhln follr HI feet of thc edge of the pa\-emenL
If the work done under this permit interferes in alJY way with the drainage of lhe counlY mall, the grantee !.hall Wholly and at his llWlI expen~ /lla~e
such llrovision as the cngineer may direct to take C:lre of said drainage.
On completion of said work herein cOlltemplated all rubbish and dcbris shall be immediately rellluved and the TOildway and rnadside !>hall be left neat
and presentable and satisfactory to the engineer.
All of the work herein contemplated shall bc done under the supervision and 10 the satisfilction of the Count)' Engineer and the cIlIirc cxpeme of said
supcrvisioll shall be borne by the ,~nY:l\~:,1!e\w;wholll tbis permit is issued.
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Thc Departmcnt of Public Work~ h~reby \~J\11S' the nghllo order the change of location or the removal of any MrllelUre or slructures authorized by
this permit at :II1Y time, said chang'cl or r~I;)(\\'al!th h~ Inade at the sole expense uf the pany or parties to whom this permit is issued, or their successors
and assigns. " . ..
All such changes, reconstruction or relocution by the gr:lI1tecs shall be dOlle in ~ueh I1Hllll1er as Will cause the least interference.... ith allY of the COUll'
ty work and the County of Jefferson shall in no wise be helll liable for any d:llllagc to tile grantee by re:.lson of any sueh work 0)' thc COUnty or Jdfer'
son, it agents or represcntatives, or by the excrcisc of any rights by the Courny upon roads. liIreets, public places or structures in qucstion.
This permil or privilcge shull not be deemed or held to he all exclusive aile and !'Ih:lll [l(lt prohibit tIle COllnty from granting other permits or franchise
rights of like or othcr nature to othcr public or private utilitics. nor shall it prevcnt the COUIlIY from using uny of its roUt!!>. strcets, nr public placcs. or af.
feet its right to full supervision and control over all ur un}' part of thcm. nOlle of which is hcreby surrendered.
The Departmcnt of Public Works may revo,,"e, amend or cancel this permit or any of tllC pw\'isions thereof at :ln~' timc by giving written notice to the
permittee. The permillce shall immediately rcmove all fucilities from the right of way. Any facilities remaining upon the right of way 30 day!> after writ-
ten notice of cancellation shall be removcd by the Coullty at the cxpense of thc permittce.
The party or partics to whom this permit is issued shall maintnin at his or thcir sofe expense the structure or objecl fur which this permit is granted in
a condition satisfactory to the Department of I)ublic Worh.
SPECIAL PROVISIONS: 1- A 12" X 20' cuLvert requLred wLth gravel COver.
2- All brush shall be cut back to Lmprove sLght dLstances, 3- ApplL-
cant shall be held responsLble for all damages to the county road
rLght of way.
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NO:
0060
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jel!ersan SlIeet
P.O Box 1220
PorI Townsend. WA 983611
(206) 385.9160
Di:jl,icf No, 5
PERMIT
In accordance with all upplicablc Revised Codes of Washington and iHllclHJlllcnts thereto, and subject to all the terms, condi.
tions and provisions written or printed below or 011 any part of this form
PERMISSION IS HEREBY GRANTED TO Patten Paci.fi.c Northwest
1001 Hwy, 101 E" Sui.te 9, Sequi.m, I~A 98382
to LnstaLL a cuLvert: and prLvate drLveway on the north sLde of Larson
Lake Road at m.p, 0.46.
&~~~@WlEIDJ
County Road No.
503008
Franchise No.
Milepost 0, 46
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
received instructions from
This permit shall be void unless the work herein contemplated Sh.lll have been completed before
Dated at June 5 , 1989
June 5
,1990
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CALL 4B I
HOURS
BEFORE
YOU DIG
By ---<J~ I<~
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GENEnAL l'nO\'ISIONS AJ'I'L1CAIlLE TO ALL l'EnMITS
This permit issubjccl to all upplkablc pfovisiom urlhl.: Rl.:vhci..l Codes "fWashington, CAecpl that an)' prO\I\IUn inltm. agreement riot C(lfl~jstCllt Wilh
such resolution shall be contrulling.
A bond ill the amount of $:
is rcqu;rcu for the prulCl:lioll at the COUIlI} a... set tOllh lil the tcrlll" uf the bond
During the prugrc!>s of the work such harriers shall he elected and lIIuirHaincd us llIay be Ilccc!o.sary ur a... llJa} he directed 1111 the PrcJ(CClIOII of lhe
traveling public; the barriers slmll be properly lighted at night.
111 (l\:ccplin1\ this perfllitlhe pctitiuner, hi~ ~ut:cc~~{Jrs and as~iglls, agree~ to protect JeffclsOII COUIIIY and ~\'e It hanllle~s from all c1aLJIl~, actiom and
damages of every kind and de.!.criptioll whkh may accrue to or be .!.uffen:d by allY person or pcr~(Im, corporatlu/I or property by /l,~ason of the perfo,'
llIance of allY sut:h work, character of flI<lteriab uscd or mallller of install<llloJ\, mainlcnance allllllpcration or by tIll: improper OI.;cupallCY of right ul
way or public place or public strllcture, UIllI ill case allY ~uil or action is broughl against saiLl Jd'fersoll County for damages arising OUt of or b)' rcason or
any of the ubove eau~es, the pelitioncr, his !.uccessors or a!.signs, will U[lon Ilolice to him or thcm of COllllllcnccmellt of such action,deFend the ~mc at
his or their own sole co.!.l and eXpell.!.e and will satisfy allY judgment aftel the .!.aid suit or action shall h<l\'e fin<llly heell Jetcrmirll:d if ad\crse to the Jef.
ferson Coumy.
Except as herein uuthoriled, nll c:xcuvalioll shall be ll1<lde or obstacle placed within tbe lunits 01:1 C()IHlty road in !.Udl a manner <lS 10 interferc with
the tmvel m'cr said road.
Except as herein authorized, no excavutiol1 shall be made or oh!.tacle placetl within four (4) feel of lhe cuge of the pa\'efllelH.
If the work done under this permit interferes in any .....u)' with the drainage of the COUIlI)' road, the grantee ~1J:l1I wholly and at his OWII expense make
such provision as the engineer lIlUY direct to take care of said drainage.
On completion of said work herein contemplated all rubbish and debris shall be immediately removed and the roadway and roadside shall he left Ileat
and presentable and satisfactory to the engineer.
All of the work hercin cOlltemplatcd shall be done undcr the supervision lInd to the satisfaction of the County Engineer and the entire cxpcn~ of said
supervision shall be borne by the party or parties to whom this permit is issued.
The Depurunenl of Public Works hcreby reserves the right to order the change of location or lhe rcmoval of any structure or structures authorized by
this l}Cr~lit ut an)' time, said change or rCll1uvul to be.i~~~e illt~c ~ole 'cxpense of the party or parties to whom this permil is i~~ucd, or their successors
lInd assigns. .":.:,, :.
All such changes, reconstructioll or relocation h)' the grantees shall he done in.~uch llI<lllllCr as will t::lu~e thc k:lM irncrference wilh anr of the Coun.
ty work and the County of Jefferson shall in 110 wise be held liable fur any dUlIlilgC to lhe gruntee by re;lson of any such work by the Count)' of Jeffer.
son, it agents or representatives, or by the cxercisc of any rights by the COUllIY upon roatls, strects, public places or structures in question.
This permit or privilege shall not be decmcd or held 10 be an exclusive one and !.Imllnot prohibit the ('ounty from granting other permits or franchise
rights of like or other nature to other public or privute utilities, nor shall it prevcnL the County from using any of its roads, ~treets. or public places, or af.
feCI its right to full supervision and control ovcr ull or uny part or them, nOlle of whkh is bereby surrendered.
The Department of Public Works llIay rcvoke, amend or cunccl this permil or an)' of the provi!.ions thereof at any time by giving written notice to the
permillce. The pcrmitlce shall immediately remove..1I fllcilitics froJllthe righl of wuy. Any facilities rel1l<lining upon the right of way 30days after writ.
tcn notice of cancellation shall be removed by thc COlllltY:1I the expcn~e of the permiuee.
The party or partics to whom this permit is issued shall maintain at his or tl1dr ~ole expense the structure or object for which this permit i~ granted in
a condition sutisfuctory to the Department or I>uhlic Works,
SPECIAL PROVISIONS: 1- A 12" X 20' culvert shall be requtred wtth gravel cOver.
2- Brush shall be removed to allow for si.ght di.stances, 3- Appli.cant
shall be held responsi.ble for all damages to the county road ri.ght of way,
In accepting this permil the grantec, his successors ..nd assigns, agree th:1I uny damage or injury done to the property of thc gruntcc or an)' expensc
incurred by him through the operation of a contractor, working for the County or uny County employce shull be atlhe sole expense of the grantee, his
Sllccessors uod ussignA PAT~~ PTlJ:J.F'[.CfJ NORTHWEST, INC.
I eJOJ\.Jj /~ , thc undersigned, herehy IIccepts this permit subjcCllo the tcrms
und conditions us hercin set1tlrth.
Dntcd .his C. f I, dnyor r ' 19 )l'l
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District No.
5
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jut1erson Slreel
P,O. Box 1220
PorI Townsend, WA 98358
(206) 385.9160
N~
0061
PERMIT
In accordance with all applicable Revised Codes of Washington am.! amenuments lll\:rclo. and subject to all the terms, condi-
tions and provisions written or printed below or Oil any part of this form
PERMISSION IS HEREBY GRANTED TO Patten PacLfLc Norl-hwest lnc,
1001 Hwy, 101 E" SULl-e 9, SequLIIl, ~~^ 98382
instalL a cuLvert and prLvate driveway On the north sLde of
Larson Lake Rd. at IIl,P, 0.53
to
County Road No, 503008
Franchise No,
,53
&~~~@W~~
Milepost
No work shall be done under this permit until the party or partics to whom it is granted shall have communicated with and
received instructions from
This permit shall be void unless the work herein contemplated shall have been completed before June 5
Dated at June 5 , 19 89
~ .,.,; l CALL 48
rf""':;\,% HOURS
rr BEFORE
J... YOU DIG
a;. fl .I
1.800.424.5555
,1990
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GENElIAL l'Il0VISIONS AI'I'L1CAIII.E TO AI.L l'EllMITS
This permit is subject to ",II applicable pruvisiuns of the Ih:...i<>cLl Ctx..lcs of Washing toll, except IIL<.II any provislun III tIllS agrcclllcllt not l.:unsl,>tclH with
such rC!\OIUlioll shall he wntrolling.
A bOlld in the UlI\UUII\ of $
is n.~4uircJ for Ihl~ protectloll 01 the COUllt) as '>CI lonllm the tcrlll" 01 the bund.
During the Ilfogress of the work such barriers shall be erected UIIO maintained as lIlay he lleees!>:.!r)" or as may be JlfcctCJ tor the prutccllun 01 the
travclillg public; the barriers .'IlIall he ploperly lighted at !light.
In accepting this permit the I"lo:tiliollcr. his sw,:ccssurs ;Illd us\igm.ug,ree!O to protect Jeffefson Coullty lIlId ':klve it harllllt::ss frulll all dllilllS, actiollsand
damagcs of cvery kimI and description whkh lllUY al:crue hi or he suffered by um' f)<:rsoll or [ll:rsOlls, eOfIXJratlon or property by rcason of the perfor<
lIIancc of tlllY stich work. character of materials used Of manller of installation. muilltenance alld operatillll or by the improper IJCcupaney of fight of
way or public place or public structure, and in caSt: UIlY suit or action b brought against said Jefferson Coullty for damagcs ilrisillgout of or by rea"ollof
any of the abu\'c causcs, the petitiollcr, his successors or assIgns, will UIXJIIllOtlCe to him or them of cOllll1lclleemelll of such m:tit)il. defcnd the same at
his or their own !Oole cust alld expense and will satl\fy allY jUlJglllCllt after the !Oaid suit or action shall havc finally been dl:lerrllilled if ad\cr!Oc wthe Jef-
ferson COUllty.
Except as herein authorized. no cxcavation shall hc made or obstacle placet.! willlinlhe limils of a counl}' road in \Ud1 a manner a\ to interlcre with
the travel over said road.
Except as herein authorized, rlO excavation slwll be maue or ohstacle placeu withill four l4l fcet of the edge of the pa\'cment.
If the work done under this permit interferes in allY way with the drainage of the counly r(lild, Ihe granlee ..hall wholly and at his own expcl1\c ma~e
such provision as lhe engineer may direct 10 take ctlre of saki drainage.
On completion of said work herein contemplated all rubbish altd debris shilll he imlllediately removed alld thc roallway alltI road~ide ..hall be left neat
and presentable and satisfactory to the engineer.
All of the work herein contemplated shall be done under the supervision and to the sati,sfactiorl of lhe County Engineer and the entire expense of ..aid
supervision shall be borne by the pany or panics 10 \~boll1 this permit is i~sued.
The Depanll1enl of Public Works hercby reserves (lie right 10 order the dmllge of location or the rcmoval of arW struClUre or Mrlil.:lUrcs authori/cd h~'
this permit at any timc, said change or relllovalto be Imi.de at the sole expense of the party or panics to wholll this ~rlllil h. issued. or their SllceeSM)rs
and assigns. ' "
All such changcs. reeonstructioll or relocation by the grantces shall hc UOtlC ill \uch manncr as will cause the least interference \\itl1 any of the Coun.
ty work and the County of Jefferson shall in no wbe be held liahle for any damage to the grantee by reason of any such work by the Count). of Jeffer'
son, it agents or representatives, or by the exercise of any rights by the County upon roaus, street,>. public places or structures in question.
This permit or privilege shall not be deemed or held to be an exclusive one and shall nut prohibit the County from granting other permits or franchi!>e
rights of like or other nature to other public or private utilities. nor shan it prevent the CuuflIY from u!>ing any of its roads, streetS, or puhlic places, or af-
fect ils right 10 full supervision and control ovcr all or any purl of them, nOlle of which is hereby !>urrendercd.
Thc Department of Public Works may revoke, amend or carlcel thi!> permit or any of Ihe prm'biol1s thereof at any time by giving written nOlice to the
permittee. The permittee shall immediately remove all facilities from Ihe right ()fway. ^n~' facilities remaining upulltlle right of way 30 days after writ.
tcn notice of cancellation shall he rcmoved by the County at the expcnse of the pcrmillcc.
The party or parties to wholTlthis permit is isslled shall maintain at his or their !Oole expense the structure or object for which this permit is granted ill
a condition satisfactory to the Dep;lfImcllI of Public Works.
SPECIAL PROVISIONS: 1- A 12" X 20' culvert rcquLred wLth gravel cover.
2- Brush shall be removed for sLght dLstances, 3- ApplLcant shall be
held responsLble for all damages to the county road rLght of way,
In accepting this permit the grantee, his succes!>QfS and assigns, agree thut any dumage or injury donc to tlte property of the grantce or any cxpense
incurreu by him through the opcr1l1iorl of a contractor. working (or Ihc County or uny County employee shall he at the sole expense of the grantee, his
successors 1Iml assigns. rRATTEN ~~ClfjIC. !j..CfRTHWEST, INC.
J J ~ ~ . the unuersig,ned, hereby accepts thi\ rcrmil subjcct 10 the terms
and conditions as hercin set furthe)
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0062
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jel1crson Slrcel
P,O, Box 1220
PorI Townsend, WA 983f.J8
(206) 385-9160
Di~N riel No.
PERMIT
In accordance with all applicable Revised Codes of Washington amJ :.uncnJrncJlts tht.:TCW. and subject to all the terms, condi.
tions and provisions wrillcn or printed below or 011 any part of this form
PERMISSION IS HEREBY GRANTED TO Patten PacLfLc Northwest
1001 Hwy, 101 E., SuLte 9, SeguLm, l~^ 98382
to i...nstaLl a prLvate drlveway On the south sLde of Larson Lake Road at
m,p, 0,57
&~~~@W~~
County Road No, 503009
Franchise No,
Milepost 0, 57
No work shall be done under this permit until the pnrty or parties to whol11 it is granted shall have communicated with and
received instructions from
This permit shall be void unless the work herein contemplated shall have been completed before June 5 .19 90
Dated at
June 5
,19 89
~fi~
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CALL 48
HOURS
BEFORE
YOU DIG
By ./J~ K~
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GENEltAL l'It{)VISIONS AI'!'UCAJlLE TO ALL l'EItMITS
Thi~ permit is subject to all applkahlc provhium of thl.: RC'w'i....cd Codes of Wa~hil1l!.toll. exccpt that all)' provIsioll Julius agrcclIlclllllol comlSlcnl wilh
such resolution shall be controlling. }
A bond ill the amount of S
i!> rCl.luircJ for the prolcclloll of lhe r,;UUllti' as M:t lorth in the tcrms ul the bond
During the progress ()f tile work such barrier!> shall Ill' crcctcu and maintaineu as ma)' be tlc(;cs'k..lr~' or as mai" he lhrcclcu 101 the PIOICCIlUIl of the
traveling public: the barriers shall he properly lighted <tllligill.
In accepting this permit the petitiol1er. his suc'cssur~ and a!>signs. agrccs tu prote(;t Jeffersoll Cuunty and sa'lC il harllllcs~ from all dalln.... aclioll!> ami
damages of e'lcry kind and dcscription which lIlay a(;CHIC tn or be suffered by allY ll\:fSOII or persolls. wrporatJOll or property by leason uf the [l\:rfor-
mance of allY such wor~. character uf materials used or mallller of installation. maintenance and operatlOlI or by the improper (XcUjlancy of ri~',ht of
way or public place or public structure. and in casc allY suit or ,Il;tion i~ hrought agaillSt said Jeffersoll ('oullty for darnage~ arising out of or b} rea~m of
any of the abo'le causc!>. the petitiuller. his suc(;essor!> {)f a!osigns. will upon nulke to him or them of cornlllenCelllel1l of such a(;tion. defend the ~rne at
his or their own sole cost andcxpellse and will !>atbfy any judgmellt after the saill suit or action shall have filially hecn dctermillell if advcr!>e to the Jef.
fersonCoullty,
Except as herein authori/ed. 110 eM;avation sll.lll he made or obstucle placed witlllllthe limit, of a ('OUllty nlOH.I in !>.uch a Illallner as to interfere "'ith
dlC lravcl oyer s3id road.
Except as herein aUlhori/,ed. no ex.cavation shall be IIltll.le or obstaclc placed within four 141 feet of the edge of the pavernelll.
If the work done under this permit interferes in any way with tile drainagc of the county road. the gralllee shall wholly and at his OWI1 expcnse ma~c
such provision as the engincer may direct to take care of said drainage.
On complction of said work herein contemplatcd all rubbish and debris shall be illllllediatc1}' rcmo'led nud the roadway anll roadside shall be left neat
and presentable and satisfactory to the engineer.
All of the work herein contcmplated shall be done under tile supervision and 10 Ihe satisfaction of tile County Engineer and the entire expcll~ of !Wid
supervision shall he borne by the party or p3rties 10 whom this permit is isslled.
The Departlllelll of Public Works hereby resencs the right IU order the changc of location or the removal of an}' structure or structures authorl/.ed by
this pcr~11it at any time. said ch3nge or rellloval to ~'e made at the sole expense of the party or p.H1ics to whom this permit i!>. issued. or their succes!>Ors
and assigns.
All such changes. rcconstruction or rcloc.Hion by the grantee:>. shall he dOlle in :>.uch manner as will cause the leasl interference .....ith any of the Coun-
IY work and the County of Jefferson shall in no wise be held liable fur any damage to Ihe grantee by reason of any such work by the COUIllY of .leffer.
son. it agents or representatives. or by the exercise of any rights by the County upon mads. streets. public placcs or structure~ in question.
This permit or privilege shall not be deemed or held to be an exclusive one and shall nOl prohibit the County from granting Olher permils or franchise
rights of like or other nature to other public or private utilities. nor shall it prevellt the County from using any of its roild~. streets. or public places. or af.
feel its right to full supervision and control over all or any part of thcm. none of which is hereby surrcndercd.
Thc Department of Public Works may rc'loke. amend or cuncclthis permit or an}' of Ihe provisions thcreof at an}' time by giving written notice to the
permittee. The permittec shall immediatcly rcmove all fucilities from the right of way. Any facilities remaining upon the right of way 30 days after writ.
tcn notice of cancellation shall be removed by the County at the ex.pense of the permittee.
The party or purties 10 whom this permit is issued shull maintain at hi!>. or their sole expcmc the strtlCture or object for which this permit is granted in
a condition s.uisfaclory to the Department of Public Works.
SPECIAL PROVISIONS: 1- Brush needs to be removed t-or stght dtstances.
2- ApplLcant'shalL be held responsLbLe for aLL damages to the county
road rLght of way,
".',..
..,
In accepting this permit the grantee. his Sllcccssors ami assigns. agree th.u .lIlY damage or injury done to the property of thc grantee or any expense
incurred hy him through the operation of n contractor. working for the County or llny County employee shall he at thc sole exrcnse of the gruntce. his
sue","o" and ",sigus, !!fATTEN J~CJ~R'l'HWEST, INC.
/.1 O/'J; . tbe undersigned. hereby accepts this permil !>.uhject to Ihe terf1l~
and conditions as herein set fore
DalCdlhis ~t~ day or r ,19?1
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0063
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 JeHerson SHeal
P.O 80x 1220
PorI Townsend, WA 983t:i8
(206) 385-9160
~~~
Dis/ficl No.
5
PERMIT
In accordance wilh all applicahle Revised Codes of WasllingroJl and arncnumclIls thereto, and subject 10 all the terms, condi-
tions and provisions written or printed below or 011 any part of this form
PERMISSION IS HEREBY GRANTED TO Patten Pacific Northwest, Inc.
1001 Hwy. 101 E., Suite 9, Sequim, WA 98382
to install a private driveway on the north side of Larson Lake Rd. at m.p. 0.58.
f.\ IIDIIDrRJ, !,0'n'7fflm
lftJlflnr : ~~UlJ
County Road No. 503008
Franchise No.
Milepost 0.58
No work shall be done under this permit until the party or parties 10 whom il is grunted shall have communicated with and
received instructions from
This permit shall be void unless the work herein contemplated shall have been completed before
Dated at June 5 , '989
June 5
,1990
~f? I
J:a,;.~.
CALL 48 I
HOURS
BEFORE
YOU DIG
By Jj~ KL
.I
1.800-424-5555
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GENEIlAL l'Il0VISIONS AI'I'UCAIII,L TO ALL l'EllMITS
Tllb pr.r1llit issubjccl 10 all applicable pru\'hiotlsuf the Kcvi~u Codes of Wa~billgtof1, cACCpl that UII} prm"blOJl luthi... ugr::clllcut flul CUml\ICIII with
such resolution shall be COlli wiling.
A bono in the amount or $
is rCljuircu for the prutcctiulI of Illc county as set forth in the Ic:rlll\ of the hOlll.J
During the progress of tile wurk such barriers shall be crcl:tcJ OJIlU llWll1WlllCd as Ill<lr be /lCLCssar)' or us Illil)' be UlfcCtCt! ror the pflJ\cc\ioll uf the
traveling public; the barriers shall be properly Jightcu..1t night
1/1 accepting this permit the pclitiofler. his SUl.:l.:e~sor!> and :Js~iglls. ugrees to prolC!.:t Jefferson CoulIty und sa...e it h:Jrlllless 110m all dallll~. al.:tium and
damages of every kind and description which may uccrue to or he suffered by any person or persons. COfJlllt<Hioll or property by reason of the perfO/-
mance of aJl~' :-;uch work, character of materials used or lIlaflllCr of installatioll, maintenance alld operatiull or b~. the Improper occupallCY of ngtll of
way or public place or public structure, aud ill casc uny suit or action is brtJughl against said Jefferson Coullty for dall1a!;cs arising out of or by rea"o/l 01
allY of the abuve causes, the petitioner, his successors or assigm, will Upollllutice to him or them uf CUlIlIllellcelltCnt of su!.:h a!.:tion. defend the same at
his or their own sole cust and expen!<oe and will s:Hisfy :lIlY judgmcnt after the said !<ouil or action shall havc finally been determined if ad\crsc 10 the Jd.
ferson Coullty.
Except as herein authorized. no excavation shall he made Dr ob!>tade pla!.:ed withJl1 the limit.... of a counly road in\UI;h a manner as 10 intelfere with
Ihe Ira vel over said roaLl.
Except as herein authorized, no exca\'ation sl1..11 be made or obslade placed wilhin four (4) fect of the edge of the pavement.
If the work done under this permit interferes in any way with lhe drainage of the COUllty road. lhe grantee shllll whully and at his own expense make
such provision as the engincer may din:ct to take care of !ooOlid dntinage.
On completion of said work herein contemplated all ruhbish and lIehris shall he illlmclliately removed and the roadway and roall!.ide shaJJ be left neat
and presentable and satisfactory to the cngineer.
All of the work herein contemplated shall be done under the supervision and 10 tILe satisfaetioll of the CoulIty Engineer and the entire C\pellSC of !>aid
supervision shull be borne by the party Ilf parties 10 whom tllis permit is bsued.
The Department of Public Works hereby rcserves the right to ordcr the change of location or the remm'al of any structurc or slructures authori/cd by
this permit at any time, said change or relllovalto be made at the sole expense of the party or partics to whum this permit is issuell. or their successors
and assigns. , <
All such changes. rcconslruction or relucation by the grantees shOll! be done in !.llch manner as will cause the least interference with any of the Coun-
ty work and the CoullIY of Jefferson shall inllo wise be held liable for any lI:ullage to the grantee b~' reasoll of any such work by the County of Jeffer-
son, it agents or representatives, or by Ihe exercise of any righls by the CouTlty upon roads. streets. public places or structures in question,
This permit or privilege shall not be deemed or held to be an exclusive one and shall not prohihit thc COUlllY from grarlling other permits or franchise
righls of like or other nature to other public or private utilities, nor shall it prevent the COUllty from using any of its ro~ld!., strects. or public places. or af-
fect its right to full supervision and control over all or any pan of them. nOlle of which is hereby surrendered.
The Departlllelll of Public Works may revoke. amcnd or cancel this l'lCrlllit or any of the provisions lhcreofat any timc by giving wrillen notice to the
permiuee. The pcrmillee shall ill1mcdiately remove all facilities from the right of way. AllY facilities rem:lining upon the right of way 30days after writ-
ten nolice of cancellation shall be removed by the County at the expense of the pcrmillcc.
The pany or panics to whom this permit is issued shall maintain nl his or their sule expense thc strllcture or object for which this permit is granted in
a condition satisfactory to the Depanmenl of Public Works.
SPECIAL
1
2
PROVISIONS,
- Brush removal is required for sight
- Applicant shall be held responsible
right of way.
distance.
for all damages to the county road
In accepting this pcrmitthc grantee. his successors lIf1d assigns. agrce that any damuge or injury donc to the property of the grantee or any expcn:-;c
incurred by him through the operation of a cOlHrac\(Jr, working for the County or uny County cmplo}'t'e shall be at the sole expense of the grantee. his
successors and assigns. PATTEN VA_C~IJIC NORTHWEST, INC.
~ CJ.:VI w ~ ~ , the undersigned, hereby Ilcccpts this rcrmit subjccl to the terms
IIml conditions as hcrcintyl forth.
Dated .hi, (.,,, .la, of r ,I' '.i 1
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0064
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1620 Jeflelson S!rt:el
P.O. BOil 1220
Porl Townsend, WA98368
(206) 38~'9160
Di~lricl No. 5
PERMIT
In accordance with all upplicabJc Revised Codes of Washington l.ll1d amcndrncI1ls thereto, and subject LO all the terms, condi.
tions and provisions written or printed below or 011 any pan of this form
PERMISSION IS HEREBY GRANTED TO Patten Pacific Northwest, Inc.
1001 Highway 101 E., Suite 9, Sequim, WA 98382
to install a private driveway on the south side of Larson Lake Road at m.p. 0.66
~~~~@w~~
503008
County Road No,
Franchise No,
Milepost 0.66
No work shall be done under this permit until tllC party or parties to whom it is granted shall have communicated with and
received instructions from
This permit shall be void unless thc work herein contcmplnted shall have been completed before
Dated at June 5 , 19 89
June 5
,1990
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HOURS
BEFORE
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GENERAL I'IIOVISIONS AI'I'L1CAIlLE TO ALL l'EIlMITS
This permit is subject to all upplicahll: provision); ullbe !(cvj~cd COlJCS of Washillg.IOfl, C'!\CCpl that all~' pro~'h.i(Jn ill tllb agreement not comislcnl .... ilb
such resolution shall he controlling.
A bond in the amount of $
i... rC4uircd fur the prulcl;Uull of the COUllty as sct furth ill the lcrrm uf the bund.
During the progrc...s of the work such barriers shall he erected alllJ lIluintaillctl as IlllJ~' be lICl'Cs~...H)' or as ma)' he dirc<':lcd for the proteClIllll of the
traveling Jlublic: the barrier!> !ih<lU he properly Iightcu :11 night.
In accepting Ihili pcrmillhc petitioner, his ~ucce~~ors and as~ign~. agrees 10 protect JdTersoll County arid ~a\'e it harmle!>S fwm all dalllls, actiolls and
damages of every kind and description which JlJay accrue to or I~ suffered by any person or persoll!:>. corporallon or property by reason of the rcrfor
mancc of allY such work, character of materials used or manller of installation, maintcnance and uperation or by tlie illlpropcr occupa/lcy of Tlgill of
way or public place or public structure, and ill caM: uny suit or actioll is hrought again~t said Jeffcrson COUllty for damages <Irising OUI of or by reason of
allY of thc ahovc causes, thc petitioncr, his SUCI,:CMiorS or ussigllS, will upon nOlice to him or them of comTllenccmcnt of !-,Ul.:h aCIlU/l, defcnd the 'WIIIC at
his or their own sole cost and expense and will satisfy allY judgment ufter the s;.liJ suit or action sh:.dJ have finally bccn determilled if ud\'ersc to thc Jcf.
ferson County.
Except as herdn authorized. lIO exc;.lvaliOll shall be Illade or oh!>tacle placed wilhin the limits of a (,;oullIy rn;ut in such a manner a~ \0 interfcle wilh
JJJC JrU\'cJ over Slid Toad.
Except as herein authorized, no excuvation shall be made or obstacle ptaced within lour l4J feet of lhe edge of the pavement.
If the work donc under this permit interferes in allY way with the drainage of the cuullty road, the !;;nllllee ~hall wholl~' alld at hi... o......n CApellse make
such provision as the engineer may direct to take care of saiJ drainage,
On complction of said work herein contemplatcd all rubbish and debris ~hall hc inllllcLliately rCll10ved arid the roadway and roadside shall be left neat
and presentable am.! satisfactory to the cll!;;incer.
All of the work herein contcmplated shall be dOlle under the supervision and to the satisf;.lction of lhe County Engineer and the entire eApense of !-Jaid
supervision shall be borne by the party or parties \0 whom this permit is issued.
The Department of Public Works hereby reserves the right to order the change of location or Ihc removal of any strUCture or structures authorilcd by
this permit III any time. said change or removal to he made at the sole eApense of the party or partie... to whom lhis rcrmit is issued. or their succcs...ors
and assigns,
All such changes, reconstruction or relocution by the grantees shall he done in such manner as Will c:luse the least interfcrence with any of the Coun-
ty work and the County of Jefferson shall in no wise be held liable for any damage to tlte grantee by reason of any such work by the COUllt~' of Jeffer-
son, it ugents or representatives, or by the exercise of allY rights by Ihe COllnty upon roads, streets, puhlic places or structures in question.
This permit or privilegc shall not be deemed or held to bc an exclusive one and shall not prohibil the Coul1lY from gflullinl:! other rcrmits or franchise
rights of like or other nature to other public or private utilities, nor shall it pre\'cnt the Cuunty from using anr of its roads. streets. or puhlic places, or af-
fect its right to full supervision and contrul over all or any part of them. lIone of which is herehy surrendered.
The Department of Public Works may revoke, amend or cancel this permit nr an~' 01 the provisions theretlf at allY time by giving written notice 10 the
permittee. The pcrmiuec shall immediately remove all fllcHitics from the right of way. AllY f,lcilitics remaining upon the right of way 30 days after writ-
tcn notice of cancellation shall be removed hy the County al the expense of thc permillee.
The party or parties to whom this permit is issued shall maintain al his or their sole expense the StrUClllre or object for which this permit is granlcd in
a condition satisfactory to the Depanment of Public Works.
SPECIAL PROVISIONS:
I-Brush removal required for sight distance.
2-Applicant shall be held responsible for all
road right of way.
damages to the county
, 19 '/'1
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1820 Jel1crson Sl/ee!
u 0_ BO)l; 1220
PorI Townsend, WA 98368
(206j385.9160
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC Wll~KS
N::
0076
[)fsllicl No,
5
PERMIT
In accordance with all npplic:lblc Revised Codes of Washington and amcmJnu:nts thereto, :Jnd subject to all the terms, condi.
tions and provisions written or printed below or on any pari of lhis form
PERMISSION IS HEREBY GRANTED TO PATTEN PACIFIC NORTHWEST, 1001 Hy. 101 E., Suite 9,
SEQUIM
to INSTALL A PRIVATE DRIVEWAY ON THE NORTH SIDE OF THE CENTER CEMETERY RD. AT MP 0.29
503109
County Road No,
Franchise No.
Milepost 0.29
No work shall be done under this permit until the pany or parties to whom it is granted shall have communicated with and
received instructions from
This permit shall be void unless thc work herein contemplatcd shall have been completcd bcfore
JUNE 14 ,19 90
Dated at
JUNE 14
, 19 89
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HOURS
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GgNlmAI. 1'1l0"ISIONS AI'I'UCAIlLE TO AU, I'EIlMITS
Thh permit b!>uhjccI to'll! applicahle PlllVbjOIlS uf the Hcvi.\cd CoJC!; of Wa.'>hillgtOl1, C,\l,:l'pllhat an} pru~l..iun in thi.. iJgrCCflJCll1 1101l'Omi...tclll.....lIh
~uch resolutioll 'shall he contrulling,
^ bOlld in the UJIltJu/lt of $:
i!> required for the prutc(;lioll of the l'OUrlIY ;jJ, sel font! ill the Ie-rIm of the bOlld.
During the progrcJ.S of the work such barriers ...hall he CrCl:lcJ alllJ maintuincJ.:t!> may be ncccs~ry or i.l\ ifiLl} be Jilcl.:lcu for tile protection of lhe
traveling public; the barriers shall he properly lighted at llight.
IlIllCl:epting this permit the pctitioner, his SUIXCSSurS and ussigus, agrces to protect JefferMlIl COUllty and save it harmless from all daillls. actions and
damagcs of e\'ery kind and description which may al:crue to or be suffered by any person or persullS, corporatio/l or property by reason of lhe perfor-
Illancc of allY such work, character of materials usedllr lIlar1l1er of installation, maintenance and operatiun or b}' the impropo.:r occupancy of right of
way or public place or public structure, and in case any suit or al:tion is brought against said Jeffersoll Count}' for damages arl!:,ing (Jut of or b)' rea!.0I1 uf
uny of the above c.lUSeS, the j1CtitiOllt:r, his successors or assigns. will upon 110ticc tu him or thelll of commencemellt of such action, defend the !.:tllle at
his or their own sole cost and eJl.pcnse and will satisfy any judgmellt after the saiu suit or action shall have finally been uetwnined if auverse to the Jef.
ferson County.
Except as herein authorized, no exc:lvatioll shall be made or obstacle placed wilhinthc limits of a coullty road ill such u manner as to interfere.' with
(he lraw;~1 mw said road.
Except as herein authoril.ed, 110 excav:ltiOIl sll:.lll he made or obstacle placed within four 14) fcct of the cdge of the pa\emcllI.
If the work dOlle under this permit interferes in an)' way with tile draillagc of the county ftKH.I, the grim lee shall .... holly and at his 0.... II expense ma"c
such provision as the engineer IlHlY direct tn wke care of said drainage.
On completion of said work herein cOlltemplated all ruhbish and debris sball be imnlediately refilmed ami the roadway and roadside shall he left neat
and presentable and satisfactory to the engineer.
All of the work herein cOlltenlplated shall be done under the supervision and to the satisfaction of the COUnty Engineer and the entire expense of said
supervision shall be borne by the party or parties 10 whom this permit is issued.
The Departlllent of J'ubljc Works hereby reserves the ril:\ht to order lhe ctwllge of locatioll or the removal of any structure or structures authorized by
this permit al any time, said change or removal to be lIIade at the sole expense or the party or parties to whom this permit is issued, or their successors
Ilnd assigns.
All such changes, reconstruction or relocation by the grnntees shall be done in such ll1:1fHler as will cause the least interference with any of the Coun.
ty work :lnd lhe County of Jefferson shall in no wise be held liable for any damage to lhe grantee by reasun of UIlY such work by the County of Jeffer-
son, it agents or representatives, or by the exercise of any rights b~' the COUnty upon roads. streets, public places or structures in question.
This permit or privilege shall not be deemed or held to be an exclusive one and shalll1tlt prohibit the County from grallling other permits or franchise
rights of like or other nature to other public or private utilities, nor shall it prevelll the COlllllY from using all}' of its rowJs, streets, or public places. or af-
fect its right to full supervision and control over all or any part of them, none of which is hereby surrendered.
The Department of Public Works may re\'oke, amend or cancel this permit or any nfthe provisions therellf at any tinJt: by giving written notice to th~
pcrrnillee. The permittee shall immediately remo\'e all f:\cilities from the right of way, Any facilities remaining upon Ihe right of way 30days after wril-
ten notice of cancellation shall be removed by the CoullIY at the expense of the permiuee.
The party or parties to whom this permit is issued shall maintain at his or their sole expense the SlrUCture or object for which thi~ permil is granted in
a condition sutisf:lctory 10 the Depanmelll of Public Works.
SPECIAL PROVISIONS, I-GRAVEL COVER REQUIRED ( NQ..CULVERT REQUIRED),
2-APPLICANT SHALL BE HELD RESPONSIBLE FOR ALL DAMAGES TO COUNTY ROAD RIGHT OF WAY,
In accepting this permil the grantee, his successors and assil:\lls, agree that any d.unage or injury done to the property or the grantce or any expensc
incurred by him through the opeflltion of a contrllCtor, workilll:\ for the Coullty or any County employee shall he at the sole expcme of the grantee. his
successors lIod llssigllS.
Gf\R'f W. SM IHI
,the undersigncd, hereby acceptS this permit subject to the terms
lInd conditions us herein !'iet forth.
Dated this 22'" d d:lY of
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DiWricl No.
PERMIT
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0075
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JEFFERSON COUNTY
DEPAFlTMENT OF PUBLIC WORKS
1620 JlIl1erson SHeet
P.O. 80,1( 1220
PorI Townsend. WA 96368
(206) 365.9160
In accordance with all <IpplicabJc Rcvised Codes of Washington and <ImClH.hllCIllS thercto, and subject to all the terms, condi.
tions and provisions written or printcd below or on any part of this form
PERMISSION IS HEREBY GRANTED TO GARY SMITH/PATTEN PACIFIC NORTHWEST
1001 Hy. 101 E" Ste. 9, SEQUIM
to INSTALL PRIVATE DRIVE ON THE NORTH SIDE OF THE CENTER CEMETERY ROAD AT MP 0.20.
County Road No,
Franchise No.
Milepost .20
No work shall be done under this permit until tl1C party or partics to whom it is granted shall have communicated with and
503109
received instructions from
This permit shall be void unless the work herein contemplated sllall have been completed before
June 14 ,1990
Dated at
June 14
,1989
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GENEI(AL I'J(OVISIONS AI'('L1CAIII.E TO ALl. l'EIlMITS
This permit is subject lU all upplkable plOvbiotl\ uf tile Revised CoJc:> of Wu\hingtull, C,l;CCpl tllat any pnm...ioll jll tlli'lo Ugfl:CIIlCIlt lloll'Omhlt'1H ......ith
such rc\olution shall be controlling.
A !.xmi..l in (he UllIount of S
b required fur the pro\c(lioll of the COUlll~ i.lS '>CI fortb in the lCrlm or lhe bond
During the progrc!>S of the worl\. such barriers shull be erected and lllaillw.incLl as lIlay he Ilccc.....ary or as llHlr be dlrCl.:tcd 101 the protectlon ur the
traveling public; tile harriers shall be properly lighted at night.
111 accepting this permit the petilioner, his successors :lI1d assigns. agrees tu protect JeffersoJ1 County and ~\!e it harmless from all cIJ,Jirns, aClions <.Jlld
damages of every kind ami description which may accrue to or be suffered by any person or persollS. corporation or property by reason of the perfor.
mance of any such work, character of materials used or 1Il:lIlller of installution, l11ailltellance and operation or by the improper occuJluncy of right of
way or public place or public structure, IUld in case any suit or :U;tiOll is brought again!:>! said Jdfer!>on Coullty for damage!> arbing out of or b)' reason of
any of the above causes, the petitioner, his successors or assig.ns, will UPOfllloticc to him or lhem of commencement of such aClion, defend the same at
his or their own sole cost and c:>.pcnse and will sutisfy an)' judgmellt after the said suit or action shall have finally bccn determincd if adn:r!>e to the Jef.
ferson COUlllY,
Exccpt as herein <JUlhoril.ed. nOI.'xc,aV4Jljoll sJlaU be Illade or obstacle placed within the limits of a counly road ill such a manlier as tn interfere wilh
the truvel over said road.
Except as herein authoriled. no excavation shall be made or ohstacle placed within four (41 feel of the edge of the pavement.
If the work done under this permit interferes in allY way wilh the urainage of the coullty road. the grantee shall whlJ!ly and at his own eXllI:nsc llla~c
such provision as the cngineer may direct to take care of said drainage.
On completion of said work herein contemplaled all rubbish alld debris shall be illlllledialely removed and the roadway and ro:ldside shall be left neat
and presentable and satisfactory to the engineer.
All of the work herein contemplated shall he done under the supervision and to the satisfaction of the ('ounty Engineer and the enlire e:>.pcnse of said
supervision shall be borne by the party or parties to whom tllis permit is issued.
The Department of Public Works hercby reserves the right to order the change of loc:ltilJll or the relllo\!:ll of any structure or structures authorilcd by
this permit at any time, said change or removal to be madc at the sole e""pense of the party or panics to whum this permit is issued. or lheir successors
and assigns.
All such cIlUnges, reconslruction or relocation by the grantees shall be done in such rnarll1er as will C:lUSC the least interference with uny of the Coun-
ty work and the County of Jefferson shall in no wise be held liahle for any damage to the grantee by reason of any such work by the County of Jeffer.
son. it agents or represcntatives, or by the exercise of any rig.hts by the CoulllY urxlll roads. streels, public places or structures in question.
This permit or privilege shalln(l\ be deemed or held to be an exclusivc one amI shallnol pruhibit thc County from granting Olher permits or franchise
rights of like or mher nature to other Jlublic or private utilities. nor shall il prevent the County from u~ing al1~' of it!t rO<.Jds. strcet~. or public places, or af.
feet its right to full supervision and control over all or any pari of them, nOllC of which is hereby surrenuered.
The Department of Puhlic Works l11a~' revoke. amend or callcclthis permit or any Ilf the pr()vision~ thercof at ilTlY time by giving wri\len notice to the
permittec. The permittec shall immediately remove all facilities from the right of way. Any facilities remaining upon the right of way 30 days after writ.
len notice of cancellation shall be rcmoved by the County at the expense of lhc permiuee,
The party or parties to whom this permit is issued shall maintain at hi!t or their sole e:l>pcllse the structure or ohjcct for which this permit is grantcd in
a condition satisfactory to the Department of Public Wor\.;s.
SPECIAL PROVISIONS, l-GRAVEL ENTRANCE ( NO CULVERT REQUlRED); 2-APPLICANT SHALL BE
HLED RESPONSIBLE FOR ALL DAMAGES TO THE COUNTY RJAD RIGHT OF WAY.
In nccepting this permit the grlllllce. his successors lint! assigns. agree that any damage or injury donc to the property of the grantee or any expense
incurred by him through the O!lCralion of a contractor, working for the Cuul1lY or uny CounlY employee shall he at the sole expense of the grantee, his
successors nnd assigns.
Gf'lR'I W, SM nH
and corulitiolls us Ilerein sel forth.
Dated this 22""d dilY of
. the ulldersigned. herehy accepts this pcrmit suhject to the terms
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jclflllson Street
P,O. Boll. 1220
PorI Townsend. WA 98368
(206\ 385'916U
Di!J1ric/ No.
PEI~MIT
In accordance with <III applicable: Revised Codes of Washington and amendments thereto, and subject to aII the terms. condi-
tions and provisions written or printed below or 011 any part of this form
PERMISSION IS HEREBY GRANTED TO PATTEN PACIFIC NORTHWEST, 1001 Hy, 101 E., Ste. 9
SEQUIM,
INSTALL PRIVATE DRIVEWAY ON THE NORTH SIDE OF CENTER CEMETERY ROAD AT MP 0.04
to
County Road No,
Franchise No.
Milepost 0.04
No work shall be done under this permit uruillhc pany or parties to whom it is granted shall have communicated with and
503109
received instructions from
This permit shall be void ulIless thc work herein contcmplated shall have been completed before
Dated at June 14 ,19 89
JUNE 14 ,1990
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GENEnAL I'nOVISIONS AI'I'UCAIlLE TO ALL ('EnMITS
This permit is subject 10 all applicable pruvj~il)llS uf the Rcvbcd CoLIc!' of Wa~hil1gltm, C),(;Cpl tlHlt all}' flrovl~llm mlhJ'> agrccrncrll not wmi\tc/H with
such resolution shall be cO/llrolling.
A bond ill the alllount of $:
I!. require,! for the protection of tbe coullty <IS ~cllorltlll1 the term" of thc b01ll1
During the progrc~ of the wurk such harriers shull be erected aud lIl:lillWillCd .l!. ll1ay be ncr.;c~\ary or a!> may be l.hrcctcd for the prolcc.:uon of the
traveling public: the barriers shall he proper!}' lighted al night.
III accepting this permit the petitioner, his sUC:C:C!o!'lors and assigm., agrcc!. to protC!:l Jcfft:rsOIl County and ~ve it harmless from all dalflls, a<.:\jolls and
damages of ever}' kind and dCM:riptioll which lIlay accruc to or he sufferell h~' any person or rcrSllf1!'1, corporation or properly by reasor\of the perfor.
manee of allY such work. (,:haractcr of IIlUlerials uscd or manncr of installation. maintenance and operation or by the improper occupancy of right of
way or public place or public structure. am! ill case any suit or actioll is blOught agaimt said Jeffcrson County for damages arising Otlt of or by rea\()JJ of
allY of the above causes. thc petitioner. his succcssors or assigns. will UPUlI Ilotke to him or lhcm uf COllllllenccment of such action, defend the same at
his or their own sule cost and e"pense and will satisfy any judgment arter the said suit or action shall havc finally been deterlllilled if adverse tu the Jef.
ferson County.
Except as herein authorized, 110 excavation shall be made or oll.staclc placed within the limils of a coullly rmd ill such a manner as to interfcre with
the travel over said road.
Except as herein authorized, no e"cavation shall b~ lIlad~ 0, obstacle placed wilhin four (41 feet of thc edge of the pavement.
If the work done under this permit interferes ill any way witlllhc draillage of ll1ccounty rood. the grantee shall wholly and at hb OWI\ expense make
such provision as the enginecr may direct to take care of said drainage.
On completion of said work herein contcmplated all ruhbish and dcbris shall be immcdiately removed am! the roadway and roadside sball he left lle,ll
and presentable and satisfactory to the engineer.
All of the work herein contemplated shall be dOlle undcr the supervision and to the satisfaction of the COUllty Engineer and the ctllire expensc of said
supervision shall be borne by the party or parties to whom this permit is issued.
The Departmcnt of Public Works hereby rcserves the right 10 order the change of locatiun or the rcmoval of uny structure or !.trllcturc!> authoriled by
this permit at any time, said change or removal to be made at the solc expcn!>e of thc part)' ur panics 10 wholl1this ("l\:rfnit is issued. or their !>uccessors
and assigns.
All such changes, reconstruction or relocation by thc gratllees shall he donc in such lIlallller as will cause thc least intcrference with any of the Coun-
ty work and the County of Jefferson shall in no wise be held liable for any damage to the grantee by reason of any such work by the COUnty of Jeffer-
son, it agents or representatives, or by the exercise of any rights by the County upon rwd.s. !>treets, public places or structures in question.
This permit or privilege shall not he deemed or held to be an exclusive olle and shall not prohibit the County from granting othcr permits or franchise
rights of like or othcr nature to other public or private utilities. nor shall it rrc"ent the CoulllY from w..ing any or its roads, !otrccts. or rublic rlaces, or af-
fect its right to full supervision and control over all or any pilrt of them. none of which is hcreby surrendered.
The Department of Public Works may revoke, amcnd or cancclthis permit or anyof the rrovisions thereof at any time by giving writtcn notice to the
permittcc. The permittee shall immediately remove all facilities from the right of way. Any facilities remaining UIXlll the right of way 30 days after writ-
ten noticc of cancellation shall be rcmoved by the County at the expense of the permittee.
The party or parties to whom this permit is issllcd shall maintain ut his or thcir !.ole expense the structure or object for which this permit i!'l granted in
a condition satisfuctory to the Departmcnt of Punlic Works.
SPECIAL PROVISIONS, I-APPLICANT SHALL BE HELD RESPONSIBLE FOR ALL DAMAGES TO COUNTY
ROAD RIGHT OF WAY. 2-GRAVEL COVER SHALL BE REQUIRED (NO CULVERT REQUIRED).
In accepting this pcrmitthe grantee, his succcssors allll ussigns, agree thut any damnge or injury done to the propcrty of the grantee or any expense
incurred by him through the operation of a contractor, working for the County or any County employee shutl he lit the sole expense of the grantee. his
successors anll assigns.
G fiR, Y
amI condilions as herein set furth.
Dilled this 22. t"\ d dll}' of
v.J, 5MI'TIi
. the undersigned. hereby lIccept.~ this permit subject to the tcrms
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0073
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jllllllfson Slreel
P.O, Bo~ 1220
PorI Townsend, WA 98368
(206) 385-9160
Vis/riel No,
5
PERMIT
In accordance with all applicable Revised Codes of Washington and ..IJncndmcllls thereto, and subject to all the terms, condi.
tions and provisions written or printed below or all any part of this form
PATTEN PACIFIC NORTHWEST
10
PERMISSION IS HEREBY GRANTED TO
1001 HWY 101 E., Ste, 9, SEQUIM
INSTALL A CULVERT AND PRIVATE DRIVEWAY ON THE SOUTH SIDE OF LARSON LAKE
M.P. 0.66
ROAD AT
503008
County Road No,
Franchise No.
Milepost 0.66
No work shall be done under this permit until the pany or parties to whom it is granted shall have communicated with and
received instructions from
This permit shall be void unless lhe work herein contemplated shall have been completed before
June 14.,19.90
Dated at
,1989
June 14
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GENEI~AL l'Il0VISIONS AI'I'UCAIlLE TO ALL I'EHMITS
This permit is subject to all applicable provbiollsofthc Hcvj~cdCudcs uf WashinglOn, c).ccpt that allY pftwi\iOlI ill thisagrcc/Il'.:l1t not l.:lm,lstellt with
such resolution shall he I:Ontrolling.
A uoml in the amount of $
is required fur the prUICl.:lioll of tile COUJl(~ as WI forth in till: tcrrm of Ihe bum\.
During the progress of the wor" such harriers shall be cree leu alll.llll:1illliJl/IcJ as lIl<.l)' he !leu. s\ar}' or as Ill<lY he directed for Ibe prolcClloll of the
!raveling public: the barriers shall he properly lighted :.It /light.
In accepting this permit the petitioner. Ilis SUl;CCSSors and a~~igns. agret:s to prolel:t Jdfcr~oll COullty <Illd :.a\'e it hanllle~l> frulll all daim~, actluns and
damages of every kind anJ dc~rirtion which may accrue to or he suffereJ hy allY person or perSOIlS, corporation or properH' by reason of the perfor-
mancc of an}' such wurk, charucler uf IIHl\crial~ used or manner of installatiun, maintenancc and operatiun or b}' the improper oceupam'}' of right of
way or public place or public structure, awl in case allY suit or uctiull is brought agaimt sakllcffersoll ('ount)' for damugcsarising out 01 or hy leasollof
any of the above cause~, the pctitioner. his successors or assigns. will upon noticc to him or them of CUlIllllCllcefllclll of sudl action, defclllJ the !>aIllC al
his or their own sole C(l~t and expense and will satbfy any judgment..!'ter the said suit or action shull have finally heell determined if ..dvcrM: 10 Ille Jef.
ferson County,
Except as herein authorized, no exe:l\'utioll ~hall be marJe or ohstacle pl,ll:ed within lhe limits of <I county mad in ~ueh a marmer as 10 inlerferc with
die Inl\'c~1 O\'Cf said rood,
Except as herein authorizerJ. no excavatioll slmll be m:llle or obstacle pl:u.:ed within f"ur l41 feel of the edge of the pa\ell1ellt.
If the work dOlle under this permit interferes in any way witllthe rJrain:lge of the courltr roarJ, the grantee ...hall wholly alld at hi~ OWI\ expense ma"e
such provision as the engineer may direct to take care of said drainage.
On completion of said work herein contemplated all rubbish ami rJebri~ shall be irlllllerJiately removed am! the ruarJway and ro,u.hide shall be left neat
and presenlable and satisfactory to the enginecr.
All of thc work herein contcmplated shall be done umler the supen'ision and to the satisfaction of the County Engincer alld the entire expense of ...aid
supervision shall be borne by the party or parlics to whom this permit is bsued,
The Department of Public Works hereby reserve... the right to orrJcr 111l" change of location or tile removal of any structure or structurcs authori/ed by
this permit at any time, said challge or removal to be made at the sule expense of the pany or parties to whom this permit is issued, or their successors
and assigns,
All such changes, reconstruction or relocation by the grantees shall be done in such manner as will cause Ihe least interference with any of the Coun-
ty work and the County of Jefferson shall in 1\0 wise be held liable fur any damage 10 lhe grantee by reason of any sw.:h work by the Count}' of Jeffer-
son. it agents or rcpresclHatives, or by the exercise of any rights by the COUIlIY upon rom.ls, streets. public places or structures in question.
This permit or privilege shall not he deemed or held to be an exclusive oneanrJ slmll not prohibit the County from granting other rerrnit~or franchi~
rights of like or other nature to other public or private utililies, nor shall il preventlhe County from using OJIlY uf it~ roads, streets, or puhlic places, or af-
fect its right to full supervision and control over all or uny part of them, none of which is herehy surrendered,
The Dcpartmcnl of Public Works may revoke. amend or cancel this perlnit or allY of the provisitJrts tl1ereofat any time by gi\"ing written notice 10 the
permittee. The permittee shall immediately remove all fadlilie~ from the right of way. Any facilities remaining upon the right of way 30 days after writ-
len notice of cancellation shall be removed by lhe County at the expense of the perl11illee.
The party or panics to whom this permit is i~sued shall maintain at his or their sole expense the structure or object for which this permit is granted in
a condilion satisfactory to the Department of Public Works,
SPECIAL PROVISIONS, 1- A 12" X 20" CULVERT SHALL BE REQUIRED WITH GRAVEL COVER,
2-APPLICANT SHALL BE HELD RESPONSIBLE FOR ALL DAMAGES TO THE COUNTY ROAD R1GHT OF WAY.
In acccpting this permit lhe grulllee, his sllccessors :tnd llssigns, lIgree th:lt any damage or injury done to the property of the gruntee or any expense
incurred by him through the operutiol1 of II CmHrllctor, working for the County or any County employee shall be III the sole expense of the grantee, his
successors and assigns,
GPlR.Y W,
{Jnd conllitions ns herein set forth.
Dated this 22 lP'\J day of
'SMnl1
. the undersigned. hefCh}' accepts this permit subject to the terms
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0072
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1620 Jll!lorSOfl StrlJcl
P.Q BO:l 1220
Port Townsend. WA 98368
(206) 385.91GO
Di~lricl No.
5
PERMIT
In accordance with all applicable Revised Codes of Washington and umcnumclIls therew. and subject to alllhc terms, condi.
tions and provisions written or printed below Of on any part of this form
PERMISSION IS HEREIlY GRANTED TO PATTEN PACIFIC NORTHWEST
1001 Hwy. 101 E., SUITE 9, SEQUIM, WA 98382
INSTALL A CULVERT AND PRIVATE DRIVEWAY ON THE SOUTH SIDE OF LARSON LAKE RD.
AT M.P. 0.39.
10
County Road No,
Franchise No.
Milepost 0,39
No work shall be done under this permit umil the party or parties to whom it is granted shall have communicated with and
503008
received instructions from
This permit shall be void unless the work hcrein contemplatcd shall have heen compleled before June 14
Dated at June 14 , 19 89
,1990
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CALL 48
HOURS
BEFORE
YOU DtG
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1.800.424.5555
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GENEItAI. PROVISIONS AI'I'UCAIlLE TO ALL PERMITS
Thi!> permit is subjectlo all upplil.:ablc pfO\'i~ions of the RcvlscJ l'ooc!oo of WashillglOll, C>'CCpl that allY provbion ill this agrccmcrH nol c(lII...i~tellt wlth
such resolution shall be COlllwlling.
A bond in the <IlllOUll1 uf S
b rcquilcd for the prolcCllon of the (:OUlll) as set fOlth HI the tcrms of the bond.
During the progress of the work such barriers shall tx: l'rcL'[cJ ami mUl/lIaillcJ as lIlay be llCl.:CS\af)' III as lll<.i)' be JirCl"lcd for till: JlIotcclion oj tile
traveling public; the harriers shall he properly lighted <II nibllt.
In acccJlllllg lhi!. permit the petitioner.lLis sUl;ce:.sor:. and a:.siglls, a~rees to prote!:t Jefferson COUIlIY <llltl 1>a\'e II harmless Irom all dalllls, _H:tions and
damages of evcry kind anti description which may accrue tn or be suffered by any person or persons. corporation or property by rC:Json of the jx:rfor.
mance of allY MJch work, c1li1racter of materials uscd or manllcr of installation, Jlluinlcmmcc and operalioll or by ttle improper occupancy of right IIf
way or public place or pubHcstfucture. and ill caM: allY MIlt or action is brought against said JcfferMlIl ('oumy for damages arising out iiI' or by reOJwn of
allY of the above causes, thc IlCtitioJlcr. his succcssors or uss;gns. will UpOIl lIotke to him or thelll of COIIIlllCllCClllcnt of such action, defend the ~ruc ut
his or their own sole cost and expense alld wiJJ salisfy uny judgment after thc said 1>uit or action shalf havc finally been detcrmincd if advcrse to the Jef.
ferson County.
Except as herein authori/cd, no excav<ltion shull he Ill<ltle or obst<lcJe pl<ll.:cd within the limils of <I coullly mad III sllch <llfl<lllncr as tu illterferc wilh
the travel over said road.
Except as herein aUlhurizcd, no cxcavation sh<lll he flwdc ur (Jh~wde plal.:cd witlllll four H) fcct of the edge of the pavclllclll.
If the work done undcr this permit interferes ill any W:IY with the drailluge of the coulIty road, tbe grantcc ~h:i11 "hollY and ut hb own cxpensc lIla~l'
such provision as the enginccr may direct \0 take l.:are of ~aid iJrain<lgc.
On completion of said work herein contemplateiJ all ruhbish and dcbris shall he imlllediately rcmovcd and thc roudwllY and roadside ~hall be left ncat
and presentable and satisfactory 10 lhc cngincer,
All of the work hcrein cOlltcmpJ<ltcd ~hall be iJone uniJer the supervision and to the s<ltisfaction of the Coullty Engincer <lnd thc entirc C"'pcll~e of said
supervision shall be borne by the party or parties to whom this permit i:l issued.
The Department of Public Works hereby reserves the right to order tlte change of locatiollllf the rellloval of any structurc or structures authori/cd by
this permit at any time. said change or removal to he nwde at the sole eX!}ellsc of thc pany or partics to whom this permit is issucd. or their MJl.:CCS-,ors
and assigns.
All such changes, reconstruction or relocation by the grantees shall he done in such manner as will cause the IC<lst interferellce with any of the Coun.
ty work and the County of Jefferson sball in no wisc be held liable for any d..Ilnage to the gralllec by reason of any sllch work b}' the COUnty of Jeffer.
son, it agents or representatives. or by the exercise of any rights by the County upon roads, streets, public places or structures in question.
This permit or privilege shall not be deellled or held to he an exclusive one <llld shall mil prohibit the Coullty from granting othcr permits or franchise
rights of like or other Il<lturc to otller public or private utilities. nor shall it prevent the CoulIty from u!>ing any of its roads, streets, or public places, or af.
feel its right to full supervision and control over all or any part of them, none of which is herchy surrendered.
The Department of Public Works may revoke, amend or cancel this permit or any of the provisions thereofut uny time by giving wrillen nmice 10 the
pcrmillce. The permittee shull immediately remove all facilities from the right of way. Any facilities remaining upollthe right of wuy 30days <lfter writ.
ten notice of cancellation shall be rcmo\'ed by the County at the expense of thc pcrlllitlce.
The pany or parties to whom this permit is issued shall maintain <It hisor thcir sole expense the structure orohject for which this permit is {!.ranted in
a condition satisfactory to the Dcpartment at' Puhlic Works.
SPECIAL PROVISIONS, I-A 12" X 20" CULVERT HSALL BE REQUIREO WITH GRAVEL COVER.
2-APPLICANT SHALL BE HELD RESPONSIBLE FOR ALL DAMAGES TO THE COUNTY ROAD RIGHT OF WAY.
In accepting this permit the grantee, his successors and assigns. _lgrec tlmt uny t.lamnge or injury done to the property of the grllntee or any expensc
incurred by him through the operation of U cOlltr:letor. working for the CUlllllY or any County employee shall he at the sole expense of the gralllee, his
successors and assigns,
GPtR. Y
and conditions as herein set forth.
VJ. SMITH
,the undersigned, herehy accepts this permit suhject to the terms
DUled this
2 2 \'\d duy of
,19 '3'1
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0071
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820JelletsonSlreel
PO Oox 1220
PorI Townsend. WA 98368
(206) 385.9160
N::
DI'lrlcl No, 5
PERMIT
In accordance willI all applicable Revised Codes of Wushingtoll and amendments thereto, and subject to allthc terms, condi-
tions and provisions wriltcn or printed below or 011 any parl of this form
PERMISSION IS HEREI3Y GRANTED TO PATTEN PACIFIC NORTHWEST, 1001 Hwy. 101 E., SUITE 9,
SEQUIM, WA 98382
INSTALL A CULVERT AND PRIVATE DRIVEWAY ON THE SOUTH SIDE OF LARSON LAKE ROAD
AT M.P. 0.48
to
County Road No,
Franchise No.
503008
Milepost 0.48
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
received instructions from
This permit shall be void unless thc work herein contcmplated shall have becn completed before
Dated at June 14 ,19 89
June 14
,1990
~,.,,; I CALL 48
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ar BEFORE
J... YOU DIG
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1.800.424.5555
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GENEI~AL l'Il0VISIONS AI'I'UCAIIl.E TO ALL l'EIlMITS
Thi!. permit is subject 10 all appli~ablc provisions of the Hcvhcd Coucs uf WlJl>hillgUHl. exccpt tbal an)' pruvisioll in tillS agrcclTlcm /lot c()mi~tcllt Yo lit!
,such resolution !ilwlJ be cOIltrolling.
A bond in the allluUIlI of $
h n:Lluircd I'm llle prulcl:llllll of the I.:{)unty as ~l forth ill the lcrrn~ oj the hond
During the progrc!>.'l of the work such barriers shall be crcl.:tcJ allUlllaintalllcu a!. lIIa> he Ilccc'~r}' or as 11M}" tx: iJircl;lcu for the protectiun of the
travcling public; the barriers !>hall be mopedy lightcJ at night.
In acceJlling this perm;t the petitioner, his successor!> and a~siglls. ugree~ to jlrotel.:t Jclfer~on COUllt}' and ~a ve it harmless flOlI1 all duiltl..., actions alllJ
damages of every kind and description whkh lIlay aCl.:rue to or he suffered by any person or persons. corporatioll or property b>' reaSOII of the perfor-
mance of any such work, l.:haracter of materiuls used or manner of insl<lllutioll, llluintenance am.! uperation or by the improper occupancy of right uf
wa}' or public place or public strw:lurc, and ill case allY suit or action b brou!;ht against said Jdfersoll ("oum)' f{)f damages ari~il1g out of or by rCOl~JIl of
any of the above causes. the /lCtitiollcr, his successors or a!>signs, wilJ UpOlI IJUlice to hilll or them of COll1lllencement of such actioll. defend the !>allle ut
his or their own sole cust and eXpcII!>c OlIUJ will sOltisfy allY judgl1lelll ..fter till' said suit or ul.:tion !>hull have fillOlIl>' bt=ell determined if Oll.l\'er..e to the Jef.
ferson County,
Except as herein authorized, no excavOltioll !>hall be rn.uJe or obstacle placed within the limits of a cnunty road ill such a manner as to illterfcle \\.ith
ale lfa\'el O\w said road,
Except as herein aUlhorizl.'d, no excavation shull he lIlade or ()h~l<lcle plal.:l'd within four (4) feel uf Ihe edge of the pavement.
If the work done ulld~r this permit interferes ill allY way with Ihe drainage of the COUllty UlOId, Ihl.' gralllee !-hall wholl)' alld at lib 0\1011 eXrcll~e make
such provision as the engineer In<lY dirl.'ct 10 take care of ~aid drain<lge,
On completion of suid work herein cOIlIelllplated all ruhbish :llld debris shall he imlllediately re/ll()\'ed anu the roadway and roalbide shall he Icfl neat
and prescntabh: and satisfactory 10 the engineer.
All of the work herein contemplated shall he done under Ihe supervision and tu the sati..faction of the County Engineer am/lhe entire e,xpense of said
supervision shall he borne by the party or parties to wholl1 this permit is isslled,
The Deparunent of Puhlic Works l1ereby reserves the right 10 order the clllJllge of locati{,n or tile removal of any structure or struclures authorizcd by
this permit at any time. liaid change or relllovalto he maue at the sole expcnsc of the party or purties to whom this permit is issued. or their sllccessors
and assigns.
All such changes, reconstruction or relocation by Ihe grantees shall be done in stich manner as will cause the least interference with any of the Coun.
ty work and the County of Jefferson shall in no wise be held liable for any damuge to Ihe grantee by reason of any such worl-; by the County of Jdfer'
son, it agents or rcprescntatives, or by the exercise of any rights by the COUIllY upon roads, streets, public places or structures in question,
This permit or privilege shall nol be deemed or held to be an cxclusive olle and shall nO{ prohibit the County from granting other pcrlllit~ or franchise
rights of like or other naturc to other public or privatc utilitics, nor shall it prevent the County frolll ming <Ill)' of its muds. streels, ur puhlic places, or af.
feet its right to full surcn'ision and control ovcr all or any part of them. none of which is hercby surrendered.
The Department of Public Works may re\'oke, umcnd or cancel this permit or an)' of the provisiuns thereof al ,In}' time by gi\'ing written notice to the
permittee. The permittee shall imlllcdi:.l\cly remove all f:lcililies from the right of way. All}' f:lcilities rcmaining upon the right of way 30 days aftcr writ.
ten notice of cancellation shall be removed by the County at Ihe expcnse of the pcrmillee,
Thc pany or parties to whom lhis permil is issued shall Oluintain ut his or Iheir sole cxpense the structurc or objecl for which this permit is granted in
a condition satisfactory to the Dcpartmcnt of Public Works.
SPECIAL PROVISIONS, I-A 12" X 20" CULVERT SHALL BE REQUIRED WITH GRAVEL COVER.
2-APPLICANT SHALL BE HELD RESPONSIBLE FOR ALL DAMAGES TO T~E COUNTY ROAD RIGHT OF WAY.
,
In accepting this permit the gmlllee. his Sllccessors nnd nssigns. agree thai uny damage or injury dune to the property of the gr:mtce or any expcnse
incurred by him through the opcrmion of n conlructor, working for the County or !IllY County employce sl1:l11 be lit the sole expense of the grantee. his
successors llnd ussiglls,
G~RY v..J, SMITH
IIlld conditions as herein set forth,
, the undersigned. herehy llccepts this permil subject to thc lerms
Dated this
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
lS20 Jt:Herson Street
P,O, BOll 1220
Porf Townsend. WA 98368
(206) 385-9160
N::
0092
District /yo.
PERMIT
In accordance with ulJ applicable Revised Codes of WasJlinglon and amcnurncllls (hereto, and subjcCl (0 alllhe terms, coru..lj.
lions and provisions written or printed below or on any pUrl of this form
PERMISSION IS HEREBY GRANTED TO Port Townsend Water Department
540 Water Street Port Townsend, WA 98368
to
Open cut shoulders of 7th Avenue to push a 3/4 water service to 331 7th Avenue.
H \ECE~\fED
JUL 0 :31989
JEFrEh;:,ul\J L;uuNTY
PU BLlG \NORKS DEPT,
COUnlY Road No, 665709
Franchise No,
Milepost .30
No work shall be done under this permit until the party or parties to whom it is granted shall have communicillCd with and
received instructions from Don Ol$n 385-9140
This permit shall be void unless the work herein contemplated shall have been completed before June 27
Dated at June 27 , 1989
, 1990
1~.
CALL 48
HOURS
BEFORE
YOU DIG
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GENEnAL l'nOVlSIONS Al'l'UCAIILE TO ALL l'EnMITS
This pcrmil is subject to all applicable provi~iorJs of the Revised Codes of Washillgton, except that an}' pruvhion ill thiS agrccml:llt nul COIl\IHcnl with
such resolution shall he controlling.
A bOlld in the amount of S
is required for the protection of the county as set forth jJl the terms of the bomL
During the progress of the work !ouch barriers shall be erected amJ maintained us lIla}' be Ilcccs~r~' Uf as may be din.:(;(cu for the protection of the
traveling puhlic; the barriers shall bl: properly JighlciJ ul night.
III accepting this rcfmi' the petitioner. his successors and assigns. agrees to protect Jeffer~m Coullty ;Iud sa\'e it harmle:.s frolll all claims, actions and
damages of every kind ami de~ription which may accrue to or be suffered by any persoll or perSllllS, corporation or property b}' reason of the perfor.
mallCC of any such wor", character of materials used or manlier of installation, maintenance and operation or by the improper occupanc)' of ri~bt of
way or public place or public structure, and in case allY suit or action is brought against said Jefferson ('ount}. for damages arising out of or b~ rea,on of
any of the above causes, the petitioner, his successors or assigns, will UpOllllolice to him or them of COllllllencement of such action, defend the \>arlIt: at
hisor their own sole cost and expense and will liati!:>fy any judgment aflcr the said suit or action shall have finally been deLCrlllincd if ad\'c"c to the Jef.
fcrson County.
Except as herein authorizeiJ, no excavation shall be made or obl>tade placed within the limits of a cHumy road ill such a manner as to inlerfere with
the travd over liilid road.
Except as herein authori:Led. 110 excavation shall be made or ohstacle placed wilhin four 141 feet of the edge of the p<J\'ernenl.
If the work dOlle uuder thi!. permit interferes in any way Wilh the drainage of the coul1ly road. thc grantee sh;lll "holl~' :.IIld:il his own c/\pcn~ make
such provision as the engineer may direct 10 take care of said drainage.
On completion of said work herein contemplated all rubbish and debris shall he irmneuiately rClllovcd and thc roadw:.JY and roadsidc shall be left ncat
and presentable and satisfactory to the cngineer.
All of the work herein contemplated shall he done under the supervision and to the satisfaclion of the Count}' Engincer and the entire c>.pcnse of said
supcrviliion shall he borne by the party or parties to whom this permit is issued.
The Depmlmel1t of Public Works hereby rcserves the tighl to aruer the change of location or the removal of any structure or strUctUICS authorized hy
this permit at any time, said change or removal to be made 31 the sole expcnse of Ihe party or parties to whom this permit is issued, or their successors
and assigns.
All such changes, reconstruction or relocation by the granlees shall be done in such manner as will cause the least interference with any of the Coun.
ty work and the County of Jefferson shall in no wise be held liable for an~' damuge to the gran lee by reason of any such wor" by the County of Jeffer-
son, it agents or representatives, or by thc excrcilie of any rights by the CoUnt~' upon roads, streets. public places or structures in qucstion.
This permit or privilcg.: "hall not be deemed or hell.! to be an exclusive one and shall nOl prohibit the COUnty frolll granting other permits or franchi!iC
rights of like or other nature to other public or privale utilities, nor shall il prevent the County from using any of its roads, streelS, or public places. or IIf-
fect its right to full supervision and control over all or any part of thcm. none of which is herehy surrendered.
The Department of Public Works may revoke, amend or cancclthis permit or any of the provisions thereof at an~' lime b~' ~i\'ing written notice to lhe
permittee. The permittee shall immediately remove all facililies from the right of way, Any faeililies remaining upon Ihe right of way 30 days after writ.
ten nolice of cancellation shall be removed by Ihe County at the expense of the permittee.
The party or parties to wholllthis permit is issued shall maintain III his or their sole e/\pensc the structure or object for which this permit is granted in
a condition salisfactory to the Dcpanlllenl of Public Worh
SPECIAL PROVISIONS,
1) Water line shall be buried a minumum of 36" below existing shoulder
2)
Applicant shall be held responsible for all damages to the County Road
Right of Way
In accepting this permit the grantee, his successors and assigns, agree that llllY iJamage or injury dOlle to the property of Ihe grantee or any expense
incurrcd by him through the opera lion of a conlraclor, working for the County or allY County employee lihall be at the sole expense of Ihe grantee, his
successors and assigns,
PT WCLler D~f
. the undersigned, hereby accepts Ihis permit subject 10 the terms
and conditions as herein set forth.
",Hed this :2 S- dny of ~
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fee P,lld_ Ye3 _ No
1820 Jellerson Slreel
P.O. BOK 1220
Potl Townsend, WA 98:'68
(201); 385-9160
Jl.t(;C'I'I"O
Addre~ Requt:M _ YC1> _ No
Mile Pu.l -~ 0
AI'I'UCATION FOI{ l'EIlMIT
To Departmem of Public Works,
Jefferson County, Washington, 0 _,., , ' ,/ ,
The undersigned /0 A. f 1~.trJ/}'.<::'c-//d (.I }c;. rr*/- D--#7
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Irerebyapp/~ jorpermlssiolllo "'~<"-vl c.t"J .sA6w/d",,/'50'~
7'~.gl- k ~,t51t ~.. LV ;7;;'"";';:~':;;;';""""~
331 '7 tI. .s:.1-
SKETCH:
On County Road:
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and agre;.-,-- to do the work ill accordance wilh your rules alld regulations and subject to your inspection and approval.
Dale >.;;::,.....~ ~ ::J /') 19~
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v _ L ~Ijaprlicanl il- a copurlnership. sel rorth names or copartners)
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DEI'AIUMENT OF PUBLIC WORKS
District No, 6,
Permit No. ',)(") ,.,.I: -;
SUfJer\'isor's J{clJort No.
Supervisor will make detailed report with his recommendation 011 this applico/ioll. Whenever {Jossible show skeu:h of proposed
work. Supervisor will also make additional repurls alll! }illal report giving dale of completioll of work 011 this form.
Preliminary l{cport:
!.oc"fpcf
(.,...,., ; it, ""vO z-,r'r-j~' f.-J $"
-;ti.. A~l ,.4' /'Ie. :>0
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-riff
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Date:
G' ~?3-1?<t
Signed: ~=-~
Final Report:
PE~INSPECTION ImpORT
Work covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control.. adequate
- inadequale
REMARKS
I)ute: 2, "3' t:5r
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jelltllson Street
P.Q BOll 1220
Port Townsend. WA 98368
(206) 385-9160
t'-J~
0895
Diwricl No.
6
PERMIT
In accordance with all applicable Revised Codes of Washington and al1lCmlmcllts tht..:rclO, and subject to all the (crms, condi-
tions and provisions written or printed below or on any parI of this form
PERMISSION IS IlEREBY GRANTED TO City of Port Townsend Water Department
540 Water St., Port Townsend, WA 98368
to
Install 6" water main from Rhody Drive at mile post 2.70 to the East along Market
St. to the East side of Holman Blvd,
County Road No, 952007
Franchise No.
Milepost 2,70
No work shall be done under this permit untillhc party or parties to whom it is granted shull have communicated with and
received instructions from
This permit shal1 be void unless the work herein contemplated shall have been completed before October 12
Daled at October 12 ,19 88
.1989
~Fi~
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CALL 48
HOURS
BEFORE
YOU OIG
By ..JJ~ I<-~
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GENEllAL I'HOVISIONS AI'I'UCAIILE TO ALL I'EHMITS
This permit is subjl.'ct to till upplic:Jhlc provi\iollS of the Hcvhcu CoJc.' of Wushinglon. except that :.III} pHwislon lllllw. <.Igrcclflcnlnol cun,j,tcnl with
such rcsoJUlioll shall be controlling.
^ bUild ill the amount of $
b rCljuircd fur the protcCtJUIl uf the COUl\() us set (unl! Iutlle tcrlllS 01 the bonJ.
During Ihe progress of tile work such harriers shall be erected .Illd maill[;.l;ncu as IIH1Y be IlCCC:-.\MY or as lIlay he dlft.'(Iclllor the prUICl."lioll of the
lruvcling public: the barriers shall tJ\: properly jig/lieu at flight.
In accepting tltis pcnnillhe pelilioner. his SUcce!l~urs and a...siglls, agrec:s lu protcct Jenen.on COUllt~' a/ld sa\'c II harlllle!ls frolll all d:llrn,>, Oll:IIOns and
damages of every kind uruJ de~riplion which lltay ac('rue III or he !lufferetl by allY persol1 or pc:r~C)m, corporation or propc:rty b~ rea"ofl of the perfor.
mance of allY such work, character of materials u..ed or m:UUll.:r of installation, lItailllen:J/ll,:e and opc:rution or by Ihe illlfllOpcr occupanq of righl of
way or public place ur puhlic struclUre. und ill case allY suit or action i.. brought againsl said Jefferson COUlllY for damage!> arisillgout of or h~' n:a",orJof
any of lhe ubove cau.\es. the petilioller, his sUl.:cessors or assiglls, will Upollllolke 10 him or them of COIlIlllellcelflenl of SUI.:h actioll, defelld the ~/lIe at
his or their own sole cu~t and expemc and will ~alisfy .lIl)' Judgment after the said ~uil m actio/l shall have finally beell determined il ad\'crse to the Jef-
ferslln COUnt}'.
Except as herein autborizeLl, no excavation shall he Illude or obstacle plal'ed wilhillthe Iimil.. of a coullty road ill sUi;h a mallllcr as 10 interfere wilh
the travel over S<lid road,
Except as herein autllOri/.cd, no excavalioll !lllUlI be maue or ob!\wde plal.:ed wllhin fuur (4) feet of the ed!;e of the pavemcnt.
If the work done under Ihis permit inlerferes in allY way Wilh the drainage of the county road, the granlee shall Wholly and at his own cxpell!le makc
such provision as the engineer may direcl to take care of ~aid drainage.
On completion of said work herein cOlltemplated all rubbish alld debris shall be immediately removed and the fOudway and roonh-ide ~hall be left nCilt
and prescntable ilnu SJlisfaetory to lhe engineer.
All of the work herein cOlltemplated slwll be done 'um.lcr the supervision and 10 the satisfaclion of the COUllty Engineer and the entire cxpcme uf !laid
supervision shull be borne by the part}' or partics 10 whom this permit is is!>ued.
The Departmcllt of Public Works hereby reserves the right to order the change of location or the removal of an)' struclure or structures aUlhurized by
this permit at any lime. said cbange or removal to be madc at the sole expense of the party or partics 10 whom this permil is issLlcd. or thcir ,>ucccs!\ors
and assigns.
All such changes. reconslructlon or relocation by the grantees shall be done in such manller a~ will cau...e lhe least interfercnce with any of the Coun.
ty work and the CoulllY of Jefferson shall in no wise be held liablc for any damllge 10 the gramee b~' reason of any ~uch work by the COUnty of Jeffcr-
son. it agents or represcntatives. or by the excrcise or any rights by the COUlllY llpon ruads, streets. public places or SlruclUres in question.
This permit or privilege shall not be deemed or held to be an exclusive one and slwllnot prohibit the CoulllY frol11 grnnlillg other permils or franchise
rights of like or other nalure to other put!ic or private ulilities, nor shall it prevent the County from using uny of its ronds, streets, or public places, or af.
fect its right 10 full supervision and control over all or any part of them, !lone of which is hercby surrendered.
The Depanmelll of Public Works may revoke, amend or cancellhis permil or any of the provisions thereof lit any timc by giving wrillen nOlice to the
permittee. The permittee shall immediately remove all facilities from lhe right of W,IY. Any facilities remaining upon the right of wa~' 30 days after wril'
ten notice of cancellation shall be removed by the County at the expense of the permillee.
The putty or parties to whom this permil is issued shall maimuil1llt his or their sole expense the Slrllcture or object for which this permit is grantcd in
a condition sUlisfactory to lhe Department of Puhlic Works.
SPECIAL PROVISIONS,
1. Waterline shall be a minimum of 30. below existing ground elevation,
2.
All areas disturbed during construction shall be restored to original condition.
In acceplinglhis permit the grantee. his sllccessors and nssigns. ll!!ree th,ll uny damnge or injury done to the property of the grantee or any expense
incurred by him through the opet4ltiol1 of a contruclor, working for the COUlllY or any Coullty employee shall he nt the sole eXpense of the grantee, hi~
succcssors and assigns.
"nd cog;(;o~t. hC~C~" fJ ~I"'-'-p
Dmed this 10 duy uf 6e---/.,
, the umlersigl1l'd. hereby accepts this permit subject to Ihe terms
, 19 'D2!
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6
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jeflerson Street
P,O, BOA 1220
Porl Townstmd. WA 983GB
(206) 385.91(iO
[\J~
0036
PERMIT
In accordance with all applicable Revised Codes of Washinglon and i.lJllCnUmCllls thcn:lo, and subject Lo alllht: terms, condi.
tions and provisions written or printed below Of on any pan of this form
Port Townsend Water Dept.
LO
PERMISSION IS HEREBY GRANTED TO
540 Water St., Port T.ownsend, WA
Open cut shoulder of Rhody Drive to
to the property line.
98368
install I" water service from the 1411 main line
County Road No.
Franchise No.
952007
3.11
Milepost
No work shall be done under this permit until the pany or parties to whom it is granted shall have communicated with and
received instructions from Don Olin - 385-9140
This permit shall be void unless the work herein contemplated shall have been completed before
Dated at May 18 ,19 89
~~
J~
CALL 48 1
HOURS
BEFORE
YOU DIG
1.800.424.5555
I
L
May 18
,19 90
&~W~@Wl8ID
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GENI:I{AL l'iHlVISIONS AI'I'UCAIII.E TO ALl. I'EI{J\IITS
This permit h liubjccllO 1.111 :.JJlplic:lblc provi~ioll~ of the Hcviscd ('odes of Wll!',hinglOl1. except thallwy provision III this <l1.~rt;crll~111110( COml~lC'nl wIth
such resolutiolJ shall be COlllrolling.
A bum.! in the amuunt uf $
is rC4uircd for the prolCCllOl1 of the l.:Ulllll) <IS set lurlll ill thl.' tCIlIl' 01 lhe bond.
During the progrc~ of the work such harriers lihaJl he cfcclcll allt..! fHaillWincu as lIlay he Ilccc...~r}' Of as IIlil)' he directed for the protc~'tj(Jn o! the
trnvclillg public; the lKlrriers shaH be properly lighted al lligtll.
III acccjllillg this pcrmillhc petitio/ler. his :-.uccc:-.:-.or:-. and a:-.:-.igns. lIgree~ to protect Jeffcr!.OII County am.l save II harmless from all dairm. a\:tlonsand
damages of every kind and descriptio/l which Illay accrue tn or he suffered hy allY person or rJCrl>ons, corporatioll or properly by reason of Ihe ~rfur-
milllee of allY such .....ar", character of lllaterillll> used or manncr uf hll>tallatioll, mailllcllilllce and uperalion or by Ihe improper lx.:i:upanC}" of rlghl ul
way or public place or Jlublic MrUcture. and in case any suit or action is hroughl agaillM :-.aid Jeffcrson ('numy for daftlllgcs arising out uf or by rea:-'O/l of
any of the ahove causes, the petitioner, his successu(!; or a:-.signs, will upon !lolicc to hilTl or them of COlll/llencement of such actioll. lh:fcnd the ~mc at
his or their own :-.ole Cost and cxpcn:-.e ami will satisfy llny judglllelllllfler the said suil or action :-.hall have finally been determined if adver!>e to the jef-
ferson County.
Except as herein authori/"ed, no excavation :-.hall he made or obstacle placet! within the limits ut" a cuullly road in such a lTIallnCr as to intcrfCrt: .....ith
the Ira vel over said road.
Except as herein ,luthorizcd, no excavation shall be made or obstacle placed within fuur 14) fect of tlte edge of tlte pavement.
If the work done under this permit interferes in allY way with the drainage of the county road. the grantee Shllll w!lolly and at his own e),pell:-.e lIIa~e
such provision as the engineer may direct to take cure of said drainage.
On completion of said work herein conlemplated all ruhbish und debris shall he imJlJediately removed and the roadway and ro.ll,hide shall be left Ileal
and prcsentllble and satisfactory to the engineer.
All of the work herein contemplatcd ShlllJ be done under Ihe supervision and to the satisfaction of the Count}' Enginecr and the entire c),pcme of sllid
supervi~ion shall be borne by the party or panics to whom this permil is issllcd.
The Depanment of Public Works hereby reserves the right to order the clJallge of l(x.:atioll or the rcmoval of an~' slructure or MrUClures authori:ted by
this permil llt any timc. said changc or rCll\ov,llto be made lit the solc expcnse of the pany or panics to whom this permit is i:-.sued, or thcir succcssors
and assigns.
All such changes. reconstruction or relocalion by the grantees shall be done in sllch milnner as will cause the JcllSt interference witlt any of the Coun.
ty work and the County of Jcffer~n shall in no wise he held liable for any damage 10 the gralllee by reason or allY such work by the COUllt)" of Jeffer.
son, it agents or representatives, or by the exercisc of any rights by the Coumy upon rmlds, street!>, public places or structures in queMion.
This permit or privilegc shall nOI be deemed or held to be an exclusivc olle and slmllllot prohibit the COUl1t~. from grIHuing other permils 01 franchise
righls of like or other nature to other public ar privatc utilities, nor shall it prCVent the County from using any of its roads, streets, or public places. or af.
fect its right 10 full supervision and control over all or any part or them, none uf which is herehy surrendered.
The Department of Public Works may revoke. amend or cancclthis permit or allY uf the provisions thereof at any time by giving written notice 10 the
pcrmillee. The permittee shall imlllediately removc all facilities from the right of way. Any fadlllies remaining upon Ihe right of way 30 days aflcr writ-
ten notice of cancellation shall be removed by the COllnty lit the expense of the permittec.
The party or partics to whom this permit is issued shallmainHlin at his or their sole expcnse the structure or ohject ror which this permit is granted in
a condition sutisractory to the Department of Public Works.
SPECIAL PROVISIONS,
1.
Water line shall be buried a minimum of 36" below existing asphalt shoulder.
2.
Applicant shall patch open cut shoulder,
:'trI33ir,iApj;J,i~a~tj7~h\,,1l be held responsible for all damages to county road right of way.
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In accepting this permit the grantee. his succcssors and assigns, ngree Ihat allY damage or injury dOlle to the property of Ihe grantee or any expcn\C
incurred by him through the operation of n contraclor, working for tIle County or llny County employee shall be at the sole cxpcnse of the grantee. his
SUCCeSsors and assigns.
~ P~l'f 7Oeo#sp",d WQ/~;- D</,f
and condilions as herein set forth.
Dnted lhi?' :z.;Z dny or*'??1ay
. the undersigned, hereby accepts this rcrmit subject to the terms
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fee P:lid_ YC) _ No
1820 Jellerson Streel
P.O. Box 1220
PorI Townsend. WA 98368
(206) 385.9160
Il.e<<lpl No.
Addrc~ RC(jut:~t _ y~ _ No
Milt' P~t ) .11
AI'PLlCATION rem I'ERMIT
To Department of Public Works,
Jefferson County, Washington.
The undersigned )::t") r"',l --;r;..) (t J } J :- t''''' ) , r~
herebyapp/L!::.L- for permission to C,~/.J (".'\
I., ",,'/ <"r n .,.. I,) f-
Oil! .::;:), 0 tlld "/: of
t.-lI'I,!JWIII ",/I,I",""'~'J"II)' ..It<lll... ",,/w'/lJd,,1
R hcx.ly Dr'
7C> 11'151,,11 I" u.Jlvt-"I' $;f't V,<!t
Ie> fJl"Ofutlf '''"C''
trDIr) 0 (~/' /-9'" (CJcYJ<"'" ;lltI,'Jr
SKETCH:
011 County Road: I? J\ {J d ,( 0 t'
be/Weell /-( ~ '",.,!r R d
IS/O("'II'tl/t'I/.'W'H/W.'Ir>rmil"f'"IIIIJ
and agree~ to do the work in accordance with your rules Gild regulations and subject to your inspection and approval.
Dare -.::,-- )~- 19~
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ISlllnulUrtuf Alll'licUl111
, (If applicnlll is a copartnership, set forlh nlUllCS of copnrtners)
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Phone No.
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JcHcrsun Co.
Distric/ No.
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DEPAHTMENT 01' )'UBLlC WOl~KS
Permit No, nO 5' C
Supcf\o'isor's J{CIJUct No.
Supervisor will make detailed report lvith hl\' recommendation Ofllhi.\' application fVheflever possible show sketch of proposed
work. Supervisor ll,'i/J also make additional reports and final report gil'il1g date of comple/ioll of work all this form.
Preliminary Report:
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Dale: S - /7.. f')9
Final Report:,
PERMI~ ~SPECTION REPORT
V- ~ork covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control.. adequate
. Inadequate
Si~ned: p~_, d_'
REMARKS
nail':
1~6 -87
,
SI~ned: ~>-C'\.
CITY or PORT TOWNSEND
(Building Permit Appliealion) WATER SERVICE PLAN
1.0 Show streets SlIITOUlldillg block in which lots arc located.
2.0 Show nearest waterline and size.
2.1 Show route of proposed w:llcrlinc to properly.
DDDDD
The above proposed waterline will use_feet of_pipc._tces._crosscs._hydrants.
_inch saddles,_ tapping sleeves, inch valves, Ditching and backfilling will be
accomplished by , Pipe and fittings will be installed by
(Contractor or City)
. It is estimated that the cost will he S to be borne
(Contractor or City)
by applicant 0 assessmenl districIO. The city has agreed 0 has not agreed 0 to bear
S or Ihe cosls incnrred,
dale
(Owner/Contractor)
(Water Superintendent)
date
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: NTY ROAD NO.~
.TATE LOG NO.
ULE POST ~Mo2.s?<,
OFFICE USE' ONLY
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC UDRKS
Jefferson County Courthouse
Port Townsend, ~IA 9B368
~.
PERMIT NO.<;?<,r- '11'~ 17 -S" ~
FEE PAID ~es _No f
OFFICE USE ONLY , :
ced'14() S' .f',;ls:fl ELlS",:"",
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CHECK ONE:
o RESIDENTIAL
APPLICATION FOR ROAD APPROACH
:@,COMMERCIAL
Go
Application is he~by made for a permit to construct, operate and 'maintain a road approach.
P~ease describe' ioaction (attach map or drawing)
WEST 2 3c.?" c~,/:-~ E/l 6~)L.//%/)~,Y OF A;/.;<.'<.:-L /.;' 4.r ~Jrl<--,L/,'r' C/V :4r/-/K'..../~-:./;J /v,/ e;,r/:.?dC I),.: ik,
1"528" )
Applicant agrees to perform the work in strict comp~iance with the terms and conditions set
out herein, and any specia~ provisions attached hereto.
ApPlican~ N~me Et~(;/'..:c/./ C:J.,Ic.< L=-.:.x/tFc€ }Z~~'1;contractor Namedc/~ .--S.4I(Jc...L:)
Address %/flL!/A' ,4\'N<"',","'-" //,::;-:c/i,-,,=-' Address
, /, I,~rfi:~ 56:1 ,',
l\PPlic~I?-t;. signattire~..f--"-.-'t_A-="'( <-,.<-~<:2:{'-;l.~t.-.'~_J) Contractor Siqnature
Date. .f,111/'?,<) . 'I . . .' Date
Note: Xndewp.ty prov(sions of paragraph.. 2' :.ancl 3 '.on: reverse side.
PERMIT
&mBtr
Subject 'to the terms and conditions on the reverse side, PERMISSION IS HEREBY GRANTED to
Applicant ~o construct, ope~ate and malntain a road approach as requested above. and any
special provisions attached hereto.
No work sha~l be d~ne under this permit unti~ the app~icant or contrac~rhas notified
. telephone
APPROVED BY, ~,j.~ K.'~
Date
8-/5:- 88,
CAll 48 HOURS
BEFORE VOU DIG
1-800-562--6478
PERMIT INSPECTION REPORT
~rk covered by permit has been comp~eted
~ satisfactori~y.
_work is not completed.
_Recommend permit be cance~led.
_Traffic control - adequate
inadequate________
REMARKS
INSPECTED BY:'\)~
DATEl.'&~8~
Form 113-0 (RNA 2-jlZl'
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~E~ERAl PP.OVISIONS
1. THIS PERMIT IS SUBJECT TO ROI 36.75.130.. .1l.iO lotIO .150 AIIO AMENDMENTS THUIETO.
2. ~~~, ~~ANr~~i o~~s o~u~~~~~;s O~N~V~~~ 1 ~~~D ~~~E~~S~~I ~~~~~C~H ~~~f~~O:C~~~T~O"'~~ ~~V~U::[=~~M~~S~'j~A~~";~~,
PERSONS OR PROPERTY BY REASON OF THE .P[RfORMAHCE OF ANY SUCH WORK, CHARAClER OF MATERIALS USEl.I OR I1AJHlER
OF INSTALLATION' IH CASE ~y SUIT OR ACTION IS BROUGHT AGAINST TH[ COUNTY FOR DMiAc;ES ARISWG OUT OF OR BY
~~~~O~FO~U~~,( A~~ I~~~ ~~~~~D C~~~E~AI1~H~T PH~ T ~g~~REX~~~S~U~~S~~~~ S~~ ~~I~~G~~~~j ~~~ I ~gJ {~~R~~Rg~~~NCE-
DETERMINED ADVERSE 10 JEffERSON COUNTY.
3. IF .THE GRANTEE ENTERS INTO It. CONTRACT OR ACREEMENT HlT:i A THIRD PARTY TO PERFORH THE WORK AUTHO'UZEO
~~J~~ F~~R~~[D ~~",~~:D A~~R~~FE~~ ~H~A~~U~~Y T~~ ~g~~~g~~~I~~T~O~H:T:R~~7~~~~~ ~:T~A~~r~~'2~G:~~~E ~O
c,. ~~YT~~~A~~R~~T";~ ~~N1~~ ~~~~{"~~~nC:N~O=~Q~~=~~~~I: ~~~~:: ~D~Ay~R S~frU:~B~:C~H~H~~R~E:liH~O G~~I~~_
LATlOH A5 HERE IH PROVIDED.
S. DURING THE CONSTRUCTION OF THE FACILITY, THE GRANTEE SHALL COMPLY WITH THE &!:UJf.' ON UNIFnRH. TRAFFIC CONTROl
nF.VJCF~ FOR STREETS AND HIr.HHAYS PUBLISHED BY THE U.S. DEPARTMENT OF TRAHSPOHTAT ION.
OH COMPLETION Of SAID WORK HEREIN CONTEMPLATED, ALL RUBBISH AND DEBRIS SHALL BE IMEDIATELY REI'tOVED AND
tHE ROADWAY AND ROADSIDE SHALL BE LEfT HEAT AHD PRESENTABLE AND SATISfACTORY TO THE COUNTY.
7. THE COUNTy RESERVES THE RIGHT TO ORDER THE CHANGE OF LOCATlOft OR THE REttOVAl OF MY STRUCTURE OR STRUCTURES
AUTHORIZED BY THIS PERMIT AT AHY TIME" SAID C.w.GE OR REMOVAL TO BE AADE AT SOLE EXPENSE Of THE 'ARTY OR
PARTIES TO WHDI1 THIS PERMIT IS ISSUED, OR THEIR SUCCESSORS AND ASSIGNS.
~~~ ~~~T C~~~~~~ER:~~~N~ ~~~~N O~R T~~Lg~~~}~ S B~O~~E ~A~~~~:~L j~NWC~l~L S~H ~ ~~E:[A~[~ Ltl~:~:E
FOR AliY DAKAGE. TO THE GRANTEE BY REASON OF ANY SUCH WORK BY JEFFERSON COl..ny, ITS AGENTS OR REPRESENTATIVES,
OR 8Y,THE EXERCISE OF ANY RIGHTS BY THE COUNTY UPON ROADS" STREETS, PUB1.1C PLACES OR STRUCTURES IN OUESTl,OH.
9. THE GRANTEE SHALL NOTIFY THE COUNTY'S REPRESENTATIVE UPOtt COI"\PLETlOH OF THE WORK lW'lDER THIS P[RI1IT SO THAT
~ FJ~Al INSPECTION CAfi "BY HADE.
,6.
, S.
SPECIAL PROVISIONS
APPLICABLE PROVISI~S ARE DENOTED tv AN (Xl
-0 "1. _~O~~~~~~l~~~A~~~~~Tz~~Ai~ :~Ig"pi~~I~O:I~~I~'T~DC~~~~~~~E~I~~~~~~A~~EI'\ENTS, AT ALL TIMES DURING THE
~2~~ -TU~' A;~P~O~H;"';SH~~Lb- CONSTRUCTED IN ACCORDANCE WITH THE ATTACHED DESIGN PLATE TYPE c.o~^,,..y Rt)~
Jl.PPROACH. A FT .LENGTH OF ~ INCH DIAMETER CULVERT PIPE SHALL BE PLACED IN
DnCH AHD LAID TO A TRUE LINE AND GRADE. THE APPROACH SHALL BE SURFACED TO THE LIMITS AS SHOWN OH
~~~E~~/'~~ ~~~F~~~D~A~~R T~~o~P~~~~~~E S~:~~E=~Y I~N~~cg~e:~~E R~~~~~~~:~O~;:i ~g~T:~L '~M1~~E~~'
lHE APPROACH SHALL BE SUFFICIENTLY SURFACED BACK AN ADEQUATE DISTANCE fROM THE EDCf OF THE PAVEMEhT TO
PREVENT MY. ,",UD' TRACKING ONTO THE COUNTY ROAD. AHY I1UD TRACKED ONTO THE COUNTY ROAD SHALL BE IW\EDIATflY
CLEANED UP BY THE GRANTEE OR HIS AGENT.
Q"'3.
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IF NECESSARY "'To rHCAEASE SIGKT DISTANCE, STUMPS AND BRUSH SHALL BE AEttOVED FRO/1 80TH SIDES Of THE
c:r~~A~~ALL T~~T I~~I~~:~~{,~~E ~U~~~~~y O~O~~R~~~~~Z~~H~~~BER OR DISF IGU~ING OF ANY FEATURE OF SCENIC
S. WORK SHALL BE RESTRICTED TO THE HOURS BETWEEN 9:ooA.H. AHD 4:00P.H. IIILfS5 OTHERWISE AlIfttORIZED IY THE
[NGINEER.
6. A SURETY BOND IN THE Al'tOUNT OF S ~ WRlnEN BY A SURETY COMPANY AUTHORIZED TO
DO BUSINESS IN THE STATE OF WASHINGTON, SHALL BE FURNISHED TO INSURE COMPLIANCE WITH ANY AND ALL OF THE
TERtjS AND CONDITIONS OF THIS PERMIT AND SHALL REt'lAIN IN FORCE lIiTlL ALL HORK UNDER THIS PERHIT HAS
BEEN COMPLETED AND APPROVED BY THE COUNTY.
BEFORE ANY LOG HAULING OPERATIONS BEGIN, A SURETY BOND IN THE AMOUNT OF S a SHALL
BE fURNISHED BY THE GRANTEE TO PROTECT THE COUNTY AGAINST ANY DAXAGE TO THE COUNTY ROAD AND TO INSURE
COMPLETE REMOVAL OF THE APPROACH AND CLEANING UP OF THE RIGHT.OF.WAY TO THE SATISfACTION Of THE COUNTY.
APPROVAL OF ALL CLEAN UP WORK SHALL BE SECURE,p BEfORE THE BOND WltL BE RELEASED.
SPECIAL CONSIDERATIONS R(,Ai) 4!3i?I'O,t1c...# ~II"'L.L l3~ ("("J<'7""I~\AC.'r-fI!" -I-r, SrAJ1VJ::u+R t)
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07.
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form 113 b
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6IGKr DISTANCE REQUIREMENTS
"OSTED 6IGIrr DISTANCE
IiPP.ED LIMIT, MINIHlIM DESIREAllLE
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"orES:
euiv;;Z;' shan aeet:' alnhnm IIpeci'ficaUons
'Eor t1S-20 loa,Ung. Approved types include:
I) concrete
2) corrugated .etal
3) corrugated polyethylene tublng-AASBTO H2.J2)'
COlD\ty road shoulder shall be left at 'IE n
existing profile.
I.)
25
.. ..110
.115
40 '
45
SO
160 FT.
200 FT.
240 FT.
275 FT.
SIS FT. '
SSO FT.
200 FT.
240 FT.
275 FT.
SSO FT.
410 FT.
475 FT.
2.)
-~PiOVALS:
1
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D1a1rman. Board of a 9Jt ~
County CollllD1adonera . c. L . .)
Date 9~-!.3
Oirector. Department
of Public Works
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II ' ,f. SECTION 10. ~TOWNSH)e ,29 NOR TH, RANGE J WEST w.M.
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jetlcrsoll Street
P,O. Box 1220
Port Town~end, WA 983GB
(206)385.9160
N~ 0005
Di~'lriCI No.
5
PERMIT
In accordance with all applicable Revised Coues of Wl.IshinglOll iJlHJ i.JlIlcndmcms thereto. and subject 10 alllhc terms, condi.
tions and provisions written or printed below or on any pan of this form
PERMISSION IS HEREBY GRANTED TO U. S. West Communications
611 6th St., Bremerton, WA 98310
Lo Install communication cable along the North side of Anderson Lake Road
and across Rhody Dr.
County Road No, 5234 08
Franchise No.
Milepost 2.48 to 2.77
No work shall be done under this permit until the pany or parties to whom it is granted shall have communicated with and
received instructions from
This permit shall be ,.,,:J unless the work herein contemplated shall have been completed before April 17 ,1990
Dated at April 17 .1989
&MIDJWm
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CALL 48
HOURS
BEFORE
YOU DIG
By .JJ~ K~
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GENEIlAL l'IHIVISIONS AI'I'I,ICAIlLE TO ALL "EIIMITS
This permit i:-. ,;ubjl.'l:IIU all apptlr.:Olblc prm'biom of the Hcviscd l'odc~ of WUi>hillgtulI. C:>.t:cpllltat allY ptlJ\'l\lllll in tIll" ag/l:clIlt:flt !lol ClJllj,j,tclll \\-ah
such resolution shall be CUlllfU[]lI1g.
A bOllo in the amount of S
is rC{Juircd for lhe prulCclJoll uJ' the l:uUrlly us sel forth in 11](: [crill'. of th~' bOlld
During the progress or the WOIK such harriers shall he erected iJm! Illallllaincu u.'> llIay be llCI.:CS'><lf)' 01 all llIil) he Jm:l.:lcd fur the protC!.:\IOIl of the
traveling public: the homier.. shall he properly lighteJ OIl night.
In accepting this permit the pelitiuner, hi~ ~UCl,;e~~ors amI a~~igns, agrees to protect Jefferson COUIlI} ,HId save it harmless from all claims, actions alld
damages of ever}' kin<J and description which may accrue 10 or he suffered by any [X:rsoll or pcr.'><HlS, corporation or pnJllCflY by rea~on of tllc perfor.
mance of any such work, ch;uaetcr of lIIaterials us~'u or 1IJ:llll1er of ;Ilstallatioll, maintenallcc and operation or by the improper (>ccupatll:}' of right of
way or public placc or public structure, alld in case allY suil or actioll is brought against ~aiJ Jdferson COUIlI}' fur datlwges arising Clut of or by reasun of
any of the ahoyc causcs, the petitioner, hb. SlK'cessurs or assigll~, will UpuIll101ice to hirn or them of COfllll1CIlCClIlelll of such action, defend the same at
his or their own sole cost und e"pCllSC und will satisfy any judgmcnt after the s:.tid suit or aclioll shall have finally heen dctermined if aJ\erse to the Jef-
ferson COUnty,
Except as herein authori('.ed, f1() e~cavati(Hl shall he made or ohstat:le placeJ within the lill]ils of a COlllllY ((lad in such a manner as IIJ irlterfen: ",ith
the traYeI oYer said road.
Excepl as hcrcin authorized. 110 excaw.llioll shall be Illude or obswcJe pla~ed within four I.U feet or the ed~l.' of the pavcmcnt.
If the work dOlle uruler this permit intcrfere~ in allY way with the drailmge of the COLllllY road. the gr:H1tc:e shall.... holly and :.tllllS OW/l cXpellsc ma!..e
such provision as the enginecr Illay dircct to t:.tJ..:e care of said druinage.
On comllh~tioll of said work herein conlemplated all ruhbish and debris shall be imr11eJiuleh' rCl110vcu t1lld the roallway and roadside shall be Icftlleat
and presentable and satisfaclory to the engincer.
All of the work herein contemplateu shall he donc under the supervision and to the s:Hisfaclion of Ihe ('ollnt~' Enginecl and thc elltire expense of said
supervision shall be borne by tile party or parties to whom this permit is is\ueu.
The DcpartfllcllI of Public Works hereby reserves the right 10 oruer the change of locatioll or the relllmal of any structure or structures uuthoriled by
this permit at allY time. said change or remoyal to bc Illade ill the sole expense of the party or parties 10 whom this permit is issued. or their successor!>
and assigns.
All such changes, reconstruction or rctucation by the grantees shall be dune in stich rmll1ller as will cause the Ie:lSI interference with an}' of the Coun-
ty work and the County of Jefferson shall in no wisc be held liable for allY damage to the grantee by reason of any such work by the COUnlY of Jeffer'
son, it agents or representatives, or by lhe cxcrcise of any rights hy the COUnty upon roads, streets, public places or ~tructures ill question.
This permit or privilegc shallllot be deemed or held to be an exclusive one :lnd shall not prohibit the County from granting othcr permils or fr:lnchise
rights of like or olher nature 10 other public or private utili lies. nor shall it prcvent the County from lIsingallY nfits road~. streets, or public places, or af.
fect its righl to full supervision and control over all or any part of them, nOlle of which is hereby surrendered.
The Deparlment of Public Works may revoke. amend or cOlnccl this permil or any of tile provisions thereofOlt any tinle by giving written notice to the
permittee. The permillee shall immediately remove all facilities from the right ofw:!y. AllY facilities remaining upon (he right of way 30 Jays after writ.
ten noticc of cancellation shall he removed by the ('oumy at the expense of the permittee,
The party or parties to whom this permit is issued shull maintain at his or their solc cxpense the structure or object for which this permit is gralltcd in
a condition sntisfOlctory to the Department of Public Works.
SPECIAL PROVISIONS,
1.
Cable shall be buried a minimum of 30" below existing ditch grade.
2. B~' ~~~l~ be held
rig~lf. . lUllO!'U,
Ud. \\ lllilll1fll ;~\
responsible for all damages to county road
In accepting this permit the t;rantee, his successors and as!iit;ns, agree tltat Olny damage or injury done 10 the property of tllc grantee or uny expcn:->c
incurred by him through the operation of n contfllclnr, working for the Coul1lY or allY Coullty elllplo}'ee shull be al the sole cxrcnse of the t;ralllee, his
successors and ussigns.
~,.~j\..."J.~"-L<<J.t..... r2 C~n)'l ,Jrlrt{~ L~1 Ll jLt..1Dl.l (!/!rn"n a, c ,the undersigned. herehy accepts this rcrmit suhjcCtlO the terms
and conditions liS herein set forth. C.
7' "'7 -y; Ii ,h 1<-(J"
D,lIcd this 0'> duy of (~A.,C'( . II) 0-(
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Je1forson Slret!l
P,O. Box 1220
Port Townsend. WA 98368
(206) 385.9160
N~
0091
In accordance with all applicable Revised Codes of Washington and amendments thereto, and subject LO all the terms, comJi.
lions and provisions written or printed below or on any part of this fOfm
PERMISSION IS HEREBY GRANTED TO u. S. West Conununications
611 6th Street Bremerton, WA 98310
PERMIT
to install a buried cable from the fire station west on the right side of Goss Road
to M.P. # .03
County Road No.
Franchise No,
Q ~;;.; rt''''' t 1\ V r.::: 0
~ "1 b ~~) .E 11 ~l !f-
JUL 071989
JEFfE.H::'UI" GL)ul\lTY
PUBLIC WORKS DEPT,
620009
Milepost .03
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
received instructions from Don Olen 385-9140
This permit shall be void unless the work herein contemplalcd shall have been completed before June 27
Dated at June 27 , 19 89
~f:~
J~~I
,1990
CALL 48
HOURS
BEFORE
YOll DIG
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GENEUAL PUOVISIONS AI'/'UCAIlLE TO ALl. "EUMITS
Thj!. permit i~ !>Ubjccllo all applu.:ablc pro\'h,ions of the Rcvi:-.cd Oxic!> 01 Washington, C;l.:ccpllhat all)' pruvhiofl ill Itlll> agrcclIlc."1I1 f101 'OIl\ISICru .....llh
such resolution shall be cOIHrolling,
A bond in the amount of $
is required for the protection of the wunty as M:l forth mIlle lelms 01 the bond.
OUrillg the progress of the work such barriers shall be erected am.! lIIaiuwillcll as fIlay he llccc!>~r}' 0( ;.!.') llIay he dircl.:lcJ for the protection of the
lruvcling public; the barriers shall be properly lighted at night.
In U(Ceflting this permit the petitioner, his successors and USJ,igllS, ugrees to prolect Jefferson COUllIY and !.aVe it harmk'J,!. from aJll.:laiIlL~. acllon!. and
damages of every ~ind and description which lIlay accrue 1O or be suffered by any person or pcrsom, corporation or property by rea~on of the pcrfor
lI1ance of all)' such work. character of materials used or manlier of imtaJJatioll, maintenance ano opcration ur by tilt: improper occupanc). of right of
way or public place or public structure, and ill case any suit or action is brought against said Jcffer!.oll County for damage!. arising out of or by rea~on of
any of the above causes. the petitioner, his successors or as!oigns, will upon notice to him or them of comnu:m;ement of such action, defend the S<lIllC at
his or their own sole COS( and expense amI will satisfy any judgment after the said J,uit or action shall ha\'e finally heen determined if :u.herse 10 Ihe Jcf.
ferson County.
Except as herein aUlhorized, no excavation shall be lIlade or obstacle placed within the lill\its of a count)' road In such a manner as 10 interfcle with
the travel ovcr said road.
Except as herein authorilcd, no e.t;cav.HiOrl shall be made or ollswde placed within (our (4/ fcc! of tllc eUj;c of {Ilc pa\'crnerH.
If the work i.lUllC uni.ler this pcrmit interferes ill any way with the i.lrailluge of the cuullty road. the j;rantee shall wholly and at hi!>. own expense maKe
such provision as the engineer /nay direct to take care of said drainage.
On completion of said war" herein contemplated all rubbish and debris shall be imlTlediately relllovcu and the roadway alld road~ide :'Iohall be left neal
und presentable and satisfactory to the engineer.
All of the wor~ herein contemplated shall be done under the sUflcrvisiull and to the !>atisfaction of the County Engineer and the entire expeme of 5JJid
supervision shall be borne by the pany or parties to whom this permit is isslled.
The Departmelll of Public Wor"s hereby reserves the right to order the change of location or the removal of any structur~' or structures authori/cd by
this permit at any time, said change or removal 10 be made at thc sole expense of thc pany or parties to whom this permit is issued, or thcir successors
and assigns.
All such changes, reconstruction or relocation by the gralllee!> i>haJl be dulle ill !>uch manlier as will cause tbe least interfercnce with an)' uf the COlin.
ty wor~ and the County of Jefferson shall in no wise be held liable for any damage 10 the grantee by rcasun of any such work by the County of Jeffer-
son, it agents or representatives, or by the exercise of any rights by the COUllt)' upon roads, strcet!>, public places or structures in question.
This permit or privilege shall not be deemed or held to he an exclusive one and shall not prohibit the County from granting other [..crmits or franchise
rights of li~e or other nature to other public or private utilities, nor shall it prevelll the COUnty from using any of its roaus. !>treets. or public places, or af.
fect its right to full supervision and control over all or any part of them. none of which is hereby surrendered.
The Department of Public Works may revoke. amend or cancel this permit or anyof the provisions thereof at any time by giving written notice to the
permittee. The permillee shall immediately remove all facilities from the right of wuy, Any facilities remaining upon the right of way 30 days aftcr writ.
ten notice of cancellation shall be removed by the County at the expense of the permittee.
The party or parties to whom this permit is issued shall maintain at hi!> or their sole expense the structure or object for which this permit is grantcd in
a condition satisfactory to the Department of Public Wor~s.
SPECIAL PROVISIONS,
1) All cable shall be buried a min:imumof 30" below existing shoulder
2)
Applicant shall be held responsible for all damages to the County Road
Right of Way
In lIccepting this pcrrnilthe grantee, his successors and assigns, agrec that any damage or injury dOlle to the property of the gralllee or any expense
incurred by him through the opefiltion of a contractor. working fm the County or uny County employee shull be at the sole expcnse of the grantee, his
successors and assigns.
U_"':J 'l\[t.si
and conditions as herein set forth.
,the undersigned, herehy accepts this permit subject to the terms
Dated this Q
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fcc Paitl__ YC!) _ No
1820 Jellerson Street
P,O. Box 1220
PorI Townsend, WA 98368
(206)385'9160
Rtulpl Nu
Addrt::~~ R~(juest _ Yo _ No
Mile I'tr.-I .o~>
Al'l'UCATION FOJ{ I'EIIMIT
To Department of Public Works,
Jefferson County. Washington.
The undersigned Ll S WLST CDM tv... U f\J I CA TI U f\J'S
herebyappl_ [or permission /0
IAf'f'IJlUI/I ~III""""''''J"II>' ..hu, /,,- ..'llIn 1",)"/
BUR'-! 1\JE.V\f B'~ fl~OM /:'JUIWlfJ6 TO CWSiJRL PER
ATIAC,HED 5Kt.Tc'l-l,
0UFE.R5DIJ CD, FIRL DE.PT
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011 COUIIIY Road: CAPE.. 6EDR6E... R.D,
between
(Srur"'1I'(/I,'\/fftl\\.\trt'l'lm lIli/"{N>IIlII
and agree_ to do the work in accordance ~....i{h your rules alld regulations and subject to your inspection and approval.
Date (D-l(o /9 3.9
~~ ~Q) -
ISllmulUrcufAl'l'hcunll
(If uprlicanl is u copartl1crship. sct forth names of copartners)
(CnnlrUCHlrl
(01/ (OTH 6T
1'5'R.E I\AERTD~, ,"VA,
I'ho", No, LJ..7'6' 10 '57'6
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Jefferson Co.
District No. h
DEl'AnTMENT OF l'unLle WOnKS
f'eflllitNo, no'" \
Supervisor's Hcporl No.
Supervisor ~\'ill make detailed report ~"ith his recommendatio/l on Ihi.<; application. Wile/Wiler possible show sketch of proposed
work. Supefl'isor will also make additional Tepaf/S and final report gil'ing dale of completion of ~\'ork on this form.
.Irelimlnur)' RelJOrl:
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Date: 6 ',::) [)'01
Final Report:
PERMIT INSPECTION REPORT
~ Work covered by permil has been completed
satisfactorily.
\Vork is not completed.
Recommend permit be cancelled.
Traffic control - adequate
- inadequate
Signed: 'j)._ n-.--:..
REMARKS
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COMMUNICATIONS @
WORK LOCATIQN
Add~a. ~3lf~5() ~~&' G~&o. ~~
City ~ __ -unty ~ J, ~ _ Stllle'I!tA.
Name LI P"tR -'P'T".
ORIGINATED BV ~/Jb~~ Date~
New 0 SID No, _ Due D.te
Rapalr J\!D Tel, No, '3i(-'f 'I'" Temporlze~
Rearrange OSlO No, Due Oate_
Type of S.rvlo. I~
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De~ription of Work
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Work Order
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No~ -DOl
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CONTRACTOR'S ACCEPTANCE
Firm
Signature
Tille
Unit Price 0 Colt Plu. 0
Date
Flfl Sum 0 $
Bill 10: U S WEST Communlcalions
Attention
Addres6
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APPROVAL. For FI.t Sum/Colt Plu> $
Recommended
Approved by
Oale_
f Dale_
PERMIT REOUIRED rb V.. 0 No
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COMPLETED BV
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ORIGINAL COPY
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0085
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jellerson Sllee!
P.O. Box 1220
PorI Townsend. WA 98368
(206) 385-9160
\
N~
Oislrlcl No, 5
PERMIT
In accordance with all applicable Revised Codes of Washington and amendments thereto, and subject to all the terms, condi.
tions and provisions written or printed below or on any pan of this form
PERMISSION IS HEREBY GRANTED TO U,S. i;est Communications
6d 6th Street Bremerton. WA 98310
to Install a buried service \~ire and do a road push on Ludlo: Bey Koad at ~l.P, 1.05
AlP li'>,
I! Pi IZ.:z';1 (/t;z:~ ~...,;,:;:
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JUL n;;D
J12p- , 077989
PU",!-E:r-,'SOI
Ot_IC 1"1 ,'1 Co
,OR.f"S U/V'7-"
" D12pf
County Road No, f.08209
Franchise No,
Milepost 1,05
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
received instructions from Don 01 en 385,9140
This permit shall be void unless the work herein contemplated shall have heen completed before June 22 , 1989
Dated at June 22 , 1989
~ "'" I CALL 48 1
~~;~ HOURS
rtr 8EFORE
.J. P. YOU OIG
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By ,--<)~ K~1
1.800.424.5555
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GENERAL I'I{OVISIONS Al'l'UCAIlLE TO ALL I'EHMITS
This permit is suhjcct IC) all applicable provisiolls uf the Revised Collcs of Washington, CXl,;Cpllhat UIl)' p!Uvi!>iun ill tIll!> agrccrnclllllot o.:Oll\l..,tcnl wllh
such resolution .\ihall be cOlllrolJing.
A bonu in the amoullt of $
Ji, rCtjuircd fur the prolCl.:liull of lhe (,;()ll/lly a~ ...cl fortll lothc IClfllS of the hondo
During lhe progress of the work such barriers shall he erected and maintained as IllU}' he necessary or as tllay be directed for the prutcl.:Uo/J of the
traveling public; the barriers shall he properly Iigtw:d at night.
III accepting this permit the petitioner, his successors and assigns. agrees to protect Jefferson Coullty and sa\"c it harrnlcss from all claims, aclions .Hld
damages of every kind and description which lIIay accrue to or be suffered by any person or perSOIlS, corporation or property by reOiSOIl of the ~:lCrfor.
rnance of allY such work, character of materials used or mallner of illMalJatioll, lIlaintellam:e and operation or by the impru!:lCr occupunC) of right of
way or public place or public structure, and in case any suit or action is brought against said Jeffersoll County for damages arhing out of or by reai.Ofl of
any of the abo....e causes, the petitiol1er, his successurs or assigns, will UpOIl notice to Ilim or them of commenccment of such action, defend the sarne at
his or their own sole cost and expense and will satisfy allY judgmellt aftel the saiLI suit or action shall have finally beell delcrlllillt'd if advcrse 10 the JcI.
fersoll COUllty.
Excepl as herein authoril'..cd, no excavation shall be made or obstacle plact.ld within the limits of a COUllty road in such a manner ai. to illlcrfefe with
the tra....el over said road,
Except as herein authorized, nu excavation shall he made ur ohstacle placcd within fuur (4) feet of the edge of tile pa\'erncllt.
If the work dOllc under this permit interft.lres in any way with the drainage of the county road. the grantee shall wholly alllJ at hi... own expense rna"e
such provision as the enginecr may dircct to take care of !illid drainage.
On completion of said work herein cOlllcmplalcd all rubbi~h and debris shall he illllnediatcly rel!lo....cd and the roadway and roadside shall be left neat
and presentable and sati~factory to the engineer.
All of the work herein contemplated shall be done under the supervisiun :md to thc satisfactioll of the ('ounty Engineer and the entirc exrcn~c of !.aid
supervision shall be borne by lhe party or parties to whom this l:lCrmit is issued.
The Department of Public Works hereby reserves the right to order the change of location or the removal of any strllcture or structures authori/cd by
this permit al any time, said change or removal to be made at the sole expense of the party or parties to whom this permit is issucd, or their !.ucce~...ors
and assigns.
All such changes, reconstruction or relocation by the grantees shull be done in such manncr as will cause the lea!.t interference with any of the Coun.
ty wor" and the CounlY of Jefferson shall in no wise he held liable for any damage to the gmntee by reaMm of any !;uch work by the County of Jeffcr'
son, it agcnts or representatives, or by the exercise of any rights by the COUlllY upon roads, streets, public places or structures in que~tion.
This permit or privilege shall no! b~ decmed or held to be an exclusive one and shall not prohibit the County from granting other permits or franchise
rights of like or other nature to other public or private utilities, nor shall it prevent the County from using any of its roads, i.lrcets. or puhlic place!;, or af.
fect its right to fuJlsupcrvision and control over all or any part of them, none of which is hereby surrendered.
Tile Department of Public Works may revokc, amend or cancel this permit or any of the provisions thereof at uny time by gi\'ing written notice to the
permittee, The permittee stw.1I immediately remove all facilities from the righl of way. Any facilities remaining upon the right of way 30days after writ-
ten notice of cancellation shall hc removed by the County at the expense of the permillce,
The party or parties to whom this permit is issued shall m:lintain:lt his or their sole expenSe thc structure or object for which this permit is granted in
a condition satisfactory to the Department of Public Works.
SPECIAL PROVISIONS,
1) All wire shall be buried a minill1um of 3U" below existing ditch.
2) Applicant shall be held responsible for all damages to the county road
Right of Way
In accepting this permit the grantce, his successors lInd assigns, agree that any damage or injury done to the property of the grantee or any expense
incurred by him through the opcnl\ion of II COnlractor, working for thc Coullty or any County employee shall be at the sole expense of the gramee, his
slIccessors Ilnd assigns. ()
'YJ...lUl..JVv\\....lL....- ~~
and conditions as herein set forth.
Dated this dO day of
,the undersigned, hereby accepts this rcrmit subject 10 the terms
~ju., y"Q..-
,19 '01
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Ft:e Puid_ Yes _ No
1820 Jellerson Slreet
P.O. BOll 1220
POlllownsend, WA98368
(206)385-9160
R...:cipl No
Addrc"'~ RCljut:...t _ Vel. _ No
Mile Post
AI'I'UCATlON FOIlI'EIlMIT
To Departmenl of Public Works,
Jefferson County. Washington,
The ulldersiglled U ~ WE.. 'ST CO 1V\I\AU tJ \ LA TI D IJ '::l
herebyappl_ farpermissiO/1I0 f='LJ.\c.E.. f.JtJRIE:J) ~E:RVICL WIRE... PLl2 II-IL
l..l"flllj(JIII "il/,/",,"/It'Julf.l' "/,,II/U"I'I,tll'>lud,,)
ATTAC'.HEJ) SK..t..TU-\
10'11 UJDLDw PJA'-I R.D
SKETCH:
"JE.E. AlTAC'.\-IED
011 COUIIIY Road: lJJDLDvJ BA '-I
R.D
between
(.'i/ut,.,II'Ult':\Iafl\\-."'....,"'",i/"f"'1II11
and agree_ (0 do the work in accordance with your rules and regulations and subject to your inspection and approval.
Dale ,JUtJE.. IG0 J9~
1
()(}.;l tlrnlY\! ~,~cL' Ll S 1NE.,S1
ISlllnpllllCllf AppliclLlIlI
b' I CD TH C) T Uf applicant is II copartnership, set forth nUllles of copartners)
~R ENd:R TO l\.l ,VJ/IJ.,. ~ 'b31 0
I'hone Nn, LJ7'6 - 037'6
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Jeffersun Cu.
DEI'ARTMENT OF I'UBLIC WOI~KS
Permit Nu. /","')o8S
Olstrlcl No,
s-
SUllcrvisor's ltc-purl No.
Supervisor will make derailed report ~vitlJ his recommendation 011 lhi.\' application JVlzenever possible !!I'how sketch of propmed
work. Supervisor will also make additional reports alld filial report giving date of completion of work on this form.
Preliminary Report:
L-'X..i",,1 o,J 'Tile
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a~ ..rk.,.,c1w-d d,lcl:.
I.-u t:.<.o--J &1/ ';'})Gd <.,1
-rllt ~'r;..r::- ch,.pp.d ,-;'c,.,/..,:;I
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ON WTfI
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Dale:
(~, d:<" ~t
Signed: ~J- r.:Q
Final Report:
PERMIT INSPECTION REPORT
( / Work covered by permit has been compleled
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control.. adequate
- inadequate
REMARKS
I)ale:
G, ) 't. fl
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Signed:
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Distrlcl No, 6
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jellcrson Street
P.O. Bo. 1220
Port Townsend, WA98368
(206) 385-9160
N~ 0088
H (),'.Y3
In accordance with all applicable Revised Codes of Washington and amendments thereto, and subject Lo all the terms, condi-
tions and provisions written or printed below or on any part of this form
PERMISSION IS HEREBY GRANTED TO U. S. West Communications
611 6th Street Bremerton, WA 98310
to Install a service wire and do a road push on the Cape George Road at M.P. # 6.84
County Road No,
Franchise No,
622808
Milepost
6.84
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
received instructions from Don Olen 385-9140
.1990
PERMIT
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JUL 07 1989
~G~tT~~YOR~~~~~i,
This permit shall be void unless the work herein contemplated shall have been completed before
Dated at June 26 , 19 89
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I CALL 48 I
HOURS
BEFORE
YOU DIG
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1.800.424.5555
June 26
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GENERAL l'nOVISIONS AI'I'UCAIILE TO ALL I'EIlMITS
Thi!i permit is subject to all appticublc pro\'isions of the Revised Codes of Washington, cxccpllhat any pruvi!:liun ill thi!> agu."cfIlcnt 1l01l,:OIl..,i~tcrll ....lIil
such resolution shall he controlling.
A bond in the anlount of $
is rctjuirctJ for the protection of the tuumy a!> !oC1 furth ill the tcnns of Ih~' hond
During !he progress of the work such barriers shall he erected .llld mailllailll.:d as ma}' he ncccs.'>ary or as may he directed for the protc=ctioll of the
traveling public; the barriers slUlll be properly lighted at night.
In accepting this permit the petitiuner, his successors and assigns, agrees to prutect Jcrfer~n County and save it harmless frolll all claims, aClions nud
damages of every kind and description which may accrue to or be suffered by any person or persons, corporation ur propcn~' by reason of the perfor.
mance of any such work, character uf materials used or manlier of installation, maintenance and operation ur by the improper occupancy uf right of
way or public place or public structure, and in case allY suit or action is brought against said Jeffersoll CounlY for damages arising out of or by reaw/] of
any of the abo\'e causes. the petitioner. his successors or assigns, will upon nOlice 10 him or them of commencemenl of such action. deft:nd tht: salTle at
his or their own sole cost and eXpellse and will sutisfy any judgment after the said suit or actioll shall have finally been determined if a(herse to the Jef.
ferson County.
Except as herein authorized, no excavation shall be made or obstacle placed within the lill1ilsuf a coullty road in such a manner as to interfere with
the travel over said road.
Except as herein authoriled, no excavation shall be Illade or ohstacle rlaced within four (41 feet of the edge of the pa\'ement.
If the work done under this permit interferes in any way .....ith thlalrainage of the coullly wad, tilt': grantee shall wholly and at hi... own e>.peme mal-c
such provision as the engineer may direct to take care of said drainage.
On completion of said work herein contemplated all rubhish and debris shall bc irnrnedj;nely remo\'ed and the rood way and mad~idc "hall he left lIeat
and presentable and satisfactory to the cngineer.
All of the work herein contemplated shall be dOlle under the supervision and tn the salisfaction of the ('OUlHY Engineer and the emire e>.pcnse of said
supervision shall be borne by the party or panics to whom lhis permit is issued.
The Department of Public Works hereby reserves the right 10 order the change of location or the removlll of any structure or "tructures authori/ed b)'
Ihis permit at any lime. said change or remo\'al to be made <It the sole expense of the rany or panics to wtlOm this pcrmit is issued, or their successor,\,
and assigns.
All such changes, reconstruction or relocation by the grantees shall he done in such manncr as will cause the least interference with all)' of the ('oun.
ty work and the COUnty of Jefferson shall in 110 wise be held liable for any damage to the gramee hy reason of any such .....ork by the County of Jeffer'
son, it agents or representatives. or by the exercise of any rights by the County upon roods, streets. public places or structures in question.
This pcrmit or privilege shall not be deemed or held to be an exclusive one and shall not probibit Ihe County from granting other permits or franchise
rights of like or other natllrc to other public or private utilities, nor shall it prevent the County from using any of its roads. streets. or rublic places. or af.
fect its right to full supervision and control over all or any part of them. none of which is herehy surrendercd.
The Derartmcnt of Public Works ma}' revoke, amend or cancel this permit or any of the provisions thereof at any time by giving wriucn notice to the
pcrmillee, The pcrmillce shall immcdiately removc all facilitics from the right of way. Any facilities remaining upon the right nf way 30 days after wril-
ten notice of cancellation shall be removcd by the County at the cxpense of the pcrmiuee.
The patty or parties to whom this permit is issued shall mainlain at his or their sole expcnsc Ihe structure or objecl for .....hich this permit is gr:lIl1ed in
a condition satisfactory to the Departmem of Puhlic Works.
SPECIAL PROVISIONS,
1) All wires shall be buried a minimum of 30" below existing shoulder
2)
3)
No asphalt cutting required
Applicant shall be held responsible for all damages to the County Road
Right of Way
In accepting this permit the grantce, hi.~ successors and assigns, il~ree that any damage or injury dnne 10 lhe prorcrty of the grantee or any expense
incurred by him through the opera lion of a contractor, working for the County or any County employee shall be lit the sole e.\pense of lhe grantee. his
successors and assigns.
Ll'S
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, the t1ndcr.~igned, hereby nccepts this permit subject to the terms
and conditions as herein set forth.
Daled this -3 day of ~,
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JEfFERSON COUNTY
OEPARTMENT OF PUBLIC WORKS
FCt' Paid_ Ye!o __ No
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1820 Jetrerson Slreet
P.O. Box 1220
PorI Townsend. WA 98368
(206) 385-9160
AI'I'UCATION FOR I'ERMIT
To Department of Public Works,
Jefferson County, Washington,
The undersigned U 6 WEC:::'T COMM.UtJIU^lTIOI\J'::;
herebyappl_ for permission /0
IAI1f,II'UIlI ",lId"'(f/Ii.'!"II," ..hUfhf ...."h,<''''d,,}
EJUR\/ 1:), V) FRDI\A c.LD~URE.. 100' TO FOOT
DF DR.I \JE.WA\-I tL\T lDSL\ I U\PE- 6E..DR6E.. l~D
RlliU\RL"":> ROAi) PU5I+
SKETCH:
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On County Road: CAPe.. 6E..ORtJc. RD
hell1.'een
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Qnd agree_ to do the work ill accordance wilh YOllf rules Gild regulations and subject to your inspection and approval.
Date \J U tV L Iw 19~
cx::tu /hfYVY ~^ ~'\ t ~ (~J
ISI~l1a\Ure uf APl1hCIIIll)
(If llrrlicalll is II copartnership, set forth n:lIl1es of copartners)
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DEPARfMENT OIl l'UHLlC wonKS
Pef/llit No, ec5' 83
District No.
.G
SUIJl'fVisor's Hl'lwrt Nu.
Supervisor will make detailed report with his recommendation on this applicatioll. JYhenever possible show sketch of proposed
work. Supervisor will also make additional reports and final report giving date of completion of work all this form.
Preliminary RCIJOrt: Lo~,~.I,...,.J ,at-.). C6'~ ~ro....a... 0...\- M,I?;.c- b,~c.\
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PERMIT INSPECTION REPORT
1./ Work covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Trarfic control - adequate
M inadequate
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COMMVNICATIONS GP
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Work Order
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WORK LOCATION
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CONTRACTOR'S ACCEPTANCE
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Bill to: U S WEST Communications
Attention
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Slretc~ Work Required.. Include lengthsj depth$, wire size .nd amount
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jefferson 5lree!
P.O, 80;0;. 1220
Pori Townsend. WA 98368
(206) 385.9160
N:::
0093
PERMIT
In accordance with all applicable Revised Codes of Washington and amendments thereto, and subject to all the terms, condi.
tions and provisions written or printed below or on any parl of this form
PERMISSION IS HEREBY GRANTED TO U. S. West Communicat1.ons
611 6th Street Bremerton, WA 98310
10
install a buried service wire on the east side of Paradise Bay Road at M.P. .02
going south 200'
County Road No.
Franchise No.
503609
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No work shall be done under this permit until the party Of panies to whom it is granted shall have communicated \vith and
receivcd instructions from Don 01en 385-9140
Dated at
This permit shall be void unless the work herein contemplated shall have been completed bcrorc
,1989
~Fi~
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June 27
CALL 48
HOURS
BEFORE
YOU DIG
1.800.424.5555
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June 27
,1990
By AJ~ K~
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GENERAl, I'ROVISIONS AI'I'UCAIII.E TO AI.L I'EHMITS
This permit i~ subjccllO all applicable provisions of the Rc\'j~d Codes of WashinglOll. c),ccpllhat an} prtlViSlIlH in ,hi\. agrcclIl:llt flul COII\/\lcnt with
such resolution shall be controlling.
^ honlJ ill the amount of $,
is required for the prulcctioJl of the WUIH)' a.\ ~t forih in tbe ICrllIS of the bond.
During the progress uf the work such harriers shall he crcctcu <llld lIlaillwincd ll!o ItI:JY be necessary or a:-. llliJ)' he lIircctcu for the plOtct.:tioll of the
traveling public; the barriers shall he fllOperly lighteu at night.
In acc.:cptilll:\ this permit the [>t:titiuller, hi!> !>Ul:Ce!>sOf!> and assigm, agrees to protect Jefferson County :lIld s:J\'e it harlllles\ from <Ill daillls, al.tlr,m alld
damages of every kind and de!lCriptioll which may accrue to or he suffered by allY pcr~on Of persolls. corporation or properly b}. reaMl/1of Ihe ~rfor'
mancc of allY such work, character of materials used or mallm:r uf inswllaliOIl. maintcnance and operation or b}. the illlprol>t:r occupanq' of fight of
way or public place or public str uctllre, and ill caM: any suit or actioll is brought against s.lid JcI"(erson County for damages arbing out of or by reason of
any of the above caUM:!>, the petilioner, hi!> SUcce!i.\or!> or a!>!>iglls. will upon llotke 10 him or (hcm of commencement of such action. defend the ~me at
his or their own sole cost ulld expense and will satbfy any judgrnellt after the said suit or actiun shall ha\e finally been determined if adverse to the Jef.
ferson COUllty.
Except as herein aUlhori/ed, no excavation shall be Illade or ohslacle placed witlLinlhe limits of a county road in such a mantler a\ to interfere "ilh
the travel over said road.
Exccpt as herein authorized. no excavation shall he made or ohHade placed within four (4) feet of lhe edgc of the pavement.
If the wurk done ul1d~r thi~ ~rlllit interferes in all}' way with Ihe drainage of the countr ruad,the ~ralltce shall whull}' .Hld at hi~ OVdl expCrl'tC milke
such provision as Ihe engineer llIay direct to tilke care of silid drainuge.
On completion of said wOlk herein contemp]ateu all robhish ami debris shall be immediately removed lIud the nlad.....ay ami f(xllhide ~ha]l be left neal
and presentahle and satisfuctory to the engineer.
All of the work herein cOlltemplated shall he done under the supervision and to the salisfact ion of the Cuullt)' Enginecr and the entire expensc ()f S<lld
supervision shall be borne hy the party or parties to whom this permit is issued.
The Dcpartment of Public Works hcreby reserves the right to order the ehang.e of loeatiun or the removal of any \!ruclure or str uetures aUlhorized hy
this permit al any timc, said changr. or rcmoval to be madc '11 the sole expense of the parlY or partics to whom this rcrmit is issued. or their sucCt:S\ors
ami assigns.
All such changes. reconstruction or relocation by the grantees shall he done in such manner as will cause the least interference with .my of the COU/1'
Iy work and thc CoulllY of Jcffcrson shall in no wise he hc]d liahle for a/1)' damage to the grantee by reason of any such wllrk by the ('OUlll)' uf Jeffer.
son, it agents or represcntatives, or by Ihe excrcise of any rights by the Coullty upon roads. Mrects. public places or MrUctllres ill question.
This permit or privilege shall not be deemed or held to he un exclusive one and shall nO( prohihit the County from granting. other perrlllts ur franchise
right~of like or olhcr naturc toother public or private ulililies, nor shall it pre\elll the Coullt}' froll111SingallY of its mads. ~trcet!>, or public places. oraf.
fect its right to full supervision and control ovcr all or any pari of them, none of which is hcreby surrcndered.
Thc Department of Public Works may revokc. umend or cancel this permit or any oflhe provi\ions thereof at :'IIlY time hy giving written notice to the
permittce. The permittce .~l1all immediately remm.c all f..dlitics from tllc right uf way. Any facilities rClll,lining uron the righl of way 30 days after writ.
ten notice of cancellation shall he removed by the CnulllY at the expense of the permittce.
The party or parties to whom this permit is issued shall maintain at his or their sole expense the structure or (lbjel:t fur whIch this permit b granted in
a condition satisfactory to the Departmellt of Public Works.
SPECIAL PROVISIONS:
1) All cable shall be buried a minimum of 30" below existing shoulder
2) No ashpalt cutting required
3) Applicant shall be held responsible for all darrages to the County Road
Right of Way
In accepting this pcrmilthc grantec, his successors nnd as!>igns.llgrcc that any d.unage or injury done to the property of the grantee or ,un' expense
incurred by hilllthrnugh the nperntinn of u contrnctur. working for the ('oullty or .IIlY CnullIY cnlplnyec shal] he at the sole expcnse of the grantce, his
sllecessors and assigns.
...;;it I..L'I..l '}{\ J[ C{]V~'I~tlfl~ it.; UJ [J ..Ie ~ I {'c~r\. >~ I ( ,the undersigncd. herehy accepts this permit subject to the lerlll!>
and mnditiolls as herein set forth. a
1J,1Ietlthi~ ?So day of JLt..l-I._L..- ,II) 6.((
\/1,- l '-I. </t- :/ it',l. i'! j he {.,_
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fee I)aid_ y~ _ So
(o{"C1111 So
1820 Jel1erson Slreel
P.O. Box 1220
PorI Townsend, WA 96368
(206) 38t1.9160
Addrc~~ l{eQucsl _ Yes _ No
Mile PIAl
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AI'I'L1CATlON 1'01t l'EItMIT
To Department of Public Works,
Jefferson COUnty. Washington,
The undersigned U l) \}J [c,T CO I\JIM U IJ \ CJ\\ I 0 k\')
herebyappl_ for permission /0
PLAC.L BW2IE.D
/.-1,,(,11,,1111 ".lId'''''flIJo'lu'/I'..I''Jlllo' ..;,1,,,,,,,.101
SE.R\IICE VJ\\<J::... (JEJ~ f\TiAGIE [) S\C.JTCJ-\
PARADISE- fV\\[ R'D t OA\C. fJA'{
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SKETCH:
SE..E.. A1T ACJ\ ED
On Counry Road:
heHt'eell
/SIU/o"WIll..'{(.W\\.,"'...., or mil,' (HIll/II
alld agree_ /0 do the work in accordance ~vith your rules and re[.;ulations and subject to your inspection and approl'al.
Dare JLllJt tlL; J9,~
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ISllllllllUre!lf ^l'l'h~llnn
(If applicant is a copartnership. set forth n;lInes of copartners)
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Phune No, /\ 1'6 . 02,;76
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DEl'AltTMENT OF PUBLIC wonKS
Pert"it No. (jO tJ?
District No, "- ")'
SUJ)cn1isur's ncpor. No.
Supervisor will make delai/ed report with hi~' recommendatioll on tllis applieD/iou. Whenever pu.s.~ible !Jhow sketch of propu.'jed
work. Supervisor will a/so make additional reports (Jlld Jitwl report giving date oj completion of work 011 this form.
Preliminary I{eporl:
Coc" ~~J
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oN -..-:.1[:. SAt! ~:r-.-;. of
70 i.vc: S" 0<..-71./ .100 I /<:oad
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Date:
h,,.J::L. 'Of
Signed:
Final Reporl:
PERMIT INSPECTION REPORT
~ Work covered by permit has been completed
satisfactorily.
Work is not completed,
Recommend permit be cancelled.
Traffic conlrol - adequale
- inadequale
REMARKS
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No. 3!,:.--C>l"t'
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APPAOVA" For FIB' Sum/Co.t Plu. $
Recommended
Approved by
PERMIT REQUIRED
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Jurlsdic:lon
COMP"ETED BY
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District No. 6
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jeflerson SlIeet
PO. Bolo: 1220
PorI Townsend, WA 98368
[206)385'9160
N~
PERMIT
In accordance with all applicable Revised Codes of Washington and amendments thereto. and subject LO all the terms, condi-
tions and provisions written or printed below or 011 any part of this form
PERMISSION IS HEREBY GRANTED TO Puget Sound Power & Light
310 Four Corners Road Port Townsend, WA 98368
to
Install two power poles on both sides of the Beckett Pt. Road at M.P. U .36
tu .0. No
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County Road No.
617509
Franchise No.
U~ECE~VED
JUL 0 G 1989
JEFf''EFI~O'\J COUNTY
PUBLIC V,/ORi-:'S DEPT.
Milepost .36
No work shall be done under this permit until the party or parties to whom it is gra11lcd shall have communicated with and
received instructions from Don Olen 385-9140
This permit shall be void unless the work herein contemplated shall have been completed before
Dated at June 26 . ) 9 89
June 26
.1990
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GENERAL ('IlOVISIONS AI'('UCAIILE TO ALL ('EIIMITS
Thb permit is subject to all applicable provisions of the Rcvbcd CoJcs of Washington, c.\ccpt t/ml all} prO~'I"JOIl in this aglccUlcllt /lul Con"l.,tclll .... ilh
such resolution shall be corllrulJing,
A bumJ in the :Jmoullt of $
is rCljuircd for the protectioll of the COUll!) as .\Ct furth III the tcrlll" of the hum!.
During the progress of the work such barriers shall be erected and mailltaincll as may he Ilccc..~ry ur as lIlilY he I.hfCCICu fur the protectiun of the
traveling public; the barriers !.hall be properly lighted at night.
In accepting this permit the petitioner, his successors allll a!.sigll!., ,lgrces to protect Jdfer!.lJll CoulHY anll !.ave it harllllc!.!. l'wm all claim,>, actions and
damages of every kind and lIescription which may accrue to or be suffered by any perSOll or persons, corporation or properlY by rea\on of the perlor.
lIIuncc of any such work. character of materials usell or manner of installation, maintenance allll operation or by the improper ()l;eUpa/ll':y of right (Jf
way or public place or public structure, alld in case ullY suit or action is brought against said Jefferson C{)Ufl1~' for dumage.. arising oul of ur h~ u.::a"Oll of
any of the above CUllses, the petilioner, his successurs or assigns, willupollllolk:e to him or them of COflllllenccment of such action, dekndlhe !>ame al
his or their own solec(lst ,lI1d expellse and will satisfy any judgment after the said !>uit or actLull..hall have finally heen determined if udn:r!>e to the Jd.
ferson COUllty.
Except as hereill authorized. no excavation slmll be Illade or ohstach: placed within the limits of a county road in such a manlier a!> to interfere with
the travel over said road.
Except as herein aUlhorized, no excanUlon shall he made or obstacle plal.:ell within four (41 feet of the edge of the pavement.
If the work done under lhb permit interferes in allY way with the drainage of tile COUl1ly road, the grantee !>hall ""hully IIlld at hb UWII cXpell~c lllllke
such provision as the engineer llIay direct to tuke care of said drainage.
On completion of said work herdn contelllpluted all rubhbh and debris !>hall be immediately removed and the roadway and roadside shall be left neal
and presentable and satisfactory to lhe engineer.
All of lhe work herein contemplated shall be dOlle unller the supervision and to the satisfaction of the COUllty Engilleer and lhe entire cXpcn\e of said
supervision shall be borne by the pany or parties to whom this permit i!> i!>slled.
The Departmcnt of Pu~!ic Works hereby reserves the right lu ord,~r the change of location or the removal of any structure or !>Irllcture!> authoflzed b~'
this permil at any lime. said change or removnl to be made atlhe sole expense of the party or parties 10 whom this permit b is..ued. or their ..ucces!>Ors
and assigns.
All such changes, reconstruction or relocation by the grantees shall be done in such manner as wilt cause the least interference with any of the Coun.
ty work and the County of Jefferson shall in no wise be held liable for any damage 10 the grantee by reason of any such work by the County of Jeffer-
son, it agents or representatives, or by the exercise of any rights by lhe County upon road:'.. ~treel:'., public places or structures in queslion.
This permit or privilege shall not be decmed or held to be an exclusive one and shall not prohibit the COUlllY from granting Olher permits or franchi..e
rights of like or olher nature to other public or private utilities, nor shall it prevent the County fmlll using any of ib road!>. ..treeIS. or public places. or af.
feet its right 10 full supervision and control over all or any part of them. Ilone of which is hereby surrcndered.
The Department of Public Works may revoke. amend or cancel this permit or any of the provi..iol1s thereof at any time by gh'ing written notice to the
permittee. The permittee shall immediately remove all facilities from the right of way. An)' facilities renlilining upon the right of way 30 daysnftcr writ.
ten notice of cancellation shall be removed by the County at the ex[>Cnse of the permittee.
The party or panics to whom this permit is issued shall muintain at his or lheir sole expense the structure or objecl for which :hi<. pcrmit is granted in
a condition satisfactory to the Department of Public Works.
SPECIAL PROVISIONS.
1) Applicant shall be held responsible for all damages to the County Road
Right of Way
2)
Locate required
In accepting this permit the grantee, his successors ilnd assigns, ngree that uny damage or injury done 10 the property of Ihe gramee or .my expense
incurred by him through the operation of II l.:ontractor, working for tile County or any COllll1~' employee shall be at the solc expense of the grantee. his
Sllccessors and assigns.
T"cF'(cl 50u".J 7;GCL""'" ,/ Lrqt.../-
nnd condHiolls as herein set forth. <1 {J
Dated this z~j day of
,the undersigned, herch~' accepts this permit subjcClto Ihe lerms
J un e
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JEFFERSON COUNTY
OEPARTMENT OF PUBLIC WORKS
Fcc Paid_ Yo _ No
RCI.C'II'I Su
1820 Jefferson Street
P.O. Bo-. 1220
PorI Townsend, WA 98368
(206) 385.9160
Addrt:~!I KC4uc~t_ Yc!>_ No
Mile Ill)!>t . ":\ (J
AI'!'UCATION FOR l'EItMIT
To Department of Public Wotks,
Jefferson County. Washington.
The Ufl<ler:\iglled ;/')fj-<"A "")O<""rl ~~ ,f. i-rivf-
hereby appl..u:.:5.- for permi>lioll to -5 czA- I W 0 , ec;;" I";;,;~",", In'" "~:"f::;2 -('h..tL-
1<./0 ci 8ecA:,!!.i+ PCJlrv( Rd O. 305 /?7t Ie:; -IvOt?'l
Co..Ve. GeorOf' /ZJ
SKETCH: .5::-e
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Work .:skdeJL
if yO 53{o9
On COUIlIY Road: 6e.Jcd-l- p+ ad
Co.f6 Geol'9f" n.d
~,. 0, 305 /7lrle5' fop>\'
(Slalt'II<'1/1l'" ",m, \I"~'I f" mif., pOlliO
and ag'ee~ 10 do the work in accordance with your rules and ref-,rulotiolls and subject to your inspection and approval.
Date '-.,( UVlP ((!J 19.55.X-
Al j, ~~.u:.,~ ^"",,/fr (/()~(I 't6(v:.L-
(~~/PPlicant is a copllTlner!>hip. set forth flUllles of copartncrsl
310 FoUl' COVrlPV<. t!?
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District No,
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DEI)AIHMENT 01<' I)UUUC WORKS
Permit No, eo fl '1
Supcnisor's n.CIJort No.
Supervisor lViI/make delOUed report with his recommendaliotl 011 this application. ~Vhellever possible show sketch of proposed
work. Supervisor will also make additional refJor'~' amI fillal report gil1ing dale of completioll of work all this/orm.
Preliminary Ueport:
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PERMIT 1~T10N REPORT
---<--tL" Work covered by permit has been completed
salisfnc1orily.
Work is nol completed.
Recommend permit be cancelled.
Traffic control. adequate
. inadequate
REMARKS
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fcc Paid_ Yes _ No
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1820 Jefterson Street
P.O. 1l0.ll 1220
Pori Townsend, WA 98368
(206) 385-9160
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AI'I'UCATION FOil I'EI{MIT
To Department of Public Works,
Jefferson County. Washington.
The IIndersigned tJ S ,,\lEST CUI.J\.N,LJf.JICAllO/0'::J
hereby appl_ for permission to
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SKETCH:
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RECE~VED
JUN 281989
On Coutlly Road: Ol:::/M PLL'i i:> L I!D
JEFFERSOI~ CUUNTY
PUBLIC WORKS DEPT,
bel ween
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and ogree_ (O do the work ill accordance with your rules and regulations and subject to yuur inspeclion and approval.
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UEI'AUTMENT OF I'untle WOHKS
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SUIJCrvisor's I{cport No.
Supervisor will make de/ai/ed refJOrl willi his recommendation 0/1 this application. ~Yhel1ever possible show sketch of profJo.\ed
work. Supefl'isor will al\'u make addiliollaJ reports alld lillal report giving elate oj completiull of work 011 thisJarm.
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Dale: "1- 3. 'B7
Final Report:
PERMIT INSPECTION REPORT
.\ /" Work covered by permit has heen comple'ed
satisfac'orily.
Work is not completed.
Recommend permit be cancelled.
Traffic control - adequate
~ inadequate
REMARKS
Dale: 7- ;)0 ' '89
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Work Order Complete by
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CONTRACTOR'S ACCEPTANCE
Firm
Signa tura
Title
Unit PriC<o 0 COlt Plu. 0
Date
Fie' Sum 0 $
ORIGINATED BY Yo Cot S'~ Date , -t 'f
New 0 SIO No, Due Date
Repeir 0 Tel. No, ~<(<Z'7"fCI Temporized J'i3'
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APPROVAL For Flat Sum/Cost Plus $
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Date_
Date_
Oeserlpllon 01 Work
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Jurisdiction
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JEFFERSDN COUNTY
DEPARTMENT OF PUBLIC WORKS
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Mile: Po!.t 7 If? L.-h
1820 Jel1erson Streel
P.O. Box 1220
Pori Townsend, WA 98368
(206)385-9160
AI'PLlCATION FOil l'EIlMIT
To Department of Public Works,
Jefferson County, ~ington, /./
The undersigned ' K /"J/.-//J/9t- ^ e/l..~
hereby app/~ for permission /0 /AJ 5T/Tt."L.
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JUN :10\989
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PUBLIC 'jJO"
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all County Road: FLA6LLZ7'2 Po betl\eetl ;li!ul1jJy' f?o/f{) f
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alld agree~ to do the work ill accordance with your rules and regulations and subject (0 your inspection and approval.
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DEl'AltTMENT 0.' l'UIlLIC WORKS
District No,
s-
Permit No, r'"\! n-,
SUllcrvisnr's ncport No.
Supervi5'or will make detailed report with his recommendation all this applicatioll. Whenever fJO!'i.'iible show sketch of Pfopo.w!d
work. Supervisor will a/so make addWonal reports alld filial report gil1ing dale of complf!liofl of ~vo,k 011 this form.
..rellminary Re,lort:
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Date:
'7- ~-~
Final Report:
PERMIT INSPECTION REPORT
,/
Work covered by permit has heen completed
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Work is not completed.
Recommend permit be cancelled.
Traffic control ~ adequate
. inadequate
REMARKS
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District No, 5
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 JelltHson Street
P,O. BOl( 1220
PorI rownsend, WA 98J68
(206) 38~'9160
N~
0031
PEU,MIT
In accordance with all applicable Revised Codes of Washington and <.tmendmcIHs thereto, and subject to all the terms. condi-
tions and provisions written or printed below or on any pan of this form
PERMISSION IS HEREBY GRANTED TO James R. Larimer
374 Schwartz Road, Nord1and, WA 98358
to Install a 10' to 12' wide gravel ingress/egress road to Lots 1, 2, 3, and 4 of Oak
Bay Property Short Plat of Volume 2. page 8.
County Road No,
Franchise No.
569908
3.44
Milepost
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
received instructions from Don Olin - 385-9140
This permit shall be void unless the work herein contemplated shall have been completed before
Dated at Hay 15 . 19 89
~)
J'~1r
CALL 48 I
HOURS
BEFORE
YOU DIG
J
1.800.424.5555
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May 15
.19 90
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GENEIlAJ. l'Il0VISIONS AI'I'L1CAIlJ.E TO AJ.!. l'EIlMITS
This pennit is subject to all <IppJicablc provisions of the I{c\'i~d CoJe!> of Washington. C,\,ccpllhat illlY prm'islllll ill this ;jgrC~JrlCllt 1101 (,;l!fl"'stcnl with
such resolutioll shall be COli trolling.
A hUlld in the amoUIlI of $
is rcquilcJ fUf the protccLlUII oj tIll: <.:uUtll)' <.1\ s~.t fullh III the [crm.. Ijj 1111" hwuJ
During the progress of the work such harrier!> shall he erected amllllaintuiucJ U\io lIla)' he llcccs!-.ary or aJo ilia}' he dHcLlcJ illt the pro\cl,:llurl of tIll:
traveling public; the barriers shall be properly lighted at night.
III accepting this pcrmillhc flCliliollcr. his SllCc.:CSSur\ a Ill.! assigns. agrees to prole'! Jeffersun ('OUIlIY am! !>.a\'C it harIllJc:-...lrorn all d<.lJIIl~, ;JctJOl\S <.lnd
d<.lnl<.lges of c\'ery kind and descriptiun which Illay accrue to or be suffered hy ,lilY persulI or pero,om, corporation or property hy re;I\Un ur the perfor,
mance of allY such wurk. character (If material!; used or mallller uf installatiull, lIIai/llenallCe and upcration ur by the illlpruper tK.:cupam:y ur fight 1)1'
way or public place or pUblic structure, ami in ca.~e allY \lIit or action is brought agaimt said Jeffersoll County for damages arising out of ur hy rCll~OIl of
any of the ahove causes, the IlI.:titiollcr, his !r.UCCCSMlrs or assiglls, will U("NUl notice to him or thclJI of COllllllelll.:elllcnt of such action, defel.d the same at
his or their own sole coM aml expense am.! will satisfy ..lIly jUdglllclll after Ihe said sui, or actiu/l slmll have filially heerl t..leterlllilled if a,hcrse to Ihe Jef-
ferson County.
Except as herein authori/ed. no cxcavutiun shall be lIlade or ohstacle placed within the limits of a COUllty road in such a nranller as HI interfere.... ith
the travel O\'cr said fl).uJ.
Except as herein authori/cd. 110 eXCJvatioll shall be malic or obstal'le placed within four (41 feel uf the edge of the pa\'elllelll.
If the work dUlle uuder this permit irHerferes in any way with the drainage of Ihe 1,;OUIlI}' road. the grallt~-c ~hall ....hully and at hi~ OWII c,\rx:me lIla"e
such provision as the cnginecr may dircct to take care uf said drainage.
011 completion of said work herein contclllplateli all rubbish anli debris shall he imlllediately rcmoved and the ro:Jdway and roadsidc shalt be left Ileat
and presentable and satisfactory to the engineer.
All of the work herein contemplatcLl shall be done under the surcrvisiun and to the satisfaction of the Count)' Engincer and the crllire expcnse of said
supen'isioll shall be borne by the part)' or pJrties to whom this permit is is\ueli.
The Departmenl of Public Works hereby reserves the right to on.ler the change of IOCJlioll or the removal of uny structure or structurcs aUlhori/cd b)'
this permit at any time. said change or removal 10 he made at the sole expensc of the party or parties to whom this perlllit is issued, or their sUccCS!o.ors
and assigns,
All such c1wnges, reconstruction or relocation by the grantees sh;.1I he done in such manner JS will cause thc leasl illlerfercncc with allY of the Coun.
ty work and the County of Jeffersoll shall in no wise be held liahle for any damuge to the gr:lIItee by reason uf any such wurk hy the County of Jeffer.
son. it agcnts or rcprescllt:'iivcs, or by tbe cxercise of Jny rights by the COUllt}, U[llln roads, streets, public places or structtJrcs in question.
This permit or privilege shall not bc deemed or held to he an exclusive one and shall not prohibit the COUnty from granting other permits or franchise
rights of like or other nalOre to other public or privale utilities, nor shall it prevent the County from using an}' of its roads. \trcets. or public place~, or af.
fect its right to full supervision and comrol over all or any part of thcm, nonc of which is hercby surrendered,
The Department of I}ublic Works mJ}' revoke. amend or cUllcel this [}Crlllit or any of the provisions thereof at any time b}' giving wrillen notice to the
permittee. The permittce shall immcdiatcly remove all facilities from the right of way, AllY f.\cilities remaining upon the right of way 30 liays after writ.
ten notice of cancellation shall he removed by the County at the expense o~ the permittee,
The party or partics to whom this permit is issued shall maintain at his or their sole expense the structure or ohject for which this perlllil is gr<lllled in
a condition satisfactory to the Departmcnt of Public Works.
SPECIAL PROVISIONS,
1. Applicant shall be held responsible for all damages to county road right of
way.
:'f:r~~Ji@I@~I' J?iall not
ldl1 '/IIlih;i"'!I~ i{;\
',-<:al. . Ei'ther ..~ r'cillvert or
details) .
disturb county road fill on East side of Oak Bay Road.
ditch is required along easement (contact Don Olin for
In llccepting this permit the gmnlee. his successors nnd ll~signs. agree thuI any dnmnge or injury done to the property of Ihe gmlltee or any expense
incurred by him through the opcration ofa contractor, working for the County or any County employee shull be at the sole expense of tile grantee. hi!';
stlccessor,~ and assigns.
':1 ..:....,-:q /1 r: J ~ /-Are / /'"'7/"'/e
<lmJ conditions liS herein set forth.
D.Iled Ih""'/< d~!J d.IY of-1?
,Ihe undersigned, hereby accepts this permit subject 10 the terms
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JEFFERSON COUNTY
OEPARTMENT OF PUBLIC WORKS
Fee Paid ~ ~~.b No
~Jd; lr Of:/"l-
Reall'l No
i1j~O JlIrfefson Street
P.O, Box 1220
PorI Townsend, WA 98368
(206) 385.9160
, ..
Adurc-'>!l Rel.jue~l_ y~ _ No
Mil, /,.",3 . '-I '-I
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AI'I'UCATION FOJ( ('EJ(MIT
To Department of Public Works,
Jefferson COUnty, Washington.
1Jle undersigned .. M/":?-:O-:'- /ff? A-r1 K;' /?rA:',' (,/.'/Jvr-t
hereby appl /~ S for permis.'iiolllO ,::?o 6-;"/'L P ,./ C' / 7Z' / i) I t \../,/ OL- 1\ /~" /9",:::J
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OF J'/-(eJ/c!7 /:JLijr.s, ,.o,,9c,/c g
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PL/,l7 /1?'r--c"'/C'Oc.o /,A/ VO.t.</>"1,'':- 2
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RECEIVED
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MAY 11 1989
JEFFERSON COUNTY
PUBLIC WORKS DEPT,
On CoullIY Road: (1/9 K L? /9 Y
C' f'" 0/9< /.34 Y - ~.L/fC:;' L-6.-c
between ~.. S- /"1 / ",-,I_~ S'
R"/70 Z"#E:-es,c-cr;o~,
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Gild agree q to do ,lie work ill accordance wilh your rules Gild regulations alld subject to your inspection and approval.
Date /1/1,';1 "7 /9--K5--
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d ISiBnlllUfei,r^rllh~'llrlll
h ur upplicanl is a copartnership, set forlh nllllles of copartners)
37,/ S;Crlt.l/9..er l: A?D
/Jo k?P L A r.I 0 tv A 9' ? .?.s- F A,ld""
Phone No. 3 ~.S- ... /../ ~- / ?- Phone No.
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DEI'AltTMENT 01- PUBLIC wonKS
Permit No, <:) (J ',) \
DislriCl No.
5--
SU'Jcr\'isor's l~eIJUr. Nu.
Supervisor will make detailed report with his recommendation all Ihis application. Whenel'er possible show skelch of proposed
work. Supervisor will also make additiol/al repurts and final report !;il!iflg dale of comple/ion of work olllhisform.
I)rcliminary Report: ~( I.
6- 16' .f,,;/ 0. ,I,,~ . ,,..-,.1/ S,'" ",),I:J;, L".." ;.,.,,$
Date:
1;;':-(< -C)
,
Final Report: ,
PER~PECTION REPORT,
Work covered by permit has been completed
satisfactorily. '
Work is not, compleled~
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Recommend, permit, bC",ca,ncellcI:J.
Traffic control - adequate
- inadequate
REMARKS
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Signed:
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c?F3;::'..,,':),., //ct-rI::.RSON COUNTY STATE OF WASHINGTON .'..,
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11:120 Jel1efson Sheel
PO. 80.< 1220
Port Townsend, WA 98368
1206) 385-9160
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
N~
Dil'/rict No,
PERMIT
In accordance with all applicable Revised Codes of Washington and arnclll.lmcllls thereto. and suhjl..:ct La all the terms, condi.
tions and provisions written or printed below or on any parl of this form
PERMISSION IS HEREBY GRANTED TO UNITED TELEPHONE CO.. 75 THOMPSON RD.. POULSBO 98370
to
INSTALL A BURIED SREVICE WIRE 100 FEET ON THE SOUTH SIDE OF THE EGG & I ROAD AT MP 1.70
W.o."" 2'<:12.S~'lO'7
County Road No, 516009
Franchise No,
Milepost 1.70
No work shall be done under this permit until the party ur parties to whom it is granted shall have communic:ltcd with and
received instructions from
This permit shall be void unless the work herein contemplated shall have bccn complclcd before
Dated at June 15 .1989
June 15
.1990
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II ~ HOURS
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J.... YOU OIG
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GENEflAL PI10VISIONS A.'PUCAIlU, TO ALL .'EflMITS
This permit is subjccllO all applicable provisiuns of the Re....ised Cfll.Jcsof Washington, C),CCPllhiJl any flrovi~IOIl in ttm agrcc/Ilclllnot l,:flllSI\tl:ll! ....Jlh
such rCiloJUlioll shall he controlling,
A bond in the amount of $
is rC{juircd for tilt: prutcctioll of the l.:ourLt)' as set forth in the Icum (Jf the bUIH../.
Durill!! the progress uf the work such barriers shall he erected UIlU maintained as lIIay he llCl:C~sary or LIS Illa)' he dirc,"'lcJ fur lhe protection of the
truYding public; the barriers shall he pruperly lighted iJl night.
In iJcccpling this refmit the petitioner, his '!'UCl:cssor~ and assigns. agrees to protect Jefferson COUllty amJ save it harmless frolll all dailll\. :lction~ and
damages of every kind and description which lIIay accrue to or be suffered by any person or persons, corporation or properly by rcason of the perfor-
mance of allY such work. character uf matcrials uscJ or manlier of installatioll, Illaintcll:mce amI opcratioll or by the impropcr occupancy of right of
way or public place or public Structurc, ami in caSe allY suit or actiol1 hi. brought :lgaillst said Jefferson ('OUllty for damages arb-ing out of or by rcason of
any of the abovc causes, the petilioner, his SLlCl.:essors or ;lssigm, will L1POllflutice 10 him or them of COlnlllencement of such action. dcfend the sallle at
his or their own solc cost and expellse and will salbfy any juJgll1Cfll aftcr the said suit or aClion shall have rillally been determined if advcrse to the Jef.
ferson County.
Exccpt as herein authuri/t.:d, flO excavation shall he maJe or obst:lcJe plal'ed within tht.: Jirnib of a l,;ounty road in !>lJl'h a nWlllu:r a\ 10 ill/crfcn: n"ilh
the travel mcr said road.
Except as herein aUlhori/cd, /10 cx~'a\"ation sh;lIl be made or oh\tade pJaeeLl wilhin four 141 fect of the edge of Ihe pa\'ernellt.
If the ",ark dotle under this permit interferes ill <illY way with the drainage of the COUIl\y road, the gr:ll1tec shall whullr and al hi\ o"'n expcn~ l1la~e
such provision as the enginecr may direct 10 ta~c care of said drainage.
On completion of said work herein cOlllempluted all rubbish and debris slwtl be immcdiatcfy rcmoved and the roadway and road\idc shall be left ncat
and presentable and satisfactory to the cngineer.
All of the work herein contemplated shall be done unJer the supervision and to the !>utbf,tctiol1 of the County Engineer and the entire eXpcll!>c of !>UiJ
supervision shall be borne by the pany or panics to ",hom this permit is bsucd.
The Department of Public Works hcreby rcserves the right to order thechangt.: of location or the rell10val of any structure or structures authori/ed by
this permit at any timc, said change or rcmov:tl to be madc at the !<iole cxpen\e of the palty or parties to "'ham this permit is is!.ued, or their successors
and assigns.
All such changcs, reconstruction or relocation by thc grantees shall be done in such 1TI:lllnCr as will calise the least interference with any of the Coun.
ty work and the COUnty of Jeffersoll shall in no wise he held liable for all}' d:lmuge to the grantee by reason of :IlIY such work by the COUnty of Jeffer-
son, it agents or representatives, or by the exercise of any rights by Ihe County upon roads. streets. public places or Mructures in question.
This permit or privilege shall not be deemed or held to be all exclusive one and slmll 110t prohibit the County from granting other permits or franchi!\e
rights of like or other nature to othcr public or privatc mltitics, nor !>hall it prevent the COUlIty from using any of its rmlds, strcets. or public places, or af.
feet its right to futI supervision and control over all or UI1Y part of thcrn, nunc of which is hercby surrendereiJ.
Thc Department of Public Works may revo~e. amend or cancel this permit or uny of the provisions tllt.-reof at allY time by giving written notice to the
permittee, The permittee shall immedialely remove atl facilities from the right of way. Any f,lcitities remaining upon thc right ofwuy 30days afler writ.
tcn notice of cancellation shall be removed by the COIIIHY al the expense of the permittee.
The parly or parties to whom this permit is issued shall maintain at his or their sole eXflCnse tile structtlre or object for which this permit is granted in
a condition s:ltisf:lctory to the Department of Public Works.
SPECIAL PROVISIONS, I-CABLES SHALL BE BURIED A MINIMUM OF 30" BELOW THE EXISTING DITCH.
2- APPLICANT SHALL BE HELD RESPONSIBLE FOR ALL DAMAGES TO THE COUNTY BOAD RIGHT OF WAY.
3-DO NOT CUT ASPHALT.
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~n ac' II - I~i;' permit the gr. t 'crl)is success . lIlll.assigns, agrce th,lt any dumage or injury done to the property ofthc grantee or allyexpellsc
incu db IIi hrough th per' n6f a 'ttr. .}l rking for the County or any County employee shall he at the sole expense of the grantee, his
~l 'esso ssiglls. ,-; ~ /"'
r-rrA~:C::~"" ',~ :;?d--
\..lInt! COlldltiollS us (lcr..~Plet orth.
Dared Ihi, :?-3c9.i/,y of V C?-7 L-<?__
, the undersigned. hereby accepts this permit subject to the terms
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fec Paid__ Yes _ No
1820 JeUerson Street
P.O. Box 1220
PorI Townsend, WA 98368
(206) 385-9160
R~il'INo
^ddn:~ Rcque!>l _ Yes __ No
Mile Post
AI'I'L1CATION Hilt I'EI!MIT
To Department of Public Works,
Jefferson COUlHr, W')i'hinfon, _ I' I r ,I, }
The undersigned !/tt-,'f""".,Y l-.e <~ f.'~ ""'-1 PI tL/
,=', A AI " f
hereby appU- "7 for permission to I:::, t' f{. 'T H- (!' 0 ~ _,-r V/1 / t?C( _c; ''1
~ "- I 00 ~ __ _p -(- ~I or,-/ "",;:,;;t;;""'"$'::':':;;'~
o Sf E" 77 !f r f2. 7.). ~[! ~(;7 /_ ?CJC'---'
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SKETCH:
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JUN 12 '\989
JEFf EH<::> U ,'oJ L;UUI'lI~
PUBLIC WORKS OEP
On County Road: E l' Y / 7
/17
between t?-p.f.k/ /:,..0 I p...-.c",Y'e.J-/!~
(S'U/"IIf'U't"'cr"'HI"""'Jrmil~/",lt1Il
to do the work in accordance with your rules and re1,'lJlarions and subject to your inspection and approval.
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-5
J)gl'ARTMgNT OF I'UBUC WORKS
Jefferson Cu,
Permit No, () CF7 7
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Superl1isor wit/make detailel/ report willI his recommendatioll 011 this applicatio/l, Whenever possible show sketch of proposed
work. Supervisor will also make additional repOf/s and filial report giving dati! of comp/elion of work all this form.
Preliminary Report:
L(xc,1"J ,4, /'1-''', /,70
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Date: 05 flY
Final Report:
PER~tNSPECTION REPORT
. Work covered b)' permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control - adequate
- inadequate
REMARKS
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0107
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820JufhJrsollStreel
P,O. Box 1220
PorI Townsend, WA !=ii3368
(206) 385.9160
N~
District No,
6
PERMIT
In accordance with all applicable Revised Codes of Wasllington <lnd amcnumcllls thereto, and subject to all the terms, condi.
tions and provisions written or printed below or on any pan of this form
to
PERMISSION IS IlEREBY GRANTED TO Port Townsend Water Depa rtment
540 Water Street Port Townsend, Wa 98368
open cut shoulder of Hunt Road to install a 3/4 water service to the Jensen
Res. located at M.P. .11
I,d Ie;' tr~ ~ ~ V !l"':' D
IJ~H~. f;G; ~, >~ ~ ;of C
JUL 1 C 1989
JEFfEh::>UI\J GUUI'IITY
PUBLIC WORKS DEPT.
County Road No, 634590
Franchise No.
Milepost .11
No work shall be done under this permit until the party or parties to whom it is granted sh;:ill have communicated with and
received instructions from Don 01 in 385-9140
This permit shall be void unless the work herein contemplated shall have been compleled before J ul y 14 . 19 90
Dated at July 14 .19 89
~ ~ I CALL 48
HOURS
r.1~ BEFORE
J,. '.... YOU DIG
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GENEJ!AL I'J!O\'ISIONS AI'I'UCAIILE TO ALL I'ERMITS
This permit is suhjct:1 to all applir.:abh: pf(H'i~ioll~of the Hc\'iscu ('ollcs of Wa...hingtoll, c,,"ccpt thai UlI} plU~J...iorl ill lid... agreement lloll.:(JmJ~ICI1l.....ith
!luch rC!lulutioll !>hall he controllil1g.
A bond in the U/l1011nl of $
i... rcqulrcu fur the jlrtl!CctHlrI of the (OUrIIY a." !leI forth HI the: It:rJll'' of the htJIIJ.
During [he progress of thl.: v.vrk such h.uricr... !ohall he l"fCt:ICd and lIluilllaim:u <IS may he Ill:CC.....:.try 01 as IIlOl}' he uncl.:lcd for tile protccllOll of the
traveling public; the barriers shall he properly IightcJ .It night.
In accepting this pCrlnillhc pClitiorlcr. Ilis SIU;CCS...ors and assigns, ugrccs 10 prole' I JclTcrsofl CUUllt)' and ...u\'c it harlllJc~ from all claim!>. u(;tiulls ami
damages of C'yery kintJ and description which fll:J)' accrue 10 or he ...uffered by any person or persuns. corponnioll ur properly br reason of the perfor.
mancc of any such work. character of materials Ilscd or maulIer uf illstallatiull, maintenance and operation OJ' by the improper l"l.:Upanq of right uf
way or public plal.:e or publk stru!.:ture, and in case ,Ill}' suit or action is brought :Jgainst said Jefferson COUtlt}' for danwges arising out of or by re:Jsoll of
any of th~ above caU!<i~S, the petitioller, his succe!<isors or as...igns, will UPtlllllotll.:e to him or them of COlllrnenl.:elllenl of such al.:lilJll. defend the SOlme at
his or their own sole cost and eXpcll!>>c alld will satisf}' allY judgmcnt ufter the said suit or actioll shall huve fjllall~' becn l.ktcrlllined if adverse to the Jef.
ferson County.
Except as herein authori/ed, no excavation shall be made or ubstacle pl<ll.:cd within thc limit:-. or a county ro,Il1 in such a mall/ICr liS to intcrferc with
the travel over said road,
Except as herein authori/ed, no excavation shall he mude or obstade pt,ll.:eJ within lour 141 reel of the edge of the pa\elllCl1t.
If the work done under this permit interferes In any way wilh the druill:Jge of the ,ollnty ruad. Ihe gf:Jlltl.:e sh:J1I wholly <lnd at IllS llwn el\pen.-.c Illal..e
such provision as the engineer may direct to take care of said drairwgl.:.
On completion of said work herein contcmplated all ruhhish and debris shall hI.: illlllll.:Jiatdy removed :Jlld the ruadway and roadside shall be lefl neat
and presentable and satisfactory to the engilll.:cr,
All of the work herein contemplatcd sh:J1l bc done undcr the slIpcrvhion ,lUd to the salisfaction or the CoulIty Engincer :Jnd the entire expense of !>aid
supervision shall be borne by the party or parties to whom this f)\:rmit is is:-oued.
The Department of Public Works hereby rescrvcs the right to order thc dlange of locatloll or Ihe remo\'al of anr structure or :-otruClUre:-o authorilcd by
this permit at any time, said change or relllovalto be Illade at the sole expl.:nse of the party or partics 10 wholll this permit is issllcd. or their sllccessors
~tnd assigns.
All such changes, reconstruction or relocation by the gralllees shall be done in sLlch 1Tl:lllller as will C;lllse the least interference with any of lhe Coun.
ty work and the COUnty of Jeffer:-oon shall in 110 wise be held liable for <lny dam;lge to the grantee by reason of any sudl work by tile COUnty of Jcffer'
son. it agents or representatives, or by the exercise of UllY rights by the County upon roads. streets, public places or structures in question.
This permit or privilege !<ihall not be deemcd or held to be an exclu:-oive olle and sl1<l1l not prohibit thc County from granting other permlls or franchise
rights of like or other nature to other public or private utilities. nor shall it preventthc County from using any of ils roads, ~meets, or public pl:Jccs, or af.
feet its right to full supervision and control over all or allY part of them. nOlle of which b herchy surrcndered.
The Department of Puhlic Works Illay revokc.arTlend or eun,elthis permit or allY uf thc provisions thereof at any time by glvil1g written notlee to the
permittee, The permil\cc shall immediately remove all faeilitics from the right of way. Any facilities relllidning upon the right of W,IY 30 days after writ.
tcn notice of cancellation !<ihall be removed by the CountY:lt the expense of the permittce.
The party or parties to whom this permit is Is:-oued shalllllaintain ut his or their sole expense the Slnlclllreor object for whkh this permit is granted in
a condition satisfactory 10 the Department of Public Works,
SPECIAL PROVISIONS:
1) Water line shall be buried a minimum of 30" below existing shoulder.
2) No asphalt cutting required.
3) Applicant shall be held responsible for all damages to the county road
right of way.
In accepting this permit the gnllltee, his succcssors and ussigns, ;II.Uce Ihut any dumuge or injury done to lhe prnperty of thc grantee or IIny expense
incurred by him through the operation of a COlllflll.'lor. working for the COllnty or UII}' County clllployee shall he at thc sole expense of the grantee, his
successors and ussigns. ;
p T 0 ~ lJ-. ~1.:-- tJ-Y)U4 ~....._..I' ,the undersigned. herehy accepts this permit suhjcct 10 lhe terms
and conditions as herein sel forth. ........... 7~
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fce Pair.l_ Vel> _ No
1820 Jerrelson Street
P.O. Bo1. 1220
Port Townsend. WA 98368
(206) 385-9160
Kcu:,pll"o
Ac..Idlt~~ HCl.juc!lt_ Y~_No
Mile' POSl
.11
API'LlCATION FOI{ I'ERMIT
To Department of Public Works,
Jefferson County, Washington,
Tlte undersigned R,,,,,f ;-;,0;1.....~-?rI If.l.a.it";' !)r-.pr
Iterebyapp,:y-- [orpermi.\sion to 6;:'<"''''7 C!ql 1't:,t,;;,~('c!.'0""''':.hf,,,"-::ie::::.~/ ,pd.
?d o'u;~4'/1 3,/1''' u.J II If'/" .s e>/'YI<!~ 70 .:rC'"II.s<W ;7"5. no;l'<< i' ,..,>~h1"-
Cui 17"$S~/'Y b"1. f, C ~ \1. '! E 0
JUL 10 1989
JEFFEF1SOI\, COUNTY
PUBLIC WORKS DEPT.
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between /l!PSS(?S COl'/?l!"I" IT'd -r-
ISI<lI"IIl'UI"\'l'f"'H"'~'ffllll//{"II<,illll
and agree~ /0 do the work i/1 accordance with your rilles and regulations and subject to your inspection and approval.
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6
DEI>ARTMENT OF PUBLIC WORKS
Jel'ferson Co.
Permit No, '0 \ \:)/
Supervisor's Itcporf No.
Supervisor willmoke detailed report willI his recolflmellllO/ioll 0/1 this application. Whenever possible show sketch of profJo.~ed
work. Supervisor will a/so make additiunal reports alld filial report gh!ing dare of completion of work 011 this form.
Preliminary H:cport:
LCCAt'i"C> (,) [)/ ./fcJz
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Date: 7-1),-0/
Final Report:
PE!tMIT jPlSPECTlON REPORT
L-/" Work covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic conlrol - adequate
- inadequDle
REMARKS
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820JetllJISOnS!rf;ler
P.O. Box 1220
Port Townsend, WA98368
(206) 385.9160
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N5: 0011
District No.
6
PEIlMIT
In acconJuncc with all applicable Revised Codes of Washington and ,..IJllcndmcn(s thereto, umJ subject to alllllC terms, cOJJ<Ji-
liolls and provisions wriUen or printed below or on any fmrt of this form
PERMISSION IS HEREBY GRANTED TO U . S. West Communica tions
2720 Oakridge Dr., Port Angeles, WA 98362
to Install buried survice wire along the North side of Irondale Raod
from mile post 1.78 to mile post 1.81
W.O.# 89-129
County Road No, 933507
Franchise No.
1. 78 to 1. 81
Milepost
No work shall be done under this permit until the pany or panics to whom it is granted shall have communicated with and
received instructions from Don Olin, 385-9140
This permit shail bc void unless the work herein contcmpiatcd shail have hecn compleled before Apr il 27
Dated at April 27 .1989
,1990
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CALL 48
HOURS
BEFORE
YOU DIG
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By .<J~ K~
1.800-424.5555
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GENEllAL I'I{OVISIONS AI'I'UCAIIJ.E TO ALL l'EnMITS
"nib> permit is subject lO (Ill upplkahlc pruvi~jom of tile J{cyiscLl Col.lcs of Washillgton. C"-cl'pl lh<ll all}" provisl11ll1llllw. agreement fltlllOlI'>islCnl with
such resolution lohall be controlling.
A bond in the alllOUlll of $
is rcquin:t1 for Ihe protCI:IlUIl of the COUII1} a,:> set forth ill the terms of the Ixmu
During the progress of the wurk sudl barriers shall be erected amllllailllaincJ ail 111<l}' he IlCl'CSS:HY or as IIlOl}' he Jircclcu for Ihe prulcl:llull of the
truvl.'ling public; lhe barrier!'. shall he properly Jit~hlcd ;It nighl.
III acccptillg this permit the petitioner, his !>ucce!>!>urli llm.! :J!>siglls. tlgree!> to protect Jefferson Coullty tllllJ !iave it harmless frolll all d;,lilllS, UUlorlli and
dUrIlage!i of every ~imJ and L1escriptiol1 which rna~' accrue to or be liuffereu by any l'lCrlillll or pcr!ions. corporation or property br rca,>ollof the perfor-
mance of allY such work, dmructer of matl.'rials used cr lIlallllcr uf ill!>tallatillll, muilllellanee and operatloll or b~' lhe irnprupcr (-"CUram;y of right of
way or public place or public litrueture, and ill case .\flY suit or W.:tiOll b brought ugain!>t ,>aid Jeffersul1l'ouJl(~ fordarna~cs ari\lllg OUt ofur b~. rea.,Ofl of
any of the above eaulies, tlie petitioner. hb !>UCCC!>!>OTS or tllisigll!>, will upon Ilutke to him or them of ClJIIllTlCIlCCrnCIII or !iudt <!CtiUlI, defend thc liamc at
hili or their own sole COlit and cXpcll!ie and will stltbfy any judgmellt after till.: said !>uit 01 tll,tillll lihaJJ hUH: rillally been lietcrnilncd if auvcrlie to tbe Jef.
ferson Coullty,
Except as herein authorized. no e....ca\'.uiol\ lihall he made or obstacle placl'd within the limits or a count) road In sucb tl manner as to interfcre with
the tra wi over said roat.!,
Except as herein authorized, no exca\'alioll shall be made or nb~",de pluceJ withill four 14j feet of lhe edge uf the pa\"ClIlI.:m,
Jf the work dont.: under this permit interfercs in allY way with the drainage of the COllllt}' road, the grantee lihall wholly alld at his own e),penM: llIa;..e
such provision as the engineer ma}' uireet to take care of s:lid lirainage,
On completion of said wurk herein contemplated all rubhbh ami debri.~ shall he immediately relllovet.! alld lhe roadw.l}' and roadside shall bc left neat
and prescntable and satisfuclory to the engineer.
All of Ihe work herein COlllcmplateu shall be uone under the supervision and to the satisfaction of tile COUI\I~' Engineer and the cntire e.\pcme of said
supervision shall he borne by the parlY or panics to whom this permit is issued.
The Department of Public Works hereby reservc!> lhe righttu order the change of location or the removal of an}' structure or litnlctures authuri/ed by
this permit at any time, said change or rernovullO be made at the sole expense of the pany or parties to whom thb permit is issued, or their succeSM:lrs
and assigns.
All such changes, reconstruction or relocution by the grantees shall he done in liuch mallner as will cause the least interference with any of the Coun.
ty work tllld the County of Jeffersoll lihall in 110 wise be held liable for any d.ullage to the grantee by reason of an}' such work by the County of Jeffer.
son, it agcnts or represent,ltives. or by the cxercisc of an}' rights by the CoufllY ur>on roads. MrCCls. public placcs or structures in question.
This permit or privilegc shall not he dcemed or held 10 be an exclusivc one tllld ~hall nol prohibit thc County frum granting other permilsm franchise
rights of like or other nature to other public or privatc utilities. nor shall it prcvcnllhe County from using .1IlY uf its roads, strccts, or public places. or af.
fcct its right to full supervision and control over .111 or any part of thclll, none of which is hcreby surrendered.
Thc Department of Public Works may revoke, amend or cancel this permit or ,lilY 01' thc provi!>ions thereof at anr time by giving writtcn noticc to the
permittcc, The permince shall immediately removc .II! fncilities from the righl of way, Any facilities rcmnining upon the right or W3Y 30 days after writ-
ten noticc of callcelltltion shall hc removed by thc CoulllY at the cxpense of tile permittee.
The p3rty or partics to whom this permit is issllcd !>hall mainwin at his or their sole expensc the Mrllcture or ohjcct for which this permit is granted in
a condition satisf.lctory to the ()epllrtrnCl1t of Public Works,
SPECIAL PROVISIONS,
1. Cable shall be placed a minimum of 30" below existing grade.
2. Applicant shall be held responsible for all damages to county
road right of way.
In accepting this permit Ihe grantce, his successors and assigns, ugrce that any dumagc or injury done to the property of the grantee or any cxpense
incurred by him through the Opcr:lliOllllf a cnntr;lctor, working for the CoullIY or any COllnty cmployee lilmll be .11 the sole expense of the gmntee, his
succcssors and assigns,
* !I. 5. 4/esl-
and conditions as herein set forth.
Dalcd Ih;:1<'- / day or1'
. the undcrsigned. herebr accepls this permit subjcct to the terms
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fee Paid_ Ye5. _ No
1820 Jefferson Streel
P.O. Bol'.: 1220
Pori Townsend, WA 98368
(206) 385.9160
KI;U:'PI,,"O
Addre~ Request _ Yes _ No
Mih: PO!>t
AI'!'UCATJON FOR PERMIT
To Department of Public Works,
Jefferson County, Washington,
The ulldersiglled t'1 s: It/,.. ~ f
hereby app/~ for permi,sioll tu f'J.c,,"
/S'O' '110';/ j:rM"t/'" A/
SKETCH:
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all County Road:
t( ~r(c-d :;?ervfce 4/;re ~_ /.:!/~;h4/ /1'10
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RECE~VED
APR 1 9 1989
JEFFERSON COUNTY
PUBLIC WORKS DEPT.
between
,.'i/Qll"I'~IIl'\II'm"'\I"~'1 ", mi/..p.>l/IIJ
and agree_ 10 do the work in accordance with your rules alld regulations and subject 10 your inspection and approval.
Date 19_
ISIMl1IllUrcuf Apl'h(;lIlll
1('1l0Irnc\ml
(If lIpplicant is a copUTtncrship, ~t forth n:1I11CS of copartnersl
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Jeffersun Co.
District No.
D1~I)ARTMENT 01: PUULlC WORKS
Permit No, n () , I
Supervisur's l(clHJrt No. _
Supervisor will make detailed report wi,II his recommelldaliotl Oil this applicatiofl. U?hellever possible show fJ'kerch oj proposed
work. Superpisor will also make additional repurts alld j1nol Tepor/ giving date of completioll of work on this form.
l>>reliminury ItclJOrt: JVv i.>...C I ( j,l ;j" 111 r' II> r" I. l/
0-( s'k..Jv(J",- ,-'t({,......-'r:~
Date: <.f-;"u'7r'1
Final Report:
PER~SPECTION REPORT , '
Wark covered by permit - has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control - adequate
- inadequate
REMARKS
Uale:
I-~b -57
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ORIGINATED By .0\(.1<... W~~ Dale ~fll!'"
New Jail/O No, elo'). "'~"""'l Duo O.le.!i/..!.!1!"t
Repeit 0 Tel. No, ____ Tempotizcd 0
Rearrange 05/0 No, _______ Due O.le__
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eeL. PAl' Color/B.P. T T.rm Add'U~'
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Stc.8tch Work Required - Include Lengths, depths, wire slzu and emount &,.. ..... 1/
c.. G~ NT'( .
@OUT -!...E6~1lT
IN ~
LOCATION _
Addruee _!~~s<.O'VO/J.!-G ~~______
City l1AQ h. ot....., _, County ~rPG'A.'o~_ Stlte ~
Name ~o <:.",p ~P-.. "lia!llJ'_~___
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Burled Service Wire.
Work Order
No.
Complete by
CONTRACTOR'S ACCEPTANCE
Firm
Signatute
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Unit Price 0 Con Plu. 0
Dale
Flit Sum 0 S
Sill 10, U S WEST Communlclltions
Attention
Addrss8
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Zip
APPROVAL For FI.t Sum/COil Plu. $
Rlcommended
Approved by
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PERMIT REOUIRED
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Jurisdiction
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1820 JeHelson Slreet
P,O, Bo~ 1220
POrl Townsend, WA 98368
(206) 385.9160
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
N~
0010
Disuicl No.
6
PERMIT
In accordance with all applicable Revised Codes of Washington amJ amendmellts thereto. and subject to all the terms, condi.
tions and provisions written or printed below or 011 any pan of this form
PERMISSION IS HEREBY GRANTED TO puget Sound Power and Light
310 Four Corners Rd., Port Townsend, WA 98368
to Install underground primary cable across and along the East side
of 5th Ave., then along the North side of Kinkaid St. to the East, then
across 4th Ave. Ap..E/2QlCDrnr?::>lz_
'iSCID~q5?'1
County Road No, 669109
Franchise No.
Milepost 0.27 to 0.31
No work shall be done under this permit until the pany or parties to whom it is granted shall have communicated with and
received instructions from Don Olin, 38509140
This permit shall be void unless the work herein contemplated sl1alll13vc been completed before Apr il 26 , 1990
Dated at April 26 .1989
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CALL 48
HOUilS
BEFORE
YOU DIG
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1.800.424.5555
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GENEIlAL I'IUlVISfONS AI'I'UCAIILE TO ALl. f'EIIMITS
This pennit b ~uhjccl to all applkablc provbi. !Il~ of the l{cvh,cu ('otlc!o, uf Wa~hjllgl()fl. except that all)' PfllVl~j()1I Lulh;!'> agrcclIlcnlllol WIIshlCI11 with
such resolutio/l shall be (;olltrollillg.
A bond in the UIIlOUIll of $
h. required fur the (lwICl:IIOll of the C(JUllly as ~CI forth in the [crm.. 01 tile hum!.
During the progress of the wurk J;uch barriers shall be erected and lImilllaim:J as 1I1i1)' be /leecs....lry or as may be l..Iircl:lcd for the pWICl'tlOll of the
traveling public; the bo.rders shall be properly lighted al night.
III acceJlting this permit the petitio/ler, hi!. successors ami assigns. agrees to flfUlcct Jclferson l'oulllY um.l ~ve it harrllle!l~ from all claim!.. ,u:tions and
durnage!. of every kind um.l dC!lcriptioll which llIay accrue tu or bc !.uffcrcd hy uny pcrson or per!.ons. corporatioll or property by reason of the pcrfor.
mUllce of any such work. character of matcrials u~cd or ll\Ull/ler of illMallatioll. maintenance aud operation or hy the improper occupancy uf right or
wuyor puhlic place or publicMructure. und in cu~ UIIY suit or uctioll is brought uguiml said Jeffer~(1II COUl1t~. ror damages arisingouI or or by reasorl of
uny of the ubrwe causes. the petitiollcr. hi!. ~ucces!.ors or a.ssigns. will upon ll(ltke to him or them of COllUllellCCIllCIlt of such uClioll. defcnd the same at
his or Ihc:ir own sole cost and expense and will satisf~' allY judgrnclll uftcr the said suit ur aClioll shall have finally heen determined ir ud\er~e 10 the Jef.
ferson COUnty,
Except as hereill authori/.ed, no excavation slmll be made or obstacle placed wilhinthe Jimits of U cuullly road ill .!.llch a manlier as 10 interfere wilh
lhe lrave) over .~ajd roau.
Except as herein uuthoril.cd, no excavation shall he llIade ur ohstacle placed within four 14) feet of the edge of the p.Hemellt.
.If the work done under this permit illlerfercs in all}' .....ay with the draillage of the CUlJlIIy road, the grarllet: shall wholly and at his 0.....1] expense make
such provision as the engineer Ill:!y direct to lake carc of said drainage.
Oil completion of said worl.; herein contemplated all rubbish atld debris shall be imlllcdlately rell10vcd and the roadway and roadside shall be leftllclll
and presentuble and satisfactory to the engineer.
All of the work herein contcmplatcd shall be done under the supervision and to the satisf:ICliol1 of the COUIlt}' Engineer and the entire expcnse of said
supervision shaJJ be borne by Ihe party or parties to whom this permit is issued.
The Department of Public Works hereby reserves the right to order Ihe change of location or the removal or allY structure or structures authorized by
this permit al any time, said Change or rellHwal to be In:lde at the sole expense of the party or partics to whom this permit is issued, or their successors
and assigns.
All such changes. reconstruction or relocution by the grantees slllll! be dune ill such munner as will cause the leaM interference with any of the Coun.
ty work and the County of Jefferson shall in no wise he held liable for any damage 10 the grantee by reason of any sllch work by the County or Jeffer.
son, it agellls or representatives, or by the exercise of any rights by the County upon ro:u..ls. streets. public places or structures in question.
This permit or privilege shall not he deemed or held to be an exclusive one and !\hall not prohibit the COUllt)' from granting other permits or franchise
rights of like or olher nature to other public or private utilities, nor sh:lIl it prevcnt the COUnty from using nllY of its roads. streets. or public places, or af.
fect its right to full supervision and control over all or adY part of them. nOlle of whkh h hereby surrendered.
The Depanment of Public Works may revoke, nmend orcanccJ this permit or any of the prnvision~ thereofat any time by gh'ing wrillen notice to the
permittee. The pc:rmitleeshall immediately removc all facilities from tile right or way. Any facilities remaining upolllhe right or way 30 days after writ-
ten notice of cancellation shall be removed by the COUnty ut Ihe e.\I>Cllse of the pcrmittee.
Thc party or panies to whom this permit is issued shall nlllint:lin ut hisor their sole expcnse the structure or objcct ror which this permit is granted in
u condition satisfactory to the Department of Public Works.
SPECIAL PROVIS.lONS:
1. Applicant may open cut 5th Ave.
2. C~b1e shall be a minimum of 3 feet below existing surface.
.i'
3 . Applicant' shall be held responsible for all damages to county
rQad'rightJof way.
In accepting this permit the gralllce, his successors lInd ussigns. ugree that allY dallloge or injury done to Ihe property of the grantee or ,lilY expense
incurred by him through the opcflltioll of <I cOlltr:ICtor. working for the CuUnty or any Coullty cmplnyee shall he utthe sole l~xpense of the grantee, his
successors :lIld ussigns.
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* ~qvr 7"2fl . the undersigned. hereby accepls this permit suhject 10 the terms
,1IId condi:;ons us (lcrein set forth. ~
Dated this~ / day 01''* MAY ,19-lir;c;
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JEFFERSON COUNTY
OEPARTMENT OF PUBLIC WORKS
Fl:C Paid_ Yes _ No
\
kcu:tpt Nu
1820 Jetrerson Street
P.O. Box 1220
Port Townsend, WA 98368
(206) 385.9160
Addrc~ RC4UC!lt _ Ye~ _ No
Mile Po!ot
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AI'I'UCATION FOIt l'EltJ\IIT
To Department of Public Works,
Jefferson County, Washington,
71/e undersigned 1~)l' ,. "'/(' if-.
J
hereby oppif-- for permission to
/c)/Olf 390cJ/Sc;
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/;JSTALG
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1..ll'"IIIUI/I ",11 <1.'",,1.., ,ull,'- "llUll,~ ;..,~h..\ /11 do I
EX /EIJc5/ 0',7 '
SKETCH:
I' /' '0
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~u ~v
rQ55 477.1 A iJ&
On County Road: 5/1> AVe / 1);;1){!;AJ.D 0/ t/ AC'J(!I>\,een 1../0/0/0/0
II cr-ct.Puck: ,
c) MAUVE... ST
(Stalo'''...'''.\/cw'H/r....lurmll,.p"illl)
and agreeW- to do the work in accordance with ,vour rules and ref..,1f/lations and subject to your inspection and approval.
Date A'I~;~/I, 17 i9 gCj
Lit Il,&c/J "Y.---(, /l --'
(Still1~:~nri\f1f1hCUI1U
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c:::> /0 h/'5?.-v1/ r.:./,) /J I P /,",,/'j "fZ)
^''"''''./7::1;''' , (/ )..,d q rr 3 c::. i ^,""",
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Phone No. ( /1) - q.J ( , Phone No,
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Jefferson Co.
DEI'ARTMENT OF !'UJlLlC WORKS
District No.
Permit No. no \ \)
SUIJervisor's IlcJlorl No.
Supervisor will make detailed report with hi~ recommendation all/his application. ~Yhellever possible show ,\'ketch of proposed
work. Supervisor will also make additional reports and fillal report givillg date oj completioll oj work on this Jorm.
Preliminary Ileporl: GRAV!L. Ro.,J
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Signed: ~" 0--...
Final Reporl:
PERM~I'ECTJON REPORT
Work covered by permit has been completed
satisfaclorily.
Work is nol compleled.
Recommend permit be cancelled.
Traffic CORlrol - adequale
- inadequale
REMARKS
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0957
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
lInOJt!tlerson Slreel
po, Box 1220
Port Townsend, WA9B368
(2061365-9160
N~
District No.
4
PERMIT
In accordance with all applicable Revised Codes of WashinglOll and amendments therelO, and subject to all the terms, condi.
tions and provisions written or printed below or on any part of this form
PERMISSION IS HEREBY GRANTED TO Freends of' the PheLadeLphea Streng Quartet
P.O. Box 45776, SeattLe. WA 98145-0776
to InstaLL temporary sLgns for "OLympLc MusLc FestLval" along Center Road
at mLLe post's 6.81. 7.31 and 7.74 as appLeed f'or.
County Road No. 931507
Franchise No,
See Above
Milepost
No work shall be done under this permit until the party or partics to whom it is granted shall have communicated \\.'ith and
received instructions from
This permit shall be void unless the work herein contemplated shall have been completed before
Dated at February 7 . 19 89
.19
&~mIDlW[BID
~ ""'< I CALL 48 I
~ lif':~ HOURS
it!" BEFORE
J ~ YOU DIG
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By AJ~ K~
1.800.424.5555
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GENEnAL 1'1l0VISIONS AI'I'UCAIII.E TO ALl. I'EIlMITS
Thh> permit is. subject to all applkablc pr(Jvbilln~ of the Rcvi'cd CDUC!'> of Was.lllllgtoll. c>,ccpllllal allY prU\'I!.IUll ill thi, agrccrnclH !lot Wfl'>l,>tcnl with
such resolutioll shall he cOlltrolling.
is required fur the protectioll or the COUCH} as ~t forth in thl: ternl'> of th.: bond,
A bund in the amount of S
During the progress oj' lhe wor~ such barriers shall he Clcl.:ICU and maintained as lIlU}' be 11CCC.,~ry or a,> llIay he Ullcctcd for Ihe prolct:liufllll the
traveling public; the barriers shall he properly lighted at night.
In accepting this pcrlllillhc petitio!ler, hissUI;ccs!.ors and as.,ign,>, ag,rccs 10 protect Jctfcr~m COUlll)' amI save it h<l(lllll:ss fwm all claims, al.:(lolI'> ,HId
damagt:s of every kind and lh:~rilllion whidl may Ul'CfUC to or he suffered b}' any persoll or persons. eorpuration or properlY b} rcaSUll of the perfor.
manec of any such work. charaetcr of materials used or llIanller of instullutillll, U1uilltelluru:c and uIl\:raliull or by the improper OCI:upancy of right uf
way or public placc or public structurc, and in case UIIY suit or actiun is brought again!>t said Jcffcnoll ('oullty for damages arising out of or by reason uf
any uf the abovc causes. the petitioncr, his SLlCCCS!>OfS or assiglls, will Ul)(lll nOlicc to hlln or thelll of CCJIIllI1CIlCClllcnt of !>uch action, dcfcnd the ~I1lC at
his or their own sole cost amI expense and will satisfy any judgment aftcr thc said suitm action shall have flllarry hecn JeterlllillCd if adverse to thc Jef.
ferson County.
Exccpt as herein allthori/cJ, ntl e>>cavatioll shall be Illude or ob..wclc pl<lced within tile limits of a CutJIIIY road in such a manner a!> to interferc with
the travel over said road.
Except as herein authorizcd. 110 c>>cav:ltio/l !.hall he lWllIc or ohstaclc pl:lr.:cd withJl1 four (4f fcet of the euge of the pavclllClll.
If the work Jane under this permit interferes in any way wllh lhe lIr<linagc of the COUlll}' roau, tll!: gralllec ~hall wholl}' alld at Ills uwn e>>pCll~e llla~c
such provision as the engineer may direct to take care of !>aiu drainage.
011 completion of said work herein cOlltcmplated all rubbish and debris shall be immediately relllovcd and the roadway am.! ruau~ide ~hall he left ncat
and presentable and satisfactory to the engineer.
All of the work herein contemplated shall be done under thc surcrvision and to the satisfaction of the CoulIty Engincer and the emire e>>pcnse of said
supervision shall be borne by the party or pilnics to whom this permit is is~ued.
The Dcpartmcnt of Public Works hereby reserves the right to order the change of location or tile removal of allY structure or structure!. authorized by
this permit at any time. said change ur removal to be made <It tile ~lJle expcnse of the party or panic!> 10 whom tbis permit is issued. or their successors
and assigns.
All such changes, reconstruction or relocution by the grantecs shall be done in such maTlIICr as .....iIl cause the leaM intcrference with any of the Coun'
ty work and the County of Jefferson shall in no wise be held liable for any damagc to the grall(Ce by reason of any such wl1fk by the County of Jeffer.
son. it agents or represematives, or by the exercise of uny rights by the County upon roads. !>trcet~. public places or structures in question.
This permit or privilege shall not be deemed or held to be an exclusive one and shall not prohibit the Cuunty frolll granting other permits or franchi!>c
rights of like or other n:Hure to other public or private utilities. nor shall it prevent the County from u~ing all}' of its roads, !otrects, or public places, or af-
fect its right to full supervision and control over all or any part of them. nonc or which is hereby surrendered.
The Department of Public Works may revokc, amend or cancclthis permit or nny of the provisions thercof atnny time by giving wrillen nDlice to the
permittee. The pcrmitlceshul1 immediately removc all facilities from the right of way. Any facilities rCllwining upollthe right of w.IY 30 days aftcr writ.
ten notice of cancellation shall he removed by Ihe ('ounty at the expense of the permittce.
The party or parties to whom this permit is issued shall nmint<lin <It hi!> or their sole expense the structure or object for which thi!> rcrmit isgrallted in
a condition satisfactory to the Department of Public Works.
SPECIAL PROVISIONS,
1. SLgns sllaLL not be pLaced 50 they block exLstLng sLgns or Lnter-
rere wLth vehLcuLar traffLc.
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In accepting this pcrmitthe grantee, his sllcce!>sors and llssigns, agree thai any damage or injury done to the property of the grantce or any expense
incurred b lim through the operation of a contractor. working for Ihe County or any COllnty employee shall he at the sole expense of the grantee, his
suc~ nd ussigns. ' ~ fr;c!.n<1.1 err -r1'li-. .~.c+
,tJ.,.~(/lhM1~L- tJ/Y'Jt'711~: 1l\l...t~.\f hId ,5-}n'rH &U1~he undersigned, herehy accepts this permit suhjectlo the tenns
r..' 1 Condlllons us herem s f(~.rth" ~ c.j
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To Department of Public Warks.
Jefferson County, Washington.
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Ft:c: Paid_ y~ _ No
1820 Jerlelson STreet
P.O. Box 1220
Pori Townsend. WA 96368
(206) 365-9160
R<<'f'l~ /'00
Addrc!los Rt'quc:.t _ YC!lo _ No
Milt: Post
AI'PLlCATION FOR I'EI!MIT
The undersigned Frip.nclR of tnp Pl1il.nnplphin Sf-rine f!lI.qrt"pt, ^lnn Tgl;t~dn,
herebyapp/~ fOrlJf!rtnissiol1 /0 post signs as outlined below.
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and agree~ ~ ~~ do Ihe work in accordance with your rules and re!.""alions and subject to your inspection and approval.
Date -p.__~~ 19~
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DEPAnTMENT OF !'UIlLIC wonKS
I'emlit N(},Q!~1
SUIJCrvisor's Report No.
Superllisor will make (Jelailed report with his recommendatioll Oil/his application ~-Vhellel'er possible show sketch a/proposed
work. Supervisor will also make additional reports ami filial report giving dale of complelion oJ work all this form.
Preliminary n,eport:
Dale:
Final Report:
PERMIT I~ECTlON REPORT
. V Work covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic conlrol ~ adequate
- inadequate
REMARKS
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jc!1(lfSOn Street
P.O. Box 1220
Port rownsend, WA 98368
(206) 38!r9160
DiMricl No.
5
PERMIT
In accordance with all applicable Rcvisc.:o Colles of WUSl1illgtOIl and amenuments thereto, <Jnd subject to all the terms, cOIH.Ji-
tions anu provisions written or printed below or on any part of this form
PERMISSION IS HEREBY GRANTED TO puget Sound Power and Light Co.
310 Four Corners Rd., Port Townsend, WA 98368
to Install a 40' power pole on the West side of Paradise Bay Rd.
at mile post 5.50 -"8'90E-Zqfj
County Road No. 503609
Franchise No,
Milepost 5.50
No work shall be done under tllis permit until the party or parties to whom it is granted shall have communicated with and
received instructions from Don Olin, 385-9140
This permit shall be void unless the work herein contemplated shall have been completed before Apr i 1 19 , 19 90
Dated at April 19 ,19 89
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C.\LL 48
HOURS
BEFORE
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GENERAl. J'I{()\,ISJONS AI'J'UCAIlI.E TO AI.I. I'EIIMITS
Thi~ per Illil b subject to all applkablc provisions of the Rcviscll CuJcs uf Waslllnglol1. c>,ccpllhat any provlsioll ill thi... agrcclIlcllt !lot COll'i"(I,'/l1 '.\oIlh
such rCM,lutioll shall be controlling.
^ hond in the umouut of $
is required for the prutectlun of the county as M.:l forth HI the telms of the hondo
During the prugress of the ....ork such harriers shall be erected <Inti maimaillcd as lIlay I~ Ilcccssary or as lllay he dircl.:tcd rur Ibl.' prutCC\lllll of the
traveling public; the barriers shall he prupcrly llghtctl al night.
In w.:ccpting (Ilis permit the petitioller, hi!> successors alllJ assigm, agrees to protect Jeffersun Coullty amJ save il harmless from all c1ailll'. al:tlo/l!> alld
rJallHlgcs of every kiml and description which llIay accrue to or be suJ'fcred hy allY pcr:-,oll or pcr:-.ons. corporation or properlY by rea<,ulI of the perfor.
mance of any such work. character of malerials useu ur mallner of imt<.lJlatioll. mainlenam:e alld opera lion or h~' the improper oa:upant.:y of right of
way or public place or public structure. and in case any suit or action is hroul.(hl againsl !>aid Jefferson CounlY fordalllages arising out of or hy rea"oll of
allY of the above causes, the f1Ctitioner, his successors or assigns. will Upolll1otit.:e tu him or Ihem of COllllllencemcnt of !>ut.:h ill.:tiulI. dckndthe ~IllC at
his or their own sole co!>t :.tIId expense and will satbfy an~' judgment after the said suit or action shall have filially Ocen uelerlllil\ed If adverse 10 the Jef.
ferson County.
Except as h~'rcin authori/ed. no eXl,;uvatioll shall he made or ubstacle placed witllinthe limits of a coullty road in such a mallller itS \lJ interfere with
the !ravel over said Wild.
Except as herein authorizeu. 110 excavution shall be made or obswde placcd ....Illllll fuur (4) feet of the edge: of the pave:ll1cnt.
If the work dOlle under this permit interferes in allY w:.!y wilh the dr.drwge of lhe !;UlIIlIY mall. the gratllce ~h:.LlJ wholly alld at his 0.... n expense make
such provision as the cugincer muy direct to take c:ue of s:JiLl dminal.(c,
On completion of said work herein contelllplated ..II rubbish and debris !!.hall be irllllledialcly removed and the roadway .lIll! roadside !!.hall he lcfL tical
and presentable aud satisfactory to the engineer.
All of the work herein colltempl.l\cd shall bc L10lle under the supcrvision and to the satisfaction of the COUnty Engineer and the entire e1\pcme of !.aId
supervision shall be borne by the pany or parties to wholll this permit is issued.
The Department of Public Works hereby reserves the right to order the change of locatioll or the removal of any structure or structures uutl10ri/ed by
this permit at any time. said change or removal 10 be madc althe sole expense of the parlY or punies to whomt!!is rcrmit is issued. or their successors
and assigns.
All such changes, reconstruction or relocation by lhe grantees shall he dOlle in suclt manlier as will cause the least interferertl:e with an~' of the Coun-
ty work and the County of Jefferson shall in 110 wise be held liahle for any dum.lge to the grantee by reason of any such wor"- by the County of Jeffer-
son, it agents or representatives, or by the exercise of any rights by the County urOIl roads, streets. public pl.lces or structures in question.
This permit or privilege shall not he deemeu or held to be an exclusive one and shall not prohibitlhe ('ounty from granting other permits or franchise
rights of like or other nature to other public or privale utilities, nor shall it prevent the Coullty from using any of its roads. strecls. or public places, or af.
feet its right 10 full supervision Dnd control over all or any part of them. none of which is herehy surrendered.
The Department of Public Works may revoke, .Imend or cancel this permit or any of the provisiolls thereufal any lime by giving written notice to the
permittee. The permittee shall immediately remove all facilities from the righl of way. AllY facilities remaining urOIl Ihe right of wa~' 30 days after .....rit.
ten nOlice of cancellation shall be removed by the Coutlty utthe expense of Ihe pcrmillee.
The party or parties to whom this permit is issued shall maitllain at his or their sole expense the structtlrc or object fur which Ihis permit isgrallled in
a condition satisfactory to the Department of Public Works.
SPECIAL PROVISIONS,
1. Applicant shall be held responsible for all damages to
county road right of way.
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In accepting this permit the granlee, his successors and assigns. agree that any damage or injury done to the property of the grantee or any expensc
incurred by him through the operation of II contrllctor. working for IheCoullIY or any COUllty employee shllllllc at the sole expense of the grantee. his
successors and assigns.
;nd co~~<r,?c;n s~~ ,
))at,d this Y <95 day ur'/: C~2--J
, the undersigned. hen'hy llccepts this permit suhjccI to the It'rms
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jeltcrson SlIelll
P,O. BOll 1220
PorI Townsend, WA 98368
(206) 385.9160
AI'I'UCATION n)H l'EIlMIT
To Department of Public Works,
Jeffetson County, Washington,
HIe undersigned 1:) 1 ~ "'(; (' f)-
herebyappl_ for permission to
Fee PalrJ_ Yo ___ No
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RECE~VED
APR 1 7 1989
JEFFERSON COUNTY
PUBLIC WORKS DEPT,
MI LC PosT 5.5
and ag'ee~ 10 do the work ill accordance with your rules and reb'll/alions and subject to your inspection and approval.
Date J P 17_1 L / ':<, /9...15.::L
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(If llpplic3n1 is a cop,lrtncrship, sel forth names of copmtners)
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Jefferson Co.
District No,
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DEPARTMENT OF .'UBLlC WORKS
Permit No, CO 0 7
Supcn'isor's J{c()ort No.
Supervisor will make detailed report with his recommendation oil/his application. Whenever possible .~'how skeu:h of proposed
work. Supervisor will a/so make additiollal Tepons alld final report gil!ing dale of completion of work 0/1 Ihis form.
I)rcliminar)' Ueport: f'Uj ~
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Final. ~~~L
PER~.~~ECTION REI'ORT
Work covered by permll has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control - adequate
- inadequate
REMARKS
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District No.
4
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jetlerson Street
P.O. Box 1220
PorI Townsend, WA 98368
1206) 385.9160
N::
01 19
PERMIT
In accordance with all applicable Revised Codes of Washington and amendments thereto. and SUbject to all the terms, comjj.
tians and provisions written or printed below or on any part of this form
PERMISSION IS HEREBY GRANTED TO Kei th Ell is
P.O. Box 222 Quilcene, Wa 98376
to
install a private drive way off the Thousand Trails Road at M.P. #.34
County Road No, 409109
Franchise No.
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PUB L I (~. ~~;-:;~} .'..;~) U I\! TY
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Milepost .34
No work shall be done under this permit until the party or partics to whom it is granted shall have communicated with and
received instructions from Don 01 in 385-9140
This permit shall be void unlcss the work herein contemplated Sh:'lll have been completcd before
Dated at July 24 . 19 89
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CALL 48 1
HOURS
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July 24.1990
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GENERAL 1'ltOVISIONS AI'I'UCAIlLE TO ALL l'EltMITS
This permit is subject 10 all applicable fl({)\'bjoll~ of the Revised C(Jdc~ of W<tshillgtun, CXl,;Cpt (11:.11 :JII> flro\ j"IOIJ ill lids ugrccJllcntllul (;Omlstclll \\.1111
such resolutioll shall be CUlltrolJing.
A bont! ill the amount of $
is required fur lhe prulcl.:1l01l ul lhe cjJu/ll~ :.I'> ~cl IOrlh III th~' terfllS of the bOlld.
During the progress uf the work i>lH.:h barrier!> shull he crcl:lcd ulllI llluilll;llm:u as llIay Ill.' llco.:ssury or as Ill<!) he ducl.:tcd fUI the protectio!1 of the
traveling public; the barriers shall he PlllpcrJy li~tllcd ;.It !light.
1/1 accclHing this pclll1il the 1K:[jliom:r, his MK!.:CSfiorS 'Iud ussigm., agrees to prolecl Jefferson Count)' alld s<lve It harmless frulll all dilirns, a(:lIon,> Lllld
damages of every kind 1.IIld dc...criplioll which may accrue to or he sulfeled by allY person or persolls, corporation or propert) b) rcusoll of the perfor'
malice of <Ill)' sUl:h ",urlo;, charur.;tcr of lllillcriills used or IlWnllCr of IIl\tall.Hiull, maintenance and operatioll or by the ll11plOper occupalll.;Y uf rigbl of
way or public pl:see or public slrU\::lUrc, and ill case <III)' suit or uCtiull is I1lOuglll again'>t...lid JcfferMIIl County for dalJlagcs .ul\ing OUI of or h~ lea.\01I of
any of the above ~lISes, the !lCtitioller, his sUI.:\::essors or assigns, willuptlll rllltlcc tll Ililll or IIlClll uf COllllllcrlccrneflt of sucll Llctioll, defend tile samc al
his or their OWII sole wst unu expense 'Iud will satisf)' all)' juJglllellt :lflel lhe said suit or UCUOlI shull have rlnully heen delermincd it ad\erse to lhe Jef,
ferson CouIllY.
Except as herein authori/ed. no e>.cavatiol\ shall he made or ohstude pl.lt'ed wilhin the limils or a t:OUllt)' fOall ill 'oUt'll U /II.llltlCr as to lI1terfcre with
the travel over SOlid road.
Except as herein authuri.l.ed. nu e>.t:avation sl1<111 be ll1ade or uhswcJe plat:ed vdlhin ruur HI !cl't uf the ed!,!.e 01 the pavell1ent.
If the work done under this permit interferes in any way with the drainage of the wunty road, the grumce shall whull}' and at hh 0.....[1 exrlCn~ make
such provision as the enginecr may t.lireet to talo;e care of said drairlilgc.
On completion of said work herein contcmplatcd all ruhbish and dehris shall be immediately rcrnoveu and the road.....ay and road~ide ~hall he left neat
and presentable and satisfuclUry to tile engineer.
All of the work herein contemplated shall be JOlle under thc supervi~ioll and tu the satisfaction of the ('oullty Engineer and thc cntire expeme of !'.aid
supcrvi!<.ioll shall be borne by the party or parties to whom this permit is issued.
The Department of Public Works hereby reserves the right to order the change of local ion or the rcmoval of any structure or structures authoriled by
this permit at any time, said change or rcmoval to be made at thc sole expell~e of the party or panics 10 whom this permit is hsued, or their succes\ors
and assigns.
All such changes, reconstruction or rek,c<ltion by the gmntces ..hall he done in such manner as will cause the kast interference with any of theCoun,
ty work and the County of Jefferson shall in no wise he held liable for any damage to the grantee h}' reason of any ~llch wurk by the COUIIIY of Jeffer.
son, it agents or rcpresentatives, or by the exercise of any rights by the COllnty upon Hklds, strects. public places or slructurcs in question.
This permit or privilege Sh.ll! not be deemed or held to he an exclusive olle and :o.hallnot prohihitthe County from granling other permits or franchise
rights of like or other nature to other public or private utilities. nor shall it prevent the County from u~ing al\)' of lis moltb, streets. or puhlic places. or af.
feel its right to full supervision und control over all or all)' part of thelll, nOlle of which i.. hereby surrendered.
The Department of Puhlie Works may revoke, amend or cuncel this pennit or <IllY of the prllVisioll\ thereof at any time by giving written notice to the
permittee, The permittee shall immediately remove all fllcilities from the right of way. Any facilities rellltLining upon the right of WilY 30 da)'~ aCier writ'
ten notice of cancellation shall be rClIIovct! hy the County at the expense of the permillee.
The party or parties to whom this permit is isslled sll<ll1 maintain ill hi:-. or their sole expensc the structure or object for which this permit is granted in
a condition satisfactory 10 the DCpUrlmellt of Puhlic Worlo;~.
SPECIAL PROVISIONS,
1) A 12" X 20' minimum culvert will be required with gravel cover so as not
to track mud onto county road.
2)
Applicant shall be held responsible for all damages to the county road
right of way.
In accepting this permit the grantee, his :o.lleees~nrs and assigns. agfl~e that any damage or injury done to the property of the grantee or any expense
incurred b}' him through the opeflltinn of U contr:lClor. worlo.ing for the ('(lllnt~' or any ('oullIY employee shall he at tile sole expense of the grantee, his
successors and assigns. .-
, //~I ~ gR-t~
Dnd conditions liS herein set forth.
, the undersigne!.!. hereby llccepts this permit subject to the terms
Dated this
, 19
day of
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, , Date?' '\ 0 19~
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JEFFERSON COUNTY
OEPARTMENT OF PUBLIC WORKS
3-9~ yo, -- No
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1820 Jellerson Streel
P,O Box 1220
Pori Townsend, WA 98368
(2061385-9160
Addrc!l\ RcqucSI_ Yes _ No
Mile P~t . 3'1
AI'I'UCATION FOIII'EIlMIT
To Departmenl or Public Works,
Jefferson County. Washington.
The undersigned
herebyappl_ for peffni.'isiOfI to
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DEPARTMENT 01' !'UIILlC WO!~KS
Jet'fersoll Co.
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Permit No, n / I 'f
Supervisor's Rl'por. No.
Supervisor wilt make detailed report with his recommefldalioll on/his application Whenever possible show skelch ofpropo.')('d
work. Supervisor will also make additional report!)' alld }inal report gil'iflg date of completioll of 'Work 011 {his farm.
l.reliminary Ileport:
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Date: 7 :-:> I .. 'M'i
"Final Report:
PERMIT INSPECTION REPOIU
. V Work covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control - adequate
- inadequate
REMARKS
I)ate:
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JEFFERSON COUNTY
OEPARTMENT OF PUBLIC WORKS
1820 Jc!1crson Sln:el
P.O, BOil 1220
Port Townsend, WA 98368
(2061385.9160
N~
0956
Dis/ricl No,
5
PERMIT
In accordance with all applicable Revised CoJ~s of Washington and amendments thereto, and subject to all the terms, condi-
tions and provisions written or printed below or on any pan of this form
PERMISSION IS HEREBY GRANTED TO Charawell Construction Inc.
P.O. Box 26 Port Ludlow, WA 98365
t Install two (2) private road approaches to Lot 190, Port Ludlow 2, Area 3 off of
~athfinder Lane at mile post 0.02 and mile post 0.04
County Road No,
543509
Franchise No.
Milepost 0.02, 0.04
No work shall be done under this permit until the pany or parties to whom it is granted shall have communicated with and
received instructions from
This permit shall be void unless the work herein contemplated shall have becn completed beforc January 31
Dated at January 31 . 19 89
.19 90
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HOURs
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GENEllAL 1'!tOVISIONS AI'I'L1CAIII.E TO ALL I'lmMITS
This permit is subject 10 all applicable pr{J\'isiolls of the Rt:vlscu l\lI.lc!. of Washillgtol1,Cxccjlllhat an} prtHlsioll in Ihis :.tgrcClllt'1lt /lot coll'>iHClI1 y,ith
such rc!>olutiOllshall be cuntrolling.
A buml ill the <.lllloUnl of $
is rC4uircd for the protectioll 01 the (OUllt}' as set foull ill the tcrlll'> of the bond
During the progress of tile work such barrier!> !lhall be erected and llIaill!aillCU as llIay be JlCt'cs!'...lIY O( as Illay he directed for the protection of I/le
traveling public; the barriers shall he properly Jjghted al night.
III accepting this permit lhe petitioner. his SUccessurs and <.1ssigllS, agrees to proleet Jcffersoll COUllty am.! save it harmless fWIll all claims, actions and
ililll1ages of every kind and description which Illay aCl..:rue to or he sum..red h}' all}' person or l>erSOllS, corporation ur properl~ by reason ulthe !>erfor.
mallcc of any such work, eh.lfacter of materials used or mallller of installatioll, lI1ailltellallce and ol>eration or b}' the ifT1pllJpcr occup:wcy of rlg.ht of
wayor public place or public5lructure, and ill case allY suit or action is blought again!.t saki Jeffersoll Coullty for dalll<lge!. arisillgout of or by rea':.un of
any of lhe above ~uscs, II Ie petitioner, his suc!;essors or <Issigns, will UPOlllloticc (0 him III thelll of eOIllIlll.'ncemellt of!.uch a!;tion. defend tbe same at
his or lheir own sole cost amI eXJlense and will stltis!"y allY judgment aftcr the said suit or tlcliorl shalllwve rill<l!ly been determined if advcr!.e to lhe Jef-
ferson County.
Except as herein authorized. 110 exc<lvatioll shall be made or obstacle placed Wilhill the limits of a CC)UIII~' roall in sUl.:h a mallller as to inlerfere with
lhe mlllcl m'cr said /(wd,
Except as herein aUlhori/ed. 110 excavatioll shall he malic or uhslacle placed within four (4) feet of the edge of the pavelllelll.
If the work done unller tbis permit interferes ill all}' way with the draillage of the elJlllll~' ro.Jd, the grantee shall wholly ano at hi-. 1m II e),pcnsc make
such provision as the engineer may lIirect to take care of said draillage.
On completion of said work herein contelllpl<lted all rubbish and debris ~hall be Imll1edialely removed aull the roadway and roadside shall be left neat
and present<lble and satisfactory to thc ellgilleCr,
All of the work herein contcmplated shall he done IInder the supervisioll and \ollLe satisfaction of the ('OUnty Engineer and the enlire expense of !>:fill
supervision !Cohall be borne by the pany or parties to whom this permit is isslled,
The Department of Public Works hereby reserves the right to order the change of localiun or the removul of uny structure or structures aUlhori/ed hy
this permit at any time. said chunge or removal to be made at the sok expense of the party or parties 10 whollllhi!. permit is is!.uell, or their successors
and assigns,
All such changes, reconstruction or relocation by the grantees slmll he donc in such manner as will cause the least inlerference with any of the Coun-
ty work alld the CoulIty of Jefferson shall in no wise be held li<lhle for any damuge to the gruntec by re.lson of any such work by the County of Jeffer.
son, it agents or representatives, or by lhe exercise of any rights hy the ('oumy upon roaos. streelS, public place!> or structures in question.
This permit or privilege shall nOl be decmed or held to be an exclusive one ,Lnd shall not prohibit the COUlltY from gnllllingolher permits or fmnchisc
righls of like or other naturc to other public or private Utililies, nor shall it rrevelH lhe County from using <lny of its ruads, streets. or public places,or af-
fect its right to full supervision <lnd control ovcr all or any pan of thelll, lltme of which is herehy surrendered,
The Department of Public Works may revoke. amend or cancel this permil or any of the provi!.ions Ihereof at any time by giving wril\enllOlicc to Ihe
permittee. The permittee shall immediately remove all fucilities from the righl of way, AllY f:lcilities remaining upon the right of wuy 30 days afler writ.
tcnllotice of cancellalion shall be rcmoved by the County at the expense of the pcrmi!lce.
The party or panics to whom this permit is issued shallmainlain at his or their sule expense the strucltlre or object for which this permil is granted in
a condition satisfuctory to the Dcpaflmcnt of Public Works,
SPECIAL PROVISIONS:
1. A 12" culvert a minimum of 20' long shall be installed at both B-pproBches.
2.
Applicant shall be responsible for all damages to county road right of way.
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In acccpting this permit the grantee. his Sllccessors <lnd a,~siglls, agree thutllny danmge or injury done to the property of the grantee or allY expensc
incurrcd by him through the operntioll of a contractor, working for thc C()Unl~' or nny COLlllty employee s.halJ he alll1c solc expensc of the grantee. his
stlcces;9b~ ~~d assigns. _ 1 ,
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und conditions as herein set forth,
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Daled this ~ dnyof' :: A_-oL...~if- .19 G 7
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. the undersigned, l1ereby nccepts this pcrrnil sLlbject to the lerms
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COUI:TY ROAD NO.5'1350?
STATE LOG NO. --
I11LE POST tJ oZ '; 0.0'+
OFFICE USE ONLY
JEFFERSON COUNTY
OEPARTI~ENT OF PUBLIC \WRKS
Jefferson County Courthouse
Port Townsend. ~IA 98368
PERMIT NO. 69",.6
FEE PAID /Yes _rlO
OFFICE USE or:LY
...,,,,, '/3CJ!5'T ...."GTS"",c.O
t!-~/I 0>-'17'1'"
CHECK ONE:
~'RESIDENTIAL
APPLICATION FOR ROAD APPROACH
o
COMMERCIAL
Application is herby made for a permit to construct, operate and maintain a road approach.
Please describe loaction (attach map or drawing) f >'1'./'< II Cu.! II t R.T~ ~' T ~
J't?IIi'ClvIi.U Enhe,ltIiIL'<"<" - /...'T/'1/l tt/Zea. '? P'( ,}., "Pi<.-z.,{!,;'d";2/I-<?'J1<:.-,
Une I" 74./hdT ~""l."/~~7 I../..<c/JOLJ
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Applicant agrees to perform the work in strict compliance with the terms and'conditions set
out herein, and any special provisions attached hereto.
Applicant Name CI1<<l2tli.ot?(! tc,IL~'t -1-110 Contractor Name ~"--'
Address ~o. :80><: <9 J.. ,Address
10/27 /....kcl IrOl-J /-LT}1. 9 g '3 " .r
Applica')t Si9natu~ II- '...u Q...~~contractor Signature
Date / L:J..C,t..-J'9 r: . -'-/]7-22-yy' Date
Note: Indemnity provisions of paragraph 2 and 3 on reverse side.
PERMIT
Subject to the terms and conditions on the reverse side, PERMISSION IS HEREBY GRANTED to
Applicant to construct, operate and maintain a road approach as requested above, and any
special provisions attached hereto.
No work shall be done under this permit until the applicant or contractor has notified
, telephone
APPROVED BY:
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Date / - 3/- ~ '1
CALL 48 HOURS
BEFORE YOU DIG
1-800-562-6478
PERMIT INSPECTION REPORT
~k covered by permit has been completed
------- satisfactorily.
Work is not completed.
______Recommend permit be cancelled.
Traffic control - adequate
inadequate_______
REMARKS
INSPECTED BY:
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DATE 7...2rdJ"
Form 113-0 (RevA 2..92)
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GUiEI'!.! i'1'llVIS10NS
1. THIS PERMIl IS SUBJECT 10 RC'A 3u.7~.130, .1Llll ANll .150 AflD AME:/'WMENTS THEkETO.
2,
THE GRAIUE.C, ITS SUCCESSORS AtHJ ASSIC,tl~, AGRELS 10 PROUCT JUffRSON (OutllY AND $Avf 11 ~jt.kMlE'J~ FfWt-', ALL
CLAIM:), ACTIONS OR DAMAGES OF EIJ[fi'( KIND AlHJ DESCR1PTIOr~ PiHICH MAl' ACCHUl 10 OR bE 5UFFlk[1.l h'( MIl" f'Ek~ufJ,
f'E.H~ONS. OR PROPERlY bY R(A50li OF THE PERFORMANCE Of ANY SUCH wOkI':, CHARACTER UF HAlfl'dAl 5 u~[l) OR MAru.Ek
OF INSTALLATION; IN CASE ANY SUll Ok ACTICm IS BHOUGHT AGAINST TH[ CQUN1'f fOR [)AMAGES ARISIU(, OUT Of Ok [It
RlASON OF ANY OF THE A80VE CAUSLS. THE PLlIT10NEH, IT~ SUCn~50k~ Ok AS~IGN::: 'rllll. UPON tWTlt( OF C(jMMEt/Cl~
MENT or SUCH ACTION. DEFEND TH[ SAM!: AT ITS S(jU. EXt-'LNSE Atm !:oATI!irY AN'! JUD(,lM[NT ARISING THEREFROM If
DllEkMINED ADVERSE TO JEFfEk~()N COUNTY.
i
3. IF THE GRANTEE ENTERS INTO A CONTRACT OR AGREEMlNl ...Iltt I. HtIR!) PARTY TO PlRFUR'~ THl WOk I< AuTHORIZlD
~~oi~~ r F~~R~b~6 ~~~M~~~~O A~~R~~h~~ ~H~A~6u~~y T7~ ~~~~~g~~~ll ~~ T~O~H~ T ~kge~~~~~~ ~~ T ~A~:~~~~~' 2~G:~~;E ~o
Lj. ANY BREACH OF ANY OF THE CONDITIONS AND RECUlflEMENTS HEREIN MADE. OR FAILURE Otl THE PART OF THE GRANHE
OF THIS PERMIT TO FINISH CONSTRUCTION WORK HeREUNDER WITHIN 90 DAYS' SHALL SU~JECT THIS PERMIT TO tANCEl-
LATION AS HEREIN PROVIDED.
S. DURING THE CONSTRUCT JON OF THE FACILITY. THE ijRAtHH SHALL COMPLy wITH THf. t:1AtlUAL........DlLL!ltlLDBlLrBAE..EJ~
DE"VICFS FOR STREETS AND HIGI'frt.A:t.S. PUBLISHED BY THE U. S. DL:PARTHENT OF TRANSPORTATION.
O. ON COMPLETION OF SAID WORK HEREIN CONTEMPLATED. ALL RUBI1ISH AND DEBRIS SHALL BE IMMEDIATELY REMOvED AND
THE ROADWA'r' AND ROADSIDE SHALL BE LEFl NEAl AND PRlS(NTAbLE AND SATISFACTORY TO THE COUNTY.
7. THE COUNTY RESERVES THE RIGHT TO ORDER 1HE. CtiANr.f. OF LOCATIO', Ok THE REMOVAL Of ANY ~TRUCluR[ CIR STRUCTURE.S
AUTHORIZE.D BY THIS PERMIT A1 ANY TIME, ZAID CHANG!. OH kEMOVAl Tu BE MADE M SOLE D.PENZE OF TM~ PAkTY OR
PARTIES 10 WHOM THIS PERMIT I!. ISSUED. OR THUR SUU:lS~ul<~ AljiJ A5~IGN~.
8. ALL SUCH CHANGES. RECot~STRUCTION OR RELOCATION BY THE (,RAtHEL StiAlL Bf. 1l0NE IN SUCH A MANNER AS WILL (.AU';l[
THE LEAST INHRFERANCE wITH ANY OF THE COUNTY'S WCJH'" ANll J[fFf.k5Ufl COUNTY SHAL.L IN NO WISE At tlEL.Ci LIAbLf
FOR ANY DAMAGI:: 'TO THE GRANTEE 6'1' REASON or ANY SUCH WORK By Jlf'fERSON COUNTY. J1S AGENTS OR REPHESENTATIV[!..
OR BY THE EXERCISE OF ANY HIGt1TS BY THE COUNTY UPOll ROADS. STHHTS. PUBLIC PLAns Ok 51kuCTUliES IN (.ju~STIUN,
9. THE GRANTEE SHALL NOTIFY THE COUNTY'S REPRESENT'~TlvE UPON COMF'LETION Of THE 'rlORK UNDER THIS PERHIT SO THAT
A FINAL INSPECTION CAN BY KADE.
01.
[;]/2.
SPECIAL PROVISIONS
APPLICABLE PROVISIONS ARt: DENOTED BY AN (X)
2o~~~~Ug~I~~EA~~~~~Tz~gA~~ ~~lgNpi~~1~0:li~1~'T~~Dc6~~~~S~E~I~~~~0;~~A~~EMENTS. AT ALL TIMES DURING THE
THE APPROACH SHALL BE CONSTRUCTED IN ACCORDANCE WITH THE ATTACHED DESIGN PLATE TYPE_L-.-L __
APPROACH. A~_fT,LENGTH OF---LZ",-_INCH DIAMETER CULvERT PIPE SHALL BE PLACED IN
DITCH AND LAID TO A HUE LINE AND GRADE. THE I,PPROACH SHALL BE SURFACED TO THE LIMITS AS SHOWN ON
D~~E~if~G A~~ ~~~F~~~D~A~~R T~~O~P~=~O~~E S~~~~E=iy I~Nfgcg~e~~~E R~~~~_~~~w~~O~:t~ ~g~l ~~L p~~Hi~iE~~AN,
THE APPROACH SHALL BE SUFFICIENTLY SURfACED BACK AN ADECUATE DISTANCE FROM THE EDGE OF THE PAVEMENT TO
PREVENT ANY MUD TRACI<ING ONTO THE COUNTY ROAD. ANY MuD THACKED ONTO THE COUNTY RUAD SHALL BE IMMEDIATELY
CLEANED U.p BY THE GRANTEE OR HIS AGENT.
GY3,
[j;y4.
o
o
IF NECESSARY TO INCREASE SIGHT DISTANCE. STUMPS MD BRUSH SHALL BE REMOVED FI10M BOTH SlOts OF THE
APPROACH. THE INDISCRIMINATE tUlllNG OF ME:RCHAfolTAI1LE T1MllER Ok DISFIGURING OF ANY H.ATURE OF SCENI(:
VALUE SHALL NOT BE PERMI TTED ON COUNTY ROAD RIGHT-OF-WAY.
S. WORK SHALL BE RESTRICTED TO THE HOURS BETwCEN 9:00A.M. AND 4;OOP.M. UNLESS OTHERW)SE AUTHORIZEO BY THE
ENGII~EER.
5. A SUR[lY BOND IN THE AMOUNT Of $_______. WRITTEN BY A SURETy (OMF-ANY /lUTHORIZED TO
DO BUSINESS IN THE STATE OF WASHINGTON. SHALL BE FURNISHED TO INSURE COMPLIANCE wITH Ar;Y AND ALL OF THE
TERMe AND CONDITIONS Of THIS PERMIT AND SHALL REMAIN IN FORc..E UNTIL ALL WORK UNDER THIS PERMIT tiAS
BEEtl COMPLETED AND APPROVED BY THE. COUNTY.
07.
BEFORE ANV LOG HAULING OPERATIONS BEGIN. A SURETY BOND IN THE AMOUNT Of $ . SHALL
BE fURNISHED BY THE GRANTEE TO PHOTHT THE COUNTy ACiAINST ANY DAMAGE TO TH~ROA-DANDTO INSURE
COMPLETE REMOVAL OF THE APPROACH MID ~LEANING UP Of THE RIGHT-Of-WAY TO TH[ SATISFACTION Of THE COUNTy.
APPROvAL Of ALL CLEAN UP WORK SHALL BE SECURED BEFORE lH[ BOND WILL BE RELEASED.
o 8. SPECIAL CONSIDERATIONS
forml13h
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District No.
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jellerson Street
P.O. Box 1220
Port Townsend, WA 98368
(206) 385-9160
N~
0095
PERMIT
In accordance with all applicable Revised Codes of WaShington and ,.IJl1CndmCllls thereto, and subject to all tile terms, com.Ji.
tions and provisions written or printed below or on any part of this form
PERMISSION IS HEREBY GRANTED TO Puget Power
310 Four Corners Road Port Townsend, WA 98368
to
install 250' of buried primary cable on the east side of Carey Court at M.P. #0.0
to M.P. #.04
Lu.O, 0905007
County Road No, 552909
Franchise No,
Milepost 0.0 to .04
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JUL ..
JEFF" 1. 0 7989
PUr' C:f-fi:",
oLIC . '-'1\ (;
h/OAI..' UUrV]'y
,$DEP/'.
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
rcceived instructions from Don 01 in.., 385-9140
This pctmit shall be void unless the work herein contemplated shall have bcen completed beforc June 28
Dated at June 28 . 1989
~ .,,; ~ CALL 48
~ ~!l""::~ HOURS
rtr BEFORE
J t-o YOU DIG
:.;. ell
1.800.424.5555
,1990
By ~~ r:~
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GENERAL I'HOVISIONS AI'('UCAIlLE TO ALL I'EHMITS
This permit is subject 10 all applicable provbions of the Rcvj~d Codes of Washingtun. CI\l:Cpllhut all}' pru~'bl(J1l ill Ihi.. agrcclllCllt /lot CUIl\I\(l."1l1 with
such resolutioll shall be controlling.
A bond ill the amount of $
is required fur the protection of the CQUllly us set furlh ill th~' tcrms of the bond.
During the progress of the work such barriers shall be c(c!;lcd and maintained as may he /lecessary or as may be dlrCCICl.l for the protection of the
tra.....eling public; the harriers shall he popcrly lighted at night.
In tlcl.:cpting this permit the petitioner, his successors and assigns. agrees to j1rulCCI Jefferson COUlllY ;Jnu save it harmless frolll all dairns, actions and
damages of eyery kind and description which may accrue 10 or be suffered by allY person or persons. corporation or property by rca.'>Ufl of the perfor-
mancc of any such work, character of materials USl.:d or lIlanJll.:r of installation, maintenance and operation or b~' lhe improper occupancy of ri~ht of
way or public place or public struClUrl.:, und in ca.'>e any suit or uctioll is brought a~uinst said Jefferson COUllty for dama~es arising out of ur by reuson of
any of the abm'c causcs, the petitioncr, his successors or assigns, will Upol111otke to him or thcm of COllllllcncement of .'>uch uction. defenu the !WITIC ut
his or their own sole cost and expense and wi]] satisfy any judgment uftcr the said suit or action shall have finully been dctermined if advcrse 10 Ihe Jef.
ferson CoulllY.
Except as herein authorizcd, 110 excavation shall he mude or obstacle placed within the limit!; ofa coullty road in such a milllncr tiS to interfcrc with
lhe travcl oller said road.
Excelll as herein authorizcd, 110 excavation shall he lIIade or ohstacle placed within four H) fect of the edge of lhe pa\'ement.
If the work donc under Ihis permit interfcres in any way with the drainage of the coUnty road, Ihe gmlllee shall whOlly and i1t his own c:-'pcllse llIul.;e
such provision as the engineer may direct 10 take carc of said dr:linagc.
On completion of said work hcrein contemplated all rubbish and debris slml] be immediately removed and the f(kldway ami roadside shill I he left neal
and presentablc and satisfactory to the engineer.
All of the work hcrein contemplated shall be done under the supervision and 10 the satisfaction of the County Engincer and thc entire cxpense of said
supervision shall be borne by the party or parties to whom this permit is issued.
The Department of Public Works hereby reserves the right 10 order the change of 1()Ciltion or the removal of any structure or structures authorized by
this permit at any time, sa.id change or removal to be made at the sole cxpense of the party or parties to whom this permit is issued, or their sUcce.\sors
and assigns.
All such changes, reconstruction or relocation by the grantees shall be done in such manner as will cause the leasl interference wilh any of Ihc Coun.
ty work and the County of Jeffcrson shall in no wise be held ]i.lble for any damage to the grantee by reason of any such work by the Coullty of Jeffer-
son, it agents or representatives, or by thc exercise of any rights by the COUnty upon roads, streets, public places or structures in question.
This permit or privilegc shall not be deemed or held to be an exclusive one and shall not prohibit the County from grallling olhcr permits or franchise
rights of like or othcr nalure to other public or private utilities, nor shall it prevent the County from using any of its roads. streels, or public places. or af.
fect its right to full supervision and control ovcr all or any part of them. none of which is hereby surrendercd.
The Department of Public Works may revoke, amcnd or cancel this permit or any of the provisions thereof at any time by giving written notice to the
permittee. The permittec shall immediatcly removc all facilities from the right of way. Any facilities remaining upon the right of way 30 days aftcr writ-
tcn noticc or cancellation shall be removed by the County at the expense of the permittee.
The party or partics to wholllthis permit is issued shall maintain at his or their sole expense the structure or object for which this permit is granted in
a condition salisfaetory to the Depanmelll of Public Works.
SPECIAL PROVISIONS,
1) All cables shall be
2)
3)
buried a minimum of 36" below liixisting ditch.
Applicant shall not disturb shoreline.
Applicant shall be held responsible for all damages to the county road
right of way.
In accepting this permit the grantce, his succcssors and assigns, agree Ihal allY damagc or injury done to the property of the granlee or nny expense
incurred by him through the opeflllion of a contrnctor, worl:ing for the Coullty or any County employee shall be al the sole expense of Ihe gralllce. his
successors and assigns.
y(./ ("(&-1- ~ t:.(.) C yo- ,the undersigncd. herehy aCl:erts this rcrmit suhject to the term~
and conditions as herein set forth.
Dnted this ce
,,j ()f? e
.19 -sf
day of
tJ~?;/~--
JEFFERSON COUNTY
OEPARTMENT OF PUBLIC WORKS
Fcc Paid_ Yo _ No
1820 Jel1erson Slreet
P.O. Box 1220
Port Townsend, WA 98368
(206)385-9160
Ra,t'l'l No
Addre!>\ Rt:quest _ Yes _ No
Mile P(J')t 0.0. 10 0. ~__
AI'I'L1CATION FOIl "ElIMIT
To DepartmeJ1l of Public Works,
Jcffetson County, Washington,
The undersigned i/:::,,,'(),,,;f- ~C---L---'
hereby opp/~ for permissioll to 7/te-Yt--e;!l; a-.,. I-cP d /1= CD- v""I-O-i;c-L"fJ
/--- /4/'1'/"0111 "'II""'(flf",4}',,~tJlh' "/lit...,,';}}}
J?Jt:'~/1??'z.-.(J rJ?lrUe/. LE/?6'7'1-1-=.:!-' GSO ". 1.-/)/0 C/70SCf07
SKETCH:
S-e...e...-
a---7:t?~~1
,fJ1Cep~
011 COUfl/Y Rood: &eey {lOU"e;r
D.I1 E4:5T c.:S/...QC,
~t
o c/?]) qj. 4).
/S/OI"/WUIl"t"''''H'fI'''/Ofmll,'{)<mlll
alld agree_ 10 do the work ill accordance with your rules Gnd regulations and subject to your inspection and approval.
Date ~- :" l'k/'LP~ / c:.. /9X2-
~""3/6
^'llllt~"P7J'
Phone No. '-...SK"J
~/JM~;' ~-"-'--'
ISllloalUre llf Aplllu;pnll
_ /J (If ppp1lcalll js a copurtncrship. sel fonh names of copmners)
lC4J.?-z.. L:.-t:52--iLO....-o /10>
Addrc,,"
ICnnlra~lml
Q&"1G,s(
Phone No.
100% Recycled Paper
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Jefferson Co.
District No. 5'"
DEI'AIHMENT OF l'UBLlC WOnKS
Permit No, Dc ~
Supervisor's H.cpurl Nu. __
Supervisor will make detailed report with his recommendation Oil litis application. ~.yhellever pussible show sketch afproposed
work. Supervisor will also make additiollal reports amI final report gill/lIg date oj completion of work on this form.
l'reJiminury Report: t.~C4.4,.J "'~ Tl-if: t:ArT" ,=c. 01-
Ar' t"V - "".0 -10 rr.I>" 0", -.3' 7"""") SJv::,..,ld",<-
/Va A 'f/.IA~T C<1J7::l;u:. RF Q->:n<t.J
Dute: h -d) 8 - S"1
Final Report:
/
PE~SPECTlON REPORT
Work covered by permit has heen completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control - adequate
- inadequate
REMARKS
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jellerson Streel
P.O. Box 1220
Port Townsend, WA 98368
(206) 385.9160
AI'PLlCATION FOil PERMIT
To Department of Public Wotks,
Jefferson Coumy. Washington.
Tire undersigned 1:::> ^ t\j L. "1 c:. iZ 6;' '-/
hereby app/~ for permission to / IV s (Tit L S"",,,,,,, :C,e.,.~ "e, /? .12m1.:\;" ~ f
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and agree_ to do the work in accordance with your rules and regulations and subject to your inspection and approval.
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I>l~J>AJ{TMENT 01,' J>UJJLlC wonKS
Jel'fersun Cu.
Permit No, ()o 43
Supervisor's ltel.ort No.
Supervisor will make detailed repor/ with his recommendation 011 this applicotiull. IVheflever pO!Jsible show sketch oj proposed
work. Supervisor will also make additional repulls alld jillol report givillg dale of completioll oj work 011 this form.
Preliminary Report:
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Final Report:
I'ERMIT IN
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REMARKS
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'CTlON REPORT
Work covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
TraHic control.. adequate
.. inadequate
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0043
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jellersan Street
P.O. 00)( 1220
PorI Townsend, WA 98368
(206) 385.9160
N~
Dlwrict No.
5
PERMIT
In accordallce wilh all applicable Revised Codes of Washington and umcm..1mcl1ls therelO, and subject to all the terms, condi-
tions and provisions written or printeu below or on any part of this form
PERMISSION IS HEREBY GRANTED TO Dan Lackey
60 A. Paradise Bay Rd., #102, Port Ludlow, WA 98365
10
Install a temporary service pole for power at 51 Cascade Lane, Port Ludlow.
County Road No, 510409
Franchise No,
Mileposl ,06
No work shall be done under this permit until the party or parties to whom it is grantcd shall havc communicated with and
received instructions from Don Olin - 385-9140 <S f'. ;vII -< n:-
This petmit shall be void unless the work berein contcmplaled shall have been completed before May 21 .1990
Dated at May 21 .19 89
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CALL 48 I
HOURs
BEFORE
YOU DIG
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GENEIlAL l'Il0VISIONS Al'l'UCAlILE TO ALL l'EIlMITS
Thi~ permit i!\i subject to all applicable [HOVISIOIlS of the Rcvi~cJ Codes of WashillgllJll. c),ccpllhal .1fl} pro\'l~ltm ill tlw. ag/cclllclIl not cullsiSlt'lH with
SUl.:h resolutiolJ shall be cOlllrullillg.
A bOlld ill the alllount of $
i... reqUlred for the prolccluJ/l (Jf the Coullt)' as '>Cl forth 111 the terrllS uf the bOllo.
During the progress of the work such barrier!> shall be cu.'cleu and maintained a... Illay be ncccs~r}' or as Ill"'} lJC Jlrcl;lcu lor the protectlOll of the
traveling public; the harriers .shilll be properly JighlcJ at llight.
In accepting this l1ClIllitthc pctitiuncr, his !.ucccssors and us!.igns, agrec!. to protect JcllersulI Coullty and !.a\'e it hurlldcs.. fHlm all claims, uctiun....lIId
damages uf every ~ind and de!>Cription which Illay accrue to or he suffcred b~' allY persun or persons, corporatiun ur properlY by reason of the perfor-
mance of allY such work, charal;ter of materials uscd or /JIallner uf iustallatiulI, lIIaintellam:e and operatiun or by the improper o..:cupancy of TIght of
way or public place ur public struclure, and in case any suit or action i:. brought against s:lid Jclfcrsoll Count~' for damagesarisinl:; out of or by rea..on of
any of the :Jbove causes, the petitioner, his successors or assigns, will upun floticc to him or thelll of CO/lUIICllcelllcllt of such actioll. lIefend the same at
his or theil own sole cost and expense and will satisfy allY judgment after the saill suil or actiun shall have finally I>o.:Cll lletcrmined if ad\crse to the Jef-
ferson County.
Except as herein authori/ed, 110 excavatiun shall be made or obstadc placed within thc lilllil\ of a coullty road ill!.LJch a /llanncr as to illterferc with
the travel over said m.ld.
ExceJlt us herein uuthoril.ed. 110 excavation shull be madc or ol""Olde pJOlc~'d wilJJin four H) fcelllf IJu: CUl,:l..' of 1J1~' plln.'IIlCJll,
If the work Jonc ullder this pt:rlllit intcrfere!> in :ill}' way with thc dralll:il:;C of lllc count}' rood, the gr:JlIIcc shall Yo holl}' and at hi, own clI.pense llIa~c
such provision as the engineer llIay direct to take care of said drainage.
On completion of said work herein contemplated all rubhish and debris !'hall be illllllcdi,lleJy relJ1U\'ell :Jnd the roadway ami road!>ide !>hall be left neal
and presentable and sitlisfaclory to the engineer.
All of lhe work herein contemplated shall bc done under the supcrvbioll and to lhe satisf,IClilln of the County Engineer and the ~Illire CII,JX"IISC I)f said
supervision shall he bornc by the party or panics to whom this permit is issued.
The Department of Public Works hereby reserves the right to order thc change of locatio/l or the rellloval of un}' structure or strUctures aulhorized by
this permit at any time. said change or removal to be madl..' at the solc expense of tile part}' or parlil..'s to whom this permit is i'>sued, or their !>uccessors
and assigns.
All such Ch:lllgcS. reconstruction or relocation by the grantees shall be done in such 1II:illller as will cau!>e the least imerfercnce with any of the Coun.
ty work and the County of Jefferson shall in no wise he held liable for :lny damage to the grantee by rcason of uny such work by the Count}' of Jeffer-
son. it agents or representalives, or by the exercise of any rights by the COUllty upon roads, ~trcets. public places or structures in question.
This permit or privilege shall not be deemed or held to be an exclusive one and shall not prohihit the COUllt}' frum granting other perlllit~ or franchise
rights of like or other nature to olhcr public or privatt: utilities, Ilor shall it prevent the COUnty frolll ming an}' of its ro:lds, streets, or public placcs. or af.
feet its right to full supervision and control over all or allY part of them, nonc of which is herehy surrcndered.
The Departmcnt of Public Works may revoke. amend or cancclthis pertnit 01 :Iny of the provi!.ions thereofat uny time by gh'ing written notice 10 the
permittee. The permittee shall immcdiately remove all facilities from the right of way. I\ny facilities remuining upon the right of way 30 days after writ-
len notice of cancellation shall he removed by the County ut the expense of the pCtrnillee.
The parly or parties to whom this permit is issued shall lIlaint:lin at his or their ~()Ie eXj'k:r1se the structure or object for which thi~ permit is granted in
a condition satisfactory to the Department of Public Works.
SPECIAL PROVISIONS:
1. Applicant sha~ be held responsible for all damages to the county road right of
way.
1'7fl!-::jl~ifP.f!i ile~f'~~re shall be buried a minimum of 30" below existing ditch.
!~ dt:1! 'Iill r~l ~U l~
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In acccpting this permit the granlee, his successors and assigns, agree that any dumallc or injury done to the property of Iltc grantee or any expense
incurred by him through the operation of a cOlllraClur. w()r~ing for the CoullIY or any County employee sl1:l11 he utthe sole expensc of the gramee. his
:~cessors an:O;l:V J- /?- CAd' ~
and conditions as herein set forth. Y
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Dated lhis ..2 J day of ~ ~,Y
o ~/'/
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,the undersigned, hereby accepts this permit subject to the terms
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jellerson Street
P,O. Box 1220
Port Townsend. WA 98368
(206) 385-!?160
,
AI"'UCATION F()I~ "ERMIT
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To Department of Public Works,
Jeffetson County. Washington.
The undersigned b A tV 1., -'1 c: t<. e; ,/
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erebyapp/-::--- or pemmSlOn to / /Vs 11'1 L S,'''''''''' "~I.I.e:,.';!;;7,",,",,~,r:3,,,'i?,t,,;t- (
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------
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On County Road:!'! CA 5 CA.ll 6: L." ^' ~
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alld agree_ 10 do Ihe work in accordance with your rules and re1:,.'1Jlariolls and subject to your inspection alld approval.
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District No, S
DEI'ARTMENT OF PUBLIC WORKS
Jefferson Co.
Permit No, no C/3
Supervisur's 1tl'IWrl Nu.
Supervisor will make detailed leporl ~'I,'ilh his recommendation all this application Whenever possible show sketch of proposed
.vork. Supervisor will a/so make additional reports and final report giving dale of compte/ioll of work all this form.
Preliminary Ucport:
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Final Report:
PERMIT IN 'CTlON REPORT
/ Work covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic conlrol - adequate
- inadequale
REMARKS
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jellerson Slreel
P.O, Box 1220
Port Townsend, WA 9835B
1(06) 385,9160
N::
In accordance with all applicable Revised Codes of WashinglOn und amendments thereto, and subject lo all the terms. condi.
tions and provisions written or printed below or on any part of this form
PERMIT
PERMISSION IS HEREBY GRANTED TO Dan Lackey
60 A. Paradise Bay Rd., #102, Port Ludlow, WA
98365
to Install a private road approach at mile post 11.05 Cascade Lane on the West side
of road.
County Road No,
Franchise No.
510409
.05
Milepost
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
received instructions from Don Olin 385-9140
This permit shall be void unless the work herein contemplated shall have been completed before May 15
Dated at May 15 ,19 89
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JJ-e ,
.1990
&~rmw{8ffi
CALL 48 ~
HOURS
BEFORE
YOU DIG
By ---<)~ K4-uv;
1.800.424.5555
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GENEIIAL l'Il0V1SIONS Al'I'I.lCAIlLE TO ALL I'EI~MITS
Thi.. permit i!>!>ubjcct lnull dppJicablc pruvisiofl!>of the Revised Cudc!>of Washington. c"-ccpt Ihat all)" pltniwlII ill this ag,cclIIcfllllul CI)llS.,>tCIl( .....Ith
such rcsolutiun 1>hall be contrulling.
A bond ill the amount of $
is rC4uircu fur Ihe protectioll of the COUllt} us set forth ill rill: tcrm,> uf the hund
During the progrc!>s of lhe work sudl barrier::. shull he crcl.:lcd ulUJ mui/llaim:u as lllOJ)' he IlCCCS:-.aI}' or as lllar be dJrc\,;l~d for the protection of the
traveling public; the barriers ::.hall be properly lighted aI nighL
In ac~pling this permit the petitioner, his ~Uccc!osors :LIlO as!oiglls, al;\ree!o to protect JcfferMJII Coullty ano !oave it hannJc!o!o from all daim!o, al'tium and
damages of evcry kind und description which lIIay accrue to or be suffered by any pcrsull or l'lCrSolls. corporation or property h}' reu'>tltJ of the pedur-
mallce of allY sudl work, character of materials used or manlier of imtaJlatioll, lllaintellalll.:e and opera lion or by the improper occupancy of right of
way or public place or public structure, and ill case any ~uit or actioll i!o brought against !oaid Jefferson CoulIty fur danmges arising out of or by rea'>t"lII of
any of the above causes, the petitioller, his successors or assigns, will upollllotice to him 01 them of COllllllencement of such action, defe/llJ the same at
his or their own ~ole coM and e'"pense and will sathSy allY judgment after the s<Jid suit or actioll shall have finall}' heen delermined if udverse to the Jef-
ferson COUllty,
Except as herein authori/eu. 110 excavatiun shall be made or obstacle phH.:ed within the limits of a cOUnty ruaJ in such U lIlallJler as to interfere ....ith
lhe tr<H'eJ over said road,
Except as herein authoriled, IlO excav:llion shall he lIlade or obstade placeu within four 14/ feet of the euge or the pavcmcnt.
If the work donc under this permit interferes ill any WllY with the urllirwgc of (he l,;ounty road, thc granlee shall wholly and at hi:- own ex.pcn:-e make
such provision as the engineer Illay lIirect to take care of said lIrainage.
On completion of said work herein contcmplatcd all rubbish alld dehris shall be immedi<Jtcly removed and thc rwdw<JY and road..idc shall be left ne>lt
and preselltable :ll1d satisfactory to the engineer.
All of the work herein contcmp]ated shall be done under the supervision and 10 the satisfaction of the County Engineer and the entire CXI'lCIlSC of said
supervision shall be borne by the party or parties to whom this permit is issued,
The Department of Public Works hereby reserves the right to order the change uf locatiun or the removal of any structure or structures authoril.ed by
this permit al!lny time, said change or removal to he made at the sole expense of the party or parties to whum this permil is issued, or their succeswrs
and assigns,
All such changes, reconstruction ur relocation by the grantees slwll be done in such manller as will cause the least interference with any of the Coun.
ty work and the COUllt}' of Jefferson shall in no wise be held liable for any damage to the grantee by reason of any sllch worl\ h~ the County of Jeffer.
son. it agents or representatives, or by tile e,"ercise of any righls by the County upon roads. streets, public place!> or structures in question,
This permit or privilege shall not be deemed or held to be an exclusive one and shall not prohibit the ('ollmy from graming other permits or franchise
rights or like or other nature to other public or private utili lies, nor shall it prevent the County from using any of Its roads. streets. or public places, or af-
feCI its right to full supervision and comral over all or any part of thcm, none (If which is hercby sllHenuered,
The Dcpartment of Public Works may revoke, amcnd or cuncelthis l'lCrmit or any of the provisions thereof at any time by giving wrillen noticc to the
permittce. The permittcc shall immcdiately removc all facilities from thc right of wa~', AllY facilities remaining upon the right of way 3Udays after writ.
ten notice of cancellation ~hall be removed by the COllllty at the expense of the pcrmillec.
The party or parties to whom Ihis permit is issued shall nwillluin:lt his nr their sole expense the strllcture or ohjcct for which this pcrmit is granted in
a condilion satisfactory to thc Department of Public Works.
SPECIAL PROVISIONS:
1. A 12" X 20' minimum culvert shall be required.
2,'7f1,AJ~I~Sf111~be held responsible for all damages
':,!d., \01\0 (I A
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to county road right of way.
In accepting this permit the grantee. his successors and assigns, agree that :my dumage or injury done to the property of Ihe grantee or any expense
~~:~:~~ifi~~ma~~1'1n~~~h the operation _~~;"p'.nt~~.~~,r.working for the Cuunty or any County cmpluyee shall he at the sole expense of the gralllee, his
~-;:/ I ':::-, -_......:..,<-"~c/// ,,' , Ihe uodm;gned. herehy neeeplS Ih;, perm;1 ,uhjeel In Ihe tern"
and conditions as herein set forth. (- p:;/"
Dn"d 111;'.... 17 dnyof 10- YYl<.~ '.. .. 19 \- 7
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
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1820 Jetrerson Slreet
P.O. 80x 1220
Port Townsend, WA98368
(206) 385,9160
AI'PLlCATION FOil PlmMIT
To Department of Public Works,
Jefferson County. Washinglon.
Tlte undersiglled :D A N LA c.. j(., y
Itereby app/~ for permissinll to IIV oS Till- ( A
(C-ULUErt..T)
f'fl-I '-'11 r", 11.. ~ fT j) A ff' It c,-f\ C t+
I..II"'/;'u'" ~11I",......"I/f'Jl//h 11/"11 //1' ..,0/..'.\ Iu",,'
SKETCH:
011 CoulllY Road:
CITS C for!) ~ L""N~
between
ISIUIf' Ilt>IJ'..,O/ ('''m'.ol''~'1 m mil.. f1aill/!
and agree_ to do fhe work in accordance with your rules and regulations and .\'ubject to your inspection and approval.
19KJ--
/VIA
,. ISijln01ureuf Applicllll . lCnnlraClIIr)
(If ul1l1licllnt i~ a copartnership, sri forth names of copartners)
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Phone No,3..J.-'/~1W
Jeffcrson Co.
DEPAJUMENT OF !)UBLlC WORKS
Dislrict No.
s--
Permit No, (\(),'S'c~
SUJ)cr\lisor's Itcporl No,
Supervisor will make df!wiled refJUf/ with his recommendation all Ihis afJp/icalioll. Whef1(!~'er possible show sketch of proposed
work, Supervl'ior will also make additiollal reports and fillal repof/ giving date of completion of work all Ihis form,
Preliminary ncporl:
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Final Report:
PER~PECTlON REI'ORT
Work covered by pcrmit has been completed
satisfactorily.
\Vork is not completed.
Recommend permit be cancellcd.
Traffic control.. adequate
.. inadequate
Signed:
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REMARKS
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Application is herby made for a permit to construct, o~erate ~nd mainta~p,a road apprpach~
Please describe loact},on (attach map or drawing) fJ~,A./(J~ ,~~ Yo., ,..I, A.<-C.iU44-- S' ~ OJaff'.c">!.:Lp
J9.. a ._ JI ~.L1.Ll-- ~~ ..0' ",,3 ~'{D <<~..^1f! J2 "".. ~+ ~v.:.-/..:
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App ~cant agrees to perform t e war ~n str~ct camp ~ance w1th t e terms an con 1t1ons set ,;"
out herein, and any special provisions attached hereto.
Applicant Name E:A RL tv, fY1/c..HAi;L. Contractor Name
Address 9i()-It.f,tfSIiZE:C""-- Address
.::?o i< 'i:'" '1u UJ N ~ ~ f\U) to r+StLBl3[8
Applis:ant ,sig,l,l,ature ~'J!. (0 ,1iY);",..u" 11 Contractor Signature
Date ((!,-P(.,- J'5 Date
,
I\OAD NO.
. LOG NO. 601 "}oS
,,,~E POST ~
OFFICE USE ONLY
JEFFERSON COUNTY
OEPARTMENT OF PUBLIC WORKS
Jefferson County Courthouse
Port Townsend, WA 98368
PERt1IT NO. f,J--07-t'JI-.;2...
FEE PAID ~es ___No
OFFICE USE ONLY
CHECK ONE:
o RESIDENTIAL
APPLICATION FOR ROAD APPROACH
~ COMMERCIAL
Note;
Indemnity provisions of paragraph 2 and 3 on reverse side.
~
Subject to the terms and conditions on the reverse side, PERMISSION IS HEREBY GRANTED to
Applicant to construct, operate and ma'intain a road aJ?proach as requested above, and any
special provisions attached hereto.
PER M I T
No work shall be done under this permit until the applicant or contractor has notified
, telephone
APPROVED BY:
...(),,~ K~_o-y
Date
,<- z.,7-&~-
CAll 48 HOURS
BEFORE YOU DIG
1-800~562-6478
PERMIT INSPECTION REPORT
~ covered by permit has been completed
------ satisfactorily.
______work is not completed.
~ecommend permit be cancelled.
______Traffic control - adequate
inadequate________
REMARKS
INSPECTED BY:~~
DATE 7-"5 \,~
Form 113-0 IR....A 2-J32l
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GENEHl\l PROVISIONS
1. THIS PERMIT IS SUBJECT TO RCW 36.75.130, ,]LlO ANIJ .150 AND AMENDMENTS THERETO.
2. TUi: GRANTEE1 ITS SUCCESSORS AND ASSIGN::>, AGRH.S TO PROTECT JEFFERSON COUNTY AND SAVE IT HARMLESS FROM ALL
CLAiMS, ACTIONS OR DAMAGES OF EVERV KIND AND DESCRIPTION WHICH MAY ACCRUE TO OR BE SUFHR(U BY ANY PERson,
PERSONS, OR PROPERTY BY REASON OF THE PERfORMANCE or ANY SUCH WORK, CHARACTER OF MATERIALS USED Oft HANNER
OF INSTALLATION; IN CASE ANY SUIT OR ACT ION IS BHOUGHT AGAINST THE: COUNTY FOR DAMAGES ARISING ouT OF Of! BY
REASON OF ANY OF THE ABOVE CAUSES, THE PET IT lONER, ITS SUCCESSORS OR ASSIGNS WILL, UPON NOT I C[ OF COMMENCE-
MENT OF SUCH ACTION, DHEND THE SAME AT ITS SOLE EXPENSE AND SATISFY ANY JUDGEMENT ARISING THeREFROM IF
DETERMINED ADVERSE TO JEFFER50N COUNTY.
3. IF THE GRANTEE ENTERS INTO A corHRACT OR AGREEMENT WITIt A THIRD PARTY TO PERFORM THE WORK AUTHORIZED
~~Di~~~ F~:R~b~D ~~~M[~~~D A~~RnFE~~ ~H~A~~U~~Y T7~ ~g~~~g~~~~ 1~~T~0~H~T~Rge7~~~~~ ~:T~A~:~~~~~'2~Q:~~eE;0
q. ~~Y T~~~A~~R~~ T A~~ ~~N 1~~ ~g~~+~~~~i o~N~o~~Q~~:~~~~i~ ~~~~: ~ ~8D~Ay~R S~~~~U~~B3~c~H~H~~H~E~~1 +H~o G~:~~[~ ~
LATION AS HEREIN PROVIDED.
S. DURING THE CONSTRUCTION OF THE FACILITY, THE GRAtlTEE SHALL COMPLY WITH THE fjlI.l:H.lAL!ltL!.lli..1..BlB.t...I.BAf.E.l~
D[YICE:S ~OR SafETS AND HIGIjj:!AX,S. PUBLISHED BY THE U.S. DEPARTMENT OF TRANSPORTATION.
6. ON COMPLETION OF SAID WORK HEREIN CONTEMPLATED, ALL RUBRISH AND DEBRIS SHALL BE IMMEDIATELY REMOVED AND
THE ROADWAY AND ROADSIDE SHALL BE LEFT NEAT AND PRESENTABLE AND SATISfACTORY TO THE COUNTY.
7. THE COUNTY RESERVES THE RIGHT TO ORDER THE CliANGE OF LOCATION OR THE REMOVAL OF ANY STRuCTURE OR STRUCTURt.S
AUTHORIZED BY THIS PERMIT AT ANY TIME, SAW CHANGE OR REMOVAL TO BE MADE AT SOLE EXPENSE OF THE PARTY OR
PARTIES TO WHOM THIS PERMIT IS ISSUED, OR THEIR SUCCES~OHS ArID ASSIGNS.
8. ALL SUCH CHANGES, RECONSTRUCTION OR RELOCATION BY THE GRANTEE SHALL BE DONE IN SUCH A MANNER AS WILL CAUSE
THE LEAST INTERFERANCE WITH ANV OF THE COUNTY'S WORK Atm JEFFERSON COUNTY SHALL IN NO WISE BE IIELD LIABLE
FOR ANY DAMAGE:: TO lttE GRANTEE BY f?EASON Of ANY SUCH WORK BY JEFFERSON COUNTY. ITS AGENTS OR REPHESENTATIVE~,
OR BY THE EXERCISE Of ANY RIGHTS BY THE COUNTY UPON ROADS, STREETS. PUBLIC PLACE.S OR STHuCTURES IN QUEST ION.
g. THE GRANTEE SHALL NOTIfY THE COUNTY'S REPRESENTATIVE UPON COMPLETION OF THE WORK UNDER THIS PERMIT SO THAT
A fiNAL INSPECTION CAN BY MADE.
01.
fa. 2.
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ALL' TlMeS'}OJR' ttiG:' THE
SPEEIAL PROVISIONS
APPLICABLE PROVISIONS ARE DENOTED flY AN (X)
~o~~nug~ I~~E A~j~~~1 Zi~A~~ ~~lgN pI~~1 iO:li~I~' T~~D c6~~+~~~Egl~~~~O~~~A~7EMENTS~ AT
THE APPROACH SHALL B'LCONSTRUCTED IN ACCORDANCE WITH THE ATTACHED DESIGN PLATE TYPE_ C - ,--
APPROACH. A~'r_FT.LENGTH OF---L~INCH DIAMETER CULVERT PIPE SHALL BE PLACED IN
DITCH AND LAI D TO A TRUE LI HE AND GRADE. THE APPROACH SHALL BE SURF ACED TO THE LI M IT S AS SHOWN ON
~7~E~i~~GA~~ ~~~f~~~D~A~~R T~~o~p~~?e~~E S~~~~E~~Y I ~N~gcg~~~~~E R 1 ~~~_~~:w~~o~: ~t ~~~T:~L P~~M 1~~ E~7AN.
gj 3.
TilE APPROACH SHALL BE SUFFICIENTLY SURFACED BACK AN ADEQUATE DISTANCE FROM THE EDGE OF THE PAVEMENT TO
PREVENT ANY MUD TRACKING ONTO THE COUNTY ROAD. ANY MUD TRACKED ONTO THE COUNTY ROAD SHALL BE IMMEDIATELY
CLEANED UP BY HtE GRANTEE OR HI S AGENT.
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IF NECESSARV TO INCREASE SIGHT DISTANCE. STUMPS AND BRUSH SHALL BE REMOVED FROM BOTH SIDES OF THE
e:r~~A~~^LL T~6T I~~I ~~=~7}~~~E o~ugG~~y 0~O~6R~~~~+~~~:w~~~B[R OR 01 SF I GUR I NG OF AtlY FEATURE OF SCENIC
5. WORK SHALL BE RESTRICTED TO THE HOURS BETWE~N 9:00A.M. AND q:OOP,M. UNLESS OTHERWISE AUTHORIZED BY THE
ENGINEER.
G. A SURETY BOND IN THE AMOUNT OF $ , WRITTEN BY A SURETY COMPANY AUTHORIZED TO
DO BUSINESS IN TIlE STATE OF WASHINGTON, SHALL BE FURr~ISHED TO INSURE COMPLIANCE WITH ANY AND ALL OF THE
TERM5 AND CONDITIONS OF THIS PERt-liT AND SHALL REMAIN IN FORCE UNTIL ALL WORK UNDER THIS PERMIT HAS
BEEN COMPLETED AND APPROVED BY TH[ COUNTY.
7. BEFORE ANY LOG ItAULlNG OPERATIONS BEGIN. A SURETY BOND IN THE AMOUNT OF $. .. SHALL
BE FURNISHED BV THE GRANTEE TO PHOTECT THE COUNTY AGAINST ANY DAMAGE TO THE COUNTY ROAD AND TO INSURE
COMPLETE REMOVAL OF THE APPROACH AND CLEANING UP OF THE RIGHT~OF-WAY TO THE SATISFACTION OF THE COUNTY,
APPROVAL OF ALL CLEAN UP WORK SHALL BE SECURED BEfORE lH( BOND WILL BE RELEASED.
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o 8. SPECIAL CONSIDERATIONS
Form 113 b
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0029
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jll!1l:tSOrl Slreel
P.O. Box 1220
POrI Townsend. WA 98368
(206) 385-9160
District No.
PERMIT
In accon.Jancc with all applicable Rcvisctl Codes of WLlShingtoll ;Jnd amendments thereto, and subject to all the terms, condi-
tions and provisions written or printed below or all any pan of this form
PERMISSION IS IIEREBY GRANTED TO Sho1d Excavating
P.O. Box 179, Hadlock, WA 98339
to Install a 30' private road narrowing to a 20' roadway on Beaver Valley Road at
mile post #3.61 on the East side of road,
County Road No, 941507
Franchise No.
Milepost 3.61
No work shall be done under this permit until the pany or partics 10 whom it is gmnted shall have communicated with and
received instructions from Don Olin 385-9140
This permit shall be void unless the work herein contemplated shall have been completed before
Dated at May 12 ,19 89
May 12 ,19 90
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1.800.424.5555
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(;ENEIlAL l'IHlVISIONS AI'I'l.ICAIILE TO ALL l'EIlMITS
This permit i!> subjCCllO all applicable provhjom of the Rcvisct..ll'oJcs of Washington. c),ccpl that allY pIO\'J!<'lOIl in Ibis agrccITlclllllOI I,:(JllS1StCIlI with
such rc~oluli{)n sl1<l1l be cOll\rollillg.
A bond in the amount of $
is n:tJuilcd fur the !lru{Cctioll of the countY:l" set forth in the ICrlllS 01 the bond
During the progress of the work such barriers shall he erected llmllllailllaillcu as llIa~' he IlCl,;cssary ur a.s nla~' be tiirr.=ctcJ for the prutccllor1 of tbe
lra~'cling public; the barriers shall be prul'l..'rly lig/lIcJ tit night.
In accepting this permit the petitioncr. hb successors and assigns, agrees to protect Jefferson ('oumy alld save it hiHrnlcss from all claims, .H:tium and
damages of every killd and descriptiun whkh may accrue 10 or he suffered by any person or persons, corporatiun or property by rcasoll of the perfor.
mance of allY ~uch work, character of materials used or manner of installation, rnaimenallce ami operation or by the improper occupancy of right of
way or public place or public structure, and in case any suit or action is brought agaimt 1>aid Jefferson County for daJllage~ arblllg out of or by rea!>llfl of
any of the abovc caU1>e1>. the petitioner. his SUCCl:~"urs 01 assigns, will upon notice 10 Ililll or Ihem of CO/lllllel1CCment of such action, defetuJ the !>all1e at
his or their own solccost and experlsl.: alld will satisfy any judgment :.tfter the said suit or actioll shall havc finally ~ell determined if ud\ersc to the Jcf.
fen.on COUllty.
Except as herein authorized, I1U excavation shall be made ur ohstacle placcd within the limits of a COUllty road in such a manner as to interfere with
the traVel over said road.
Except as hcrein authorized, 1\0 eJica\'atioJl slwll he Illade or ubstacle plal:ed within four (4) feet of the edge of Ihe p;l\'emellt.
If the work dOll!.: under this pcrmit interferes in an)' wa)' with the dralllage of the coullt)' road, the grantee shall whully anu at hi~ OWI\ c>ipen~ make
such provision as the engineer may Jirect to take care of said drainage.
On completion of said work herein cOlltemplated all rubbish and debris shall be immediately relllovcd and the rnadwuy and ro..Hhide shall hi: left Ileal
and presentable and satisfactory to the engineer.
All of the work herein cOlltemplated shall hI.: done under lhc supervision and to the satisfaction of the Coonty Engineer and the entire expcn~e of said
supervision shall be borne by the party or parties to whom this permit is isslled.
The Department of Public Works hereby reser....es thc right to order tbe change of localion or the rerno....ul of allY structure or structures authori/ed by
this permit at any time, said chungc or remuval to he made llt the sole expemc of the pllrty or partics to whom lhis permit is issued. or lheir succe!>sors
and assign!>,
All such changes, reconstruction or relucUlioll by the grantees shall be done ill SUdl manner as will cnuse the lea!>t interference with any of the Coun.
ty work and the County of Jefferson shall in no wise be held liable for any dallluge to the grantee by reason of any such work by the Count}' of Jeffer-
son, il agents or represl:llIutives. or by the exercise of any rights by the County upon ruads, street!>, public placc!; or structures in que!>tion,
This permit or privilege shall not be deemed or held to be an cxclusive one and shOll! not prohibit the COUIlI}' from granting other permits or franchise
rights of like or other nature to othcr public or private utilities. nor !;hall it prevent Ihe County from using any of its roads. strCCIS. or public places, or af.
fect it!; right 10 full supervision and control over all or any part of them, nonc of which is hl'reby surrcndered.
The Department of Public Works may revllke. amend or eUllccl this permit or allY of the provisions thereof at any time by giving writtcn notice to the
permittee. The permittee shall immediately remove all facilities from the right of way. Any facilities remaining upon the right of way 30 days aftcr writ.
ten notice of cancellation shall be removed by the County at the elipcllse of the permittec,
The party or p:lrties to whom this permit is isslIcd shall maint:lin at his or their !>ole e:\pense the struclLlre or ohjecl for which this pcrmit is grantcd in
a conditioll satisfactory to the Departlllent of Puhlic Works,
SPECIAL PROVISIONS,
1. A 12" minimum culvert shall be required.
2. Applicant shall be held responsible for all damages to county road right of way.
:Wj'\\J~lfiin rolffi1@1\
", \ !'~ 1 \: 111lJlm'l1 illA\
In accepting this permit the grantce, his successors and ussigns, agree thai any damage or injury donc to the property of the gruntee or uny expense
incurred by him through the orcration ofa contr;lctor. working for the ('OllnlY or any COllllty employec shllll he at the sole expense of the grantee, his
slIccessors and i1ssigns.
.,.. 6/to Ie! f'><L'4'/C"'~/;'C,
l"illd conditions as herein sel forth. .....J
Dated ,his Y II duy o( }..I\ 1\ \.(
'1:-;)2" / .Ji.(l.~
, lhe undersigned, hereby accepts this permit subject to the terms
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JEFFERSON COUNTY
OEPARTMENT OF PUBLIC WORKS
Fce Paid_ Yel\. _ No
l(C4-Ciptr-;o
18Z0 JeHerson Streel
P.O. Box 1220
Port Townsend, WA 98368
(206) 385-9160
AI'I'UCATION FOn l'EllMIT
To Department of Public Works,
Jefferson County. Washington " .
The undersigned :~' t l.O I "I L y' c' C}",' ci' -I I//C?)
herebyappl_ forpermission/O flppl'o(j(~l\ Co(",L'! j':;:ocid
IA"/JII<u", ",II d.." "/M'/lIl1y ..hulll.- .."Ii~\,,, ",,}
elf- /71,'/e -?:.o.-of 3,01 (9'1') ['45'/ ,5>',,/(" (,:q
'1::,c::.ai/er i./u /119 y 12uad;;
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MAY 11 1989
JEFFERSON COUNTY
PUBLIC WORKS DEPT,
RECEIVED
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between
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and agree_ to llo the work in accordance with your rules and regulations alld subject 10 your inspection and approval.
Date S' - J ~ -m /9 t=1c::::,
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/ .~, ~ (If~r]~:.l.~l is a copanl1crship. set forth names of copartller!il
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1)]IOIlC No. ~\--~ h S' - (~) <.1 8' 6 Phone No,
100% Recycled Paper
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District No,
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DEI'AJ{'rMI~NT OF )'UIlUC WOI{KS
Permit No, ex"',;') 9
SUl)crvisor's ItcllOrt N u.
Supervisor }l,'iIImake detailed tefJOrf with his recommendation olllhis applicatioll. ~VhelletJer possible show skelch of propo,\'ed
work. Supervisor will also make additional repOf/S aile/final report gilJing dale afcompletion afwork oll/his/orm.
I>>reliminary Ibporl: L-Ct::':,. ~ "j, :.' 'C:
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Dale: <:;.. (7. ''0'1 "
Final Report: .. ,
PE~SI.ECTION REl'ORT
Work co,,~'red by permit has been completed
. sati~~l,l~~~~ily..'l:. J
'Work is'IICit" completed.
Recommend permit be cancelled.
Traffic control.. adequale
.. inadequate
::3::::>-, ~.
Signed:
REMARKS
Dale: 1- )1- lIf-
SI~ned:'0 C. ~ I.
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COW~.~--RCiAlJ liO...bill5Ifi3
STATE LOG liD,
MILE POST ).~~ TO_____
9FFICE USE ONLY
',.,'.',........
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fRANCHISE NO.
FEE PAID ___Yes ___No
OFFICE USE ONLY
JEffERSON COUNTY
DEPARlMENT OF PUBLIC WORKS
Jefferson County Courthouse
Port lownsend, WA 9836B
APPLICATION fOR INSTALLATION Of IIll1lTlES
Applicant: Contr~9tor:
Name ",/,VI -::;:-.ea-n/ ~!ame.4",ke^"S Job No,: '/?!i'-/}!l
Address I,ddress....LQ,y9 /? Ae,ecC"~
-MAttMER I & M a _
--2:12O-1lAKlUDGUlRI"E --L:::JYLr" ,4 A/9 p/ ,cJ
Phone: PORT ANGELES, WA 98362 Phone: "/:;:'7" Co GJ.~
Application i~ hereby made for a permit to construct, operate and maintain
~J2. -6'./pr1u.."p ...G/>....,,-<.::,,p, (.</-<A C'~
The utility installation is located (attach map or drawing)
~'\...........-, ,,'7":17, "'(, -1''''/ ~,~ /;:-,L.
Applicant agrees to perform the work in strict compliance with the terms and conditions
set out herein, and states that Applicant has read and will adhere to the general provi-
sions set out on the reverse side of this form and any special provisions attached hereto.
Applicant Signature: O/.,.f7.hU4At/
Date:
,;$" /6-.fr
Y/,cz. y9z9
/ / / / / / / / / / / / / / / / / / / / ~ ~ ~ ~ ~ ~ / / / /, / / / / ~ ~~W / / @
Subject to the following terms and conditions, PERMISSION IS HEREBY GRANTED to AP~~ant
to construct, operate and maintain utility facilities as requested above.
This permit is conditioned upon Applicant's compliance with Jefferson County Ordinance
2-81 and WAC 136-40, including amendments thereto, the general provisions set out on the
reverse side of this fo.nm and any special provisions attached hereto.
No work shall be done under this permit until the Applicant has received instructions to
proceed from , telephone
APPROVED BY: ~ /.o-=t;{- K~'-"-1
o NOTE SPECIAL PROVISIONS ON R~V[~SE
I I I / / / / / I / / / ( / / I / / / / / / ~/ I / / / / / I I / I I I I I I I I I / I
PERMIT 'iNSPECTION REPORT
Date:
"'5-/7-88
~~ rCALL ...:.'.'\
~ ., BEFORE
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~~rk covered by permit has been completed satisfactorily.
_ Work is not completed.
_ Recommend permit be cancelled.
_ Traffic control_adequate; __inadequate.
REMARKS:
INSPECTED BY: ~~___
1.800.424-5555
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1. All work done under satd franchise \holi11 be ~on. tn I thorOu9h lind "'~"Un'nl 'ke minner, In thlll! '1)'1"9 of underc:lround pipelines. .nd u~lu Ind thl
(Ont.tf'\jctlon of other facilities .nd the open1nlil of trenche\, the tunnelln'jl under count)' ro.d'. rights-of....,. or other (o...nll pro~rt1u. the 9nnle.
,1'14111 leave such trenChes.. dHehe' ond tunnels In 'uch.ll ""1 n to fnterfere u little IS ponlble ...Ith p\,ltllic tr.wcl .nd ,,..111 uk~ .11 Ch,t 'f'ld
nteeu.r)' pre"utlon~ to gll.nl th. U.1T\f so th4t C:t1nJllge or InJllry shtlll not occur or .rlu b)' ru~on ot suCh work; .nd ..l'Iert '"1 of such trtncht~.
ditches or tllnne1s .re left ope"..t night. the gr..ntee sh..11 place ..arn1n9 llghll. .nd b..rrle..celo .t sue"" po,lllon..' to gl.t .dtQu"U ...r"lng ot
'uch ....ork. The 9"ntee '1'1.11 be 11.b1e for In)' inJl,lr.)' to p"rson 0" person, or c.m<lge to pr-opertl susUlned thrOl,l9h Its c.relesSl'less or neglect. or'
thr'ough .n)' "'nun! or neglect to properly gl,ltlrd or gh'e .....rnlng of an)' trenchs. ditches or tl,!nne1s dug or IIWlnUllled bl the 'Jr.ntet.
2. The 9"ntte. Its successors or esslg"s, ~h.ll eQlTfTle"ct constrl,!cttCn under such permlt 9r.nttd b)" the Count)" [nglneer ..ithln t~e tl"'ll! p"rlod sUted
In Such pennH _nd shAll h.ve COlnpleted and h.lle 1n oper"ltlon such porti.,n of the SystC'fll of lmprowemenU IS fI'o,)l ~ ~p~c"led In such penlllt or the
rights therein conftrred uPOn the gr"lntee sh.ll cuse .nd termln.te lnsof.r.s unoccupied streets. roeds. etc.. .re concern,d.
3. The gr.nttt sh.ll luve.11 streets. avenun, .lleys. roads. highways, rlghts.of-.....)" Ind other county proPerties, .fter layl,'jI~ ..nl!llnsUlllng
"""ins .nd doing constrl,!ctlo" wOrk. llIaking repairs to eQulpment, etc.. in n good .nd Slfe condltton 1n .11 resPects .s the)' ..ere before the C(,otnlenee-
IIll!nt of such lOO,.k by the gr.ntee. its .gents 0" contractors. <lnd .11 recorded llIOnUlf\ents ....hlch h.ve be!!n dlUurbed or d1splllced b.)' the wOr.. "...11 tie
ruet to the speclfic.lIticns and appro....l cf the Caunty engineer.
4. In cue of any dalTllge to uld streets. avenues. allt'ys, roads, hlgh.....)"S. rlghts~af-....a)" lOr other' count.)' propertlu. or ta paved or surhced nl.d.
",.ys. tum-cuts. gutters. ditches. wOod 0" cancrete ....alks. drtin pipes. hand lOr emb.nkment r.ns. bridges, trestles. ....harvu. IAne:!!ngs 01" lI.onwnents
b)" the !Jnntee, the said gr.ntet ~grees to rep.!r such c!alTl<lge at the urllelt time possible tit its 0'""1 cost .nd e...pel'lse.
5. When the Count.)' Enginee" detennlnes th.t an e<1\e'9f:ncy sltuatlon dees u1st. he m.)" order and hue done In.)' Ind .11 wOrk considered necesury tc
restore ta tI ufe condition any such stret't, avenue. elley. ro.d, high...y. r19ht-of-....)' or other COl,lnt.)' property left by the grlntee or .gents In .
cenditlon dtlngeI"'QUS to life or property. He "'I.y Chllt to be r,placed 0,. reset recol"ded rnon~nU If. gl".ntee hl1s to re-pl.te 01" reset S'''oII! within
. reasonable time .fter completion of con5tructlon. The grantee. upon drmand. shall pay to the county .11 tOSU of sucll canstructlon or rep.1r .nd
of doing sucll work.
6. An conurllction or 1nstalhtion of llIalns. v.lves. pipes. poles. cablu. lines fitting and facilities. unlce. rep.lr. or relocation at the
same. perfOnl\td .10ng. cller and/or under the county raaels. rlgllts-at...a.)' 101'" other county propc:rtle' subject to uld f,..nch1se sh.ll be dane i" such
. lII.nner as not tc lnterfere with the constructlon, operltton .nl! m.inten."ce af other utlllt1es. pl.lbltc or prlv.te. dr.l"s. dnln.ge ditches ,and
structures 10c4ted therein, nor with the gr'ding lOr lmpravt(nent of such COunt)' ro.ds, rlghts-cf.......)' lOr other count.)' pr-oj>trt1u.
7. TM comers of.ll other utilities. public lOr pdv.te. 1nstalled in such count)' ro.ds. r1ghtS~Of-..4y 01" other COllnt.)' prapert1es prior In tlll'llt to
the linn .nd facilities of the gr,antee ,h.ll h....e pl"'efel"'ence u te the posltlan ,and loc.tlon af sl,lch utilities so Instilled ",itn I"'upett te the
grllntee. Such preference shall continue tn the e...ent of the necessity of re10catlng or ch.nglng the grjde cf .ny slIch tcunty read or rlght.ot....y.
8. Thegr.ntee. IS far as p,.act1uble, shan construct ne.... utility facnltles undergreund. tlltension of ov,rhead hcllltles follo....lng streets,
.venuu. ",.ys. bOulevardS or thoroughfares shall be undertltr.en enly ..Ith the apprev.1 of the Caunty Englneeri PROYIOEO. ha..ever. that uld appr-oll.l
sha11 not be lln"euonably ",lthheld. Grantee sh.11 convert e.llsting overhead "cllltlts to undergl"ound facilitIes /IS and ..hen equipment rephctmfnt
is undertlken. 0" .lIen othtr elllst1ng everhead utt11tles art plllced undergrcund. unless sllch replacement Is unute. i"",r,actlcal. or t"ConomtCllly
unreasonable. Lfne elltenslon pollcles and procedures established by the grantee. .nd unHannly applied through lts service .,.e.. sh.ll be the
stanc4rd in dete,.".ining whH is "practical. Irnpr.ctlC11 oreconomlcall)" unreuonable" under this ordln.ncei proll1ded th.t ne new overhe.d utility
facilities sh.ll be constructed or est.blished In any .rell set aside fo,. public park. school. plaY9rOllnd 0" .thletlc field PllrpOUS.
9. Spechl Pro'lthto"s:
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RECEiVED
MAR 1 7 1988
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JF-FFERSON COUNT'!
Er-!GINEERS O~FICE
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WORK LOCATION
Address~ /5 3() 'i)'SC,<:>\/e:~ ~.'~
City a..:l~.5.Et/1CounIY .-J~L:!~EF."_~~__~ St"le~.
Name_-_~'f-4,jLll1 fl1?rfJuR "
ORIOINATEDBY <R'?(~..iu~ Date3..Wi!:'l
New j:{J SID No, t1!J.B.p3...!!:i- Due Dale .3 - 9.f1Z
Repair 0 Tel. No, ___ Temporized ~
Rs,mange 0 SID No, ____'_ Due Date ___
Type of Servlc..J.J:}'(..,u__
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$ket!:.h Work RequlrAd . I n\":luti~ Ll'!rngths, ..,,~ptn5, wlrA size and amOl;nt
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PERMIT REOUIRED
Receiveo from
..Jurisdiction
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Burled ServIce WIre.
Work Order
CONTRACTOR'S ACCEPTANCE
Firm
819n"ture__,______,__"
Tltl" Date
Unit "rle. 0 Cost Plu, 0 FI.t Sum [J S
81ilto, PACIFIC NORTHWEST BELL
Atten1ion
Address
City __________Zip
APPROVAL For Flat S...Fn/Cost Plus $
Recommended
Approved by
COMPLETED BY
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COUNlY f<OAU NO.~
Sr~--tt5G NO.
HI L E POS T J..fl2:..Jo...l1.fL
, l;lFFICE USE ONLY
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1 ERMIT NO.j::?-,'>'2q-<1
FRANCHISE NO.
FEE PAID _Yes _No
OFFICE USE ONLY
JEffERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Jefferson County Courthouse
Port Townsend, WA 9836B
APPLICATION FOR INSTALLATION OF IJTllITlES
Contras;Jtor:
~!ame .Lh-r(i-k.f!4.,.a. Job No, : 3{'- 90
1.ddress /0 8'? 11 fJ, eiCCC'" /f?c-/
,,;;'nr.?''1 //X/Qt'I,.. 5 (Un,
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operate and malntain
p-, 1'20 \0... L4 /.(
Applicant:
Name
AddreS~~~~~L-
MAf'lAl:itK' I &. M
-mG-eAKHffiGHtRWC
Phone: PORT ANGELES WA 98367 Phone:
Application is hereby made for a penmit to construct,
;'~.., J../U.LcP & /) Ai"C..<. JL i0:vuj,'f) '"-f"
The utility installation is~,!lcated (attach map Dr drawing)
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Applicant agrees to perform the work in strict compliance with the terms and conditions
set out herein. and states that Applicant has read and will adhere to the general provi-
sions set out on the reverse side of this form and any special provisions attached hereto.
Applicant Signature:
W. Q, Lvu
Date: 3-d ~-~
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Subject to the following terms and condi:i:n:.Mp~~ISSION I~~~~:~:~NTED t~ Applicant
to construct. operate and maintain utility facilities as requested above.
This permit is conditioned upon Applicant's compliance with Jefferson County Ordinance
2-81 and WAC 136-40. including amendments thereto, the general provisions set out on the
reverse side of this form and any special provisions attached hereto.
No work shall be done under this permit until the Applicant has received instructions to
proceed from . telephone
APPROVED 8Y: ~--;f- Jl...~
~TE SPECIAL PROVISIONS Or! a~V[RSE
L J 1 1 I I / / I I I I ( I I I I I I I I I ~,I I I I I I I / I / / I 1// I / / / / /
PERMIT 'iNSPECTION REPORT
~rk covered by permit has been completed satisfactorily.
_ Work is not completed.
_ Recommend permit be cancelled.
_ Traffic control_adequate; __inadequate.
REMARKS:
INSPECTED BY: ::1--0--.
Date: '3 - 2-S"-8R
~~ rCALL ~'I
~ "i BEFORE
J YOU DIG
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1-800-424-5555
Date: 1- ~I- &f
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(iener.l Provlllo", per Jefferson Countl 0,.121 ) 2~et .nd WAC 1)6~40.
1. All "'Grk done under utel fr.nChhe 'l.h.11 tHe dOne in 4 thO,.Ou9" 4nd ...orkln4nllle ,".oner, In the hyin9 of I,InCerQround plpelltlflS .nel c.t)ln .nel tl\t"
(ooU"uet Ion or Other he 111 tiC's .nel the opening of trenches. the lunnellng uncle,. (Ol.lnt)' rO'lh. ,",gnu.o' -"':1 or other CO","t,1 propcrll u. the 9r"lte~
sl1.11 !un such trenC~'IIU. ditChes .nel tunnels In such.. ...,:/ n to interfere n little u poulble ...ith flubllc tr....e1 'tleI ,,,.11 Uke .11 cl,"t .nd
necesury preUI,lt1ons to guard the ume 10 th.t da"Uge or Injury shall not occur or ...lu by r..\on of !.!,Ieh ..ork; .nel ."ere '"I of sue" trellChel.
dltchU or tUnflels .,.. left open.t nf9"t. the 9r.",tee sn,11 pl.ce warning Ilqhh .nd b.rrtucles .t Such. posltion.s to glwe .c!equ.te ..Hnl"q of
such ...or... The qrantu I.h.ll be I fable for any InJury to penon or personl. or dama9~ to Pn:lPertYl.ul.Uined through itl. c.relUl,.I1eu 0" neglect. or
tl1rouljll1 4ny f<ll1ure or neglect to prOPerly guard or gille Marnlnq of 41ny trenches. dttcl1n or tunnels dug 0" ~lt\Ujn~d by the "r.ntee.
2. The gr.ntee. Its SUCcenorl. or uslgns, shall CQnTrlence conitructiOn under such pemlt gr.nted by the County [nljllneer ...It'lin the time periOd louted
In such permit .nd 1.1'1<111 haye completed .nd h<lye in operation SUCh portion of the system of 1mprowerroents U ""'y be I.pecifled In such pernlt or tl1e
I"lghU th.rein conferred upon the grantee I.hall ceue and temlnue inl.ofar as unoCCupied streets. r04ds. etc.. .u conCerned.
J. The gr.lt'ltee sh.ll lu...e 111 street!.. hel'lueS. Illeys. roadl.. htgh....ys. rights-of_...y and otl1er COunty propert leS. .fter l.ylnljl 'n~ inshlll1l9
11\1i11ns .nd dofng constructIon \oIOrk. m'klng repairs to equiJ;llT'ol:nt, etc.. in as qood .nd s.f. conditiOn In .11 rupecu.s tMel ..ere before the ct,rI'rflfnce.
lI'Ient of such work by tl1e grantee. its '?f:nts or contr<lctors. '"d .11 recorded monument!. ..l1lcl1 hawe been disturbed or dhpl,ct'd by the wor.. Shtll be
rel.et to the spec.jflutions .nd .ppro....1 of the County Engineer.
4. fn c.se of any d4l1\4ge to uld streets. ....enun. .1if:,)'S. roads, hlghwoys. rlljlMs-of...ay or other county propertlu. or to p'wed or surfaced roo.d-
...ys. turn-outs. gutters. dltc~es, wood or concrete ..a1h. dr.in plpel.. l1alld or ~mb'nkment r.lls, bridges. trestlel.. ..lIt,.....u. landlnljls or monuments
by the gr.ntee. the said grantee .gree!. to repllir such d.m.ge at the e.r11estt1me possible at HI 0"," cost and upenu.
S. When the County EngIneer determlnu th.t 1111 lI!Il'Ie"lency SHylltion does elist, lie m.y order ond hhe dene .ny .nd .11 -..orll; considered neceSury to
restore to a safe condition .n)' such street. 'wenue. alley. rotd. highway. rlght.of-..<lY or ather ceunty property left by the grantee or tljlt'nU 1'1 .
condition d.ngen:lI,lS to life or pn:lperty. He Ill"y Cllyse to be replaced or reset re(o,.ded monl,#llt'nu 1f. gr.ntee hlh to rephce or reset Ullle ..ithtn
. reuonable time .fter cOIl'Ipletlon of cOnstruction. The g,..anft't', t,/pQn d~4nd. sn"n P4Y to the COunty .fT casu of such construction or rep.ir .nd
of doing such worli..
6. All construction or inst.lhtfon of mains. ....l...es. pipes. poles. cables, l1nu flttlnljl .nd facilities. ser...lce, repair. or relocation of the
SAllie. performed .10n9. o...er .nd/or undcr the county rOllds. rlljltlts.of-...,. or otl1er county properties subject to $lId fr.nchlse sh.lI be done In such
. m4nner liS not to interfere ..Ith the COnstruction. operttfon .nd mafnten'nce of othe,. utilities. publIc or pri....te. dr.fns. dr.1nage dltC'lel. .nd
structures loc.ted therein. nor w1th the grading or improwf:lTlent of sucl1 county ro.ds. rlg"u.of-"'1 or otl1er county properties.
7. Tho! owners of .n otller utt11ties. pub1ic or prf...Ate. 1nst.lled in such county ro'ds. rights-of....y or other county propertles prIor In tlme to
the lines .nd f.cilfties of tl1e gr.ntee sh.ll h....e preference as to thl position and location of SuCh utilities so Inst.lled wHh respect to tl1e
grantee. Such preference shall continue In the event of the necessity of rt'locating or ch.nglng the gr.de of IIny such COunty ro.d or riljlht.of....y.
B. The gr.ntee. as "r as pr4ct1c.ble. shall construct new utility hcil1tfu underground. htenslon of o...erhe.d factlltles fol10wln9 l.truts.
....enues. w.ys, bouleyards or thoroughfares 1.111111 be undertalot'n only ..ith the .ppro....l of the County Engineer; PROVIOEO, ho..ewer, th.t uld .ppre....l
sh.l1 not be unreuonably withheld. Grtntee sh.ll con...ert elistlng o...erhead f.cllttiu to un~er9round facilities as .nd when equipment rephcemellt
11. undertaken. or ..lien other eJht1ng o...erhead uti11ties are placed underground, unless l.uch replllcell'ent 11. unsafe. i~r.ctic.'. or t'Conomictlly
unrusonable. Line e.o;tension pol fcles .nd procedures establ hhed by the grantee. and u,.!! formly applied through 1 ts ser...lce .ru. sh.ll be the
stancard in detennlnlnljl .."Iot is "practical, impractical or economically unreason<lble" under this ordinance; pro...ided tntt no new o...erhe.d utility
flCfllties sh.ll be constructed or est.blished In .ny area set uide foro public park. sc.hool. playground or athletic fltld plOrposes.
9. Spechl Pro...tsions:
C.OIVOt.1; 7- YY)V\~"" Be ff
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fIlAR 2~, 1988
J:::[,'FE"SON COUNT'I
C:.:G;J\~EEI~S Or:~=IC~
"",1"\"".0.'1:1'"11'1, ,(::olI-~'\9.LS 10l:Jl,/,11Jf')'1':+111 "'IJIU''':!,.!..lL..:.~~..:Je'''1 "l!I..""'~."'.
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CON TRACTOR'S ACCEPTANCE
WORK LOCATION
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ORIGINATED BY :1>, h/~.t:. DOI8..:l;dJd'd'
Now J:&S/O Noe //~.?/,,"'"- Duo Del8 .lLQ,',-iJ'
Repair 0 Tel. NO,..JJ--S~..u~.2.. T~rnporlzed U
Roarrange OSlO No "'''__ Due Dale '.."__
Typo of Sorvice -L'dLf_,.
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Firm .___.__.____,.___
Slgnuturo .__.~.
Title _...._..._,.._.._.._ Dale_
Unit Pr;"" 0 COil Plu. 0 Fie, Sum 0 $
Bill 10: PACIFIC NORTHWEST BELL
Al1l:ntion _____.._..________
Adaress
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^PPROV AL Fr>r Fldt Sum/Co'.Ot Pluj $.
PERM IT REOUIRED
R&celvad from
Jurl~dlctlon _ __ No. _ Date
COMPLETED BY ___'_______ Dal
Cell for Service"
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jellerson Street
P.O. Box 1220
Porl Towflsend, WA 98368
(206) 385.9160
N~
0086
District No, 5
PERMIT
In uccordunce with all applicable Rcvised Codcs of Washington and amcndmcnls thereto, and subject to all the terms, condi.
tions and provisions written or printed below or on any part of this form
PERMISSION IS HEREBY GRANTED TO U. S. West Comminications
611 6th Street Bremerton, WA 98310
~ Install a Buried Service Wire on,the east side of, Shore Drive at M.P. ;06
p, if::" d"'''!~'' IJ ~ _
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.JUL 07 1989
JEFFEP'"O ' .
PU8uc'i1td~I,:YUI\lTY
. \.;:) DEPT.
County Road No. 506709
Franchise No,
Milepost .06
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
received instructions from Don 01 en 385-9140
This permit shall be void unless the work herein contemplated shall have been completed before June 22
Dated at June 22 . 1989
.1989
By . .J....<.<"-C'-:T- ;<--<:-;;:;'<-u
1.800.424.5555
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GENlmAI. l'Il0VISJONS Al'l'UCAlIl.E TO ALl. l'EIlMITS
This permit is subject lO all applicahle prll\'i~ioll!l of the Revised Codes uf Wa!lhingtol1, t.:Accpt that ilflY proVi~lol1 illthl!> ilgrcclIlcfH 1101 (.'omIS(CIl( with
such resolution shall be colltrolling.
A bUild in the alllOUIH of S
is required for the jlfotcctioll of the coullty as WI forth ill lhe tcrlllS 01 Ihe buml
During Ihe progress uf the work such barriers shall be erected ,JIll.! lll11intaincd as IIlU)' be IlCCl'SSar}" or as ilia}' he um:ctcd fur the pWICl.:\lllll 01 the
traveling public; the barriers 1>l1all be propcJly lighted at night.
In accepting this pcrlllillhc petitioner, his successors and assigns, lIgrees to protect Jefferson COUllt)' and save it hat rules... from all daims, .acllulIS ;UIIJ
damages of every kind and description which llIay accrue to or he suffered by allY person or persom, curporation or PHl[lCrt)' by n:aSlltl 01 the petrur
mance of any such work, character of materials used or mallller of illstll]lalioll, maintenance und operation ur by thc Improper occupant'}' of rlgbt 01
way or Jlublic pluce or public structure, and in case arty suit or al.:tioll is hlOUght lIgainM said JcfferMHl C(JUllt)' for dall1llges arising UUI ufor hy rea<,elll of
any of the above aluses, the petitiuner, his successors or assigns, will upon lIotit:e to ILilll Ilr thelll of comJIIC/lCelncllt of l'>lIch act 1011, dcfelld thc !'kIIlLe at
his or their own sole cost and cXpenl'>c und will sati~.,f)' allY judgment :lfter the said suit 01 ul.:liull shalllluVc Finally hecn detetmilled If ..d\et..e to Ihe Jcf
ferson County.
EXceJlllIS herein authorizcd, ltll exc;lvatioll shall he made 1)1 Ilhstade pl.I!.;eJ Within tile liluits Ill' it lllll/lly rll<ld itL ...ucll a IIhltlller liS III IlIll'l ICII: .... IIII
the /raw:l o\'er said road.
Except as herein authorized, 110 e,,"Cilvaliorl ~hall he made III l)h~taclc plan.'J wilhill fOLll HI k~'t 01 the cd~'.e 01 the pa~el1letll
If tile work done UtH.kr thi~ permit illlerfele~ in allY war with the lhaillage of llle COUll I}' to;ld, llie W:LILtl.e ~hall ....hlJlly ,UIU ,It iLl\ 0...... c'"pClJ'>C IIlli~C
such provision as the engineer llIay direct to take c;ne uf said umillage.
On completion of said work herein cOlllemplillcd all rubhi~h alld dehl is shall be imllledlatcly rcmoved ill1d the roadw<LY and road..ide ~hall be Idt llc;ll
and presentable and satisfactory to the engineer.
All of the work herein contemplated ~hall he done ulH.ler the supervision ami tu the satisfaction of Ihe County Ellgineer and the ell tire C"'PCIl'>C of ~aid
supervision shall be horne by the pimy or parties to whom this permit is iS~lled.
The Department of Public Works hereby reserves the right tu on.ler the challge of hlCati()f1 or the rellloval of any structure or Mructures authu/ized by
this permit at any time, saiJ change or removal to he made at the sole expense uf the party or parties tu whOll! thi~ permit is issued, or their ~llcce~sor~
and assigns.
All such changes, reconstruction or relocation by thc gralllees shall be done in such manner as will calise the least interference with anr of the COUrt.
ty work and the County of Jefferson shall in no wise be held liahle for any damage to the gnllllee by reason of allY ~tlch work by the CUUlll~' of kiTer-
son, it agents or representatives, or by the exercise of any rights by the CoulIty upon road~, streels, puhlic places or MrllClures in question.
This permit or privilege shall not be deemed or held 10 he an e...c1usive one and shallllot prohibit the Coullt)' from granting other permits or fralleht'>C
rights of like or other nature to other public or privatc utilities, nor shall it prevclllthe County from using allY of it!> roads, streets, or puhlic place~. ur af.
fcct its right 10 full supervision and control over all or any part of them, nonc of which is hercby surrcndered.
Thc Departmcnt of Public Works may re\'okc, amend or cancel this permit or any of the prnvi...illllS therenfat any time hy giving writtcn notice to the
pcrmillce. The permittee shall immediately remove all facilities frolllthe right of Will'. AllY facilit1cs remaining upon the right of way 30 dilYS aftcr writ,
ten notice of cancellation shall be removed by the County at lhe expense of the permillec.
Thc party or parties to whom this permit is issued shall maintain at his or their ~()Ie eXflCllse the structure or ohject for which this permit is granted in
a condition satisfactory to the Department of Public Works.
SPECIAL PROVISIONS,
1) All cable shall be buried a minimum of 30" below existing shoulder
2) No road cutting allowed
3) Applicant shall be responsible for all damages to the county road
right of way
In accepting this permit the grantee, his succcssors and lIssigns, .11grce that nllY dnmage or injury ltOl1e 10 tlte property of the grantee or any c),flCnse
incurred by him through Ihe oper<llion of a cuntraClOr, working for the Coullty or uny CounlY employee shall be ilt the sole expense of the grantec, his
s~~~~r~ Iln~ ass~gl1:~ ~,n ~"" 1/-. 11 \
.~ y.........'~ CC::fL.~ ,the ulIuersigned, herehy accc[lts this permit subject to the terms
llnd conditions as herein set forth.
D,,,d this 0 0 d"y of '~""''-Q.- ,19 87
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Ft'l: Paid_ Yc~ _ No
1820 Jelterson Slreet
P.O. Box 1220
PorI Townsend, WA 98368
(206) 385,9160
Rl;U:ipl r-.:o
Addrt:~H(quc.!lt_ Yell_No
Mile PO,!,t
To Department of Public W otks,
Jefferson County, Washington.
The undersigned U S \N cST CD M t\iUJ kJ I C1\T I a us
hereby appl_ for permissio/l (0
AI'PLlCATION Fon PEIlMIT
PLACE 6UfClE..D
(?I""lwUIlf ,,)1/""'''''''''/1/1/.1' ..huIJ,,' "/.J,,,,wuo/
SEJ2\JICL WIt'CJ:. PeR ATfAc.lILD S\CJ_TC\-\
91 3\-\af2 L Df<
F' M2!\i) I S L (JJA'1
SKETCH:
SEJ=- ATI ACJ\E.D
On County Road:
51-\ORE.. DR.
belJA.'een
ISIIII..tll'Ilf,.'t {.w,\-\/,..../ttr mif,'{Il,mlJ
~,~;
ISj~Il111Ure ur ArphcunU
(If lIpplicanl is a copmtncrship. set rnnh names of copanncrsl
(C'llnlrnClOrl
^'ldre~'
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JeHersul1 Co.
nEl'ARTMENT o~' punLlC wonKS
Permit No, 00 se;;
District No.
s
Supervisur's Report No.
Supervisor will make detailed report with IIis recommelldatioll Oil tllis application Wllellever possible show sketch of proposed
work. Supervisor will also make a~l~iti()lIal reports olld filial report givillg date of completioll of work Oil this form,
Preliminary Report:
AD""}') "f /"'11', .8(..
.;) j lrc.'~c) :':),~',JM~
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S'~'& _-3"' jt..,r-~ c.fA...
t\J~ /0> r:.J n..l/-,...;
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Date:
(, .;:u - go,?
Signed: .J'),.~,~,
Final Report:
PE~PECTION REPORT
Work covered by permit has heen completed
satisfactorily.
Work is nol completed.
Recommend permit be cancelled.
Traffic control - adequate
_ inadequate
REMARKS
nale: ~ -8 ~
sIAne~C5-
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'09:14 AM
JIf. r 0 1: t:-- r'"c;,;r",-':ar...-h,"':'';;''---'_ ^-~'- -'i" _ -__"":':._ ___..:..'. ~_..:.:..__ _._
WORK LOCATION ;J ~S ~
Addrm ".5lv.", Ol!. rib':. ~
City PIA L~Jbu County '-t ~~ :rMle~
Name
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ORIGINATE~Y 16(,~.r>_ DalB_
New SIO No, _, __ Due Dete
Repair Tel. No, ;-.., Z I S" Temporlze~
Rurtange OSlO No, Due Dale
Type 01 Servloe If A.. -
eSl fl,Jr Colcr/&,r,
Rel;'rl~~~~
OJe!"l11t)'
Sketch Work Required. Include Lenithl, depth&, wire 51:c 8,.,d amount
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Burled Service Wire ~
Work Order
Pa_ [7-8BI
N~-DI~
Complete by
CONTRACTOR '6 ACCEPTANCE
Firm
Signature
Title
Unit Prioe 0 Coil Plu. 0
Dala
Flo: Sum 0 $
Bill to; US WEST Communications
Atlention
Address
C~ ~
APPROVAL For Fl.' Sum/Co.t Plu. $ _____ .._._
Recommended Date_
Approved by / Dele_
PERMIT REOUIRED ~~ "((;5 0 No
Received from Verbal 0
Jurisdiction No, _ Date_
COMPLETED BY
Call
Dale_
lor Service Connection
l.ndl~ate,Nor.lh +' F ,
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ORIGINAL COpy
Note' ThIIltIcetol"ll"tWy not t... MOI.ftte ~tlc:w'l--'aJl OeuWI, It ~Ina t"- DDn1raotor'. neponebllltyto propor1)' ~I.. wufk 1111,.... r...1d
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jefferson StreeT
P,O. Box 1220
POrT Townsend, WA 98368
(206) 365.9160
N~
0034
Di.'ilricl No.
PERMIT
In accordLlflce with <.Ill applicable Revised Codes of \"Iashingtoll and amendments thereto, <.lud subject to all the terms, condi.
tions and provisions wrilten or printed below or all any part of this form
PERMISSION IS HEREBY GRANTED TO U. S. West Communications
611 6th St.. Bremerton, WA 98310
to Install buried cable along Paradise Bay Road and install Two (2) road pushes under
Paradise Bay Road at mile post 4.24.
Port Ludlow - 89-8-5542
County Road No,
503609
Franchise No.
Milepost
4.24
No work shall be done under this permit until the party or partics to whom it is granted shall have communicated with and
received instructions from Don Olin - 385-9140
This permit shall be void unless the work herein contemplated shall have been completed before May 16 .. 1990
Dated at May 16 ,19 89
&WW~@W~~
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J'tc_
CALL 48 I
HOURs
BEFORE
YOU DIG
By .z)~ K~
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1.800.424.5555
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GENEI~AL !'HOVISlONS AI'!'UCAIlLE TO ALL !'ERMITS
This permit is subject to all aplllkablc provisions of the Rcvi<;cu Cotlc~ of Washington. c>.ccpllllal all) 11'1/\';'1011 illlhl\ agreemenl 1101 l.:oll\blcnt with
such resolution shall he controllil1g,
A bond in the amount of $
i!oo rCl.juircd for the PlOlCCliull uf the l,;UUllly as set forth in tho.: tC/Ill'> of Ihe bowl
During the progrc~ of the work such b..Ifricrs shall be crcctcJ and rm.lilllailll:u as may be ncccllsar}' or as lIla}' he lhrcClcd lor lhe prolCl.:lioll of the
tr<lvcling public; the barriers shall he properly lighted at night.
In accepting this permit lilt: petitiorler, his SU~~e!<lSOfS amI a!<l!<ligns, agrees to protect Jeffer:.OlI Coullty arId ~ve it harlllkss from all claims, actions amI
dam"gcs of every kind and descriptiun which may accrue to or bt, suffered hy any person or [lCrSOIlS, corporation or propeny by tca"O/l 01 the petfor,
mallee of all~' such work, character of nHlleriab used or rnallller of illStalJation,maintellallce and operatlull or hy the illlptoper lX:t.:upam:y of right of
wayor public place or public structure. and ill ca~ any suit or at.:tio/l is hroul\ht ag<.linst ..aid Jdfersoll County fur d<.lmages arbing out of or hy (cason of
any of the above causes, thc petitioner, hi!> successors or assigns, will UpOIl J10tke to him or them of COllllllellcelllellt of such action, defend the !Wille at
his or their own sole cost and expense and will Si~!i.'fy any judglllelll after the s<.lid suitor action shall ha\'e finally been determined if <.l(l\'erse to the Jef.
ferson CouIllY.
Except as herein authori/ed, no excavation shall he made or ohstacle placed witllill the limits of <.l county road ill sUl.:h <.l manner as to IlIterfere with
the tra vel ovcr s:J id road.
Except as herein authorized, no excavatiun shall he Illade or ohstm:le placed witllin four l.H j"l;'etllf Ihe l;'dge of Ihe pa\.ellll;'lll.
If the work dOlle under this permit interferes in any way with the druirlUge of the county road. the gruntee shall ..../Jolly and 011 his u....n eJl.pcnst' make
5uch provision as Ihe engineer lIlay direct to take care of said drainage.
On completion of said work herein contemplated all ruhbish and debris shall be ifllllledialcl~' removed und the roadway <.lnd roadside sh,,1! be left ne<tt
and prc5entahle and satisfactory to the engineer.
All of the work herein contemplated shall be done under the supervision alld to the ~atbfactioll of the County Engineer and the cntire eq>t:llse of said
supervision shull be borne by the party ur panics to wl10m this permit is isslIed.
The Department of Public Works hereby reserves the right to order the change of location or the rellloval of any structure or slructuresauthorized by
this permit at any time. said change or removal 10 be made at tbe sole expen,>c of the IKlny or parties to whol11lhis permit is bisued, or theIr successors
and assigns.
All such changes, recomtruction or relocation by the grantecs shall be dOliI.' in such manner as will cause the lea51 interference with any of the Coun,
ty work and the County of Jefferson shall in no wise he held liable for any damage tn the gralllee by reason of any such work by the County of Jeffer'
son, it agents or represcntatives, or by the exercise of allY rights by the Coullty UPUfl roads. streets, public places or structures in question.
This permit or privilege shall not be deemed or held to be an exclusive one and shallllOl prohibit the County from granting other permits or franchise
rights of like or othcr nature 10 other public or private utilities, nor shall it prevent the COUnty from using any of its roads. streets, or public pl:lccs. or af-
feel its right to full supervision and control over :.11 or any part of them. !lone of which is hcrehy surrendcred.
The Departmcnt of Public Works may revoke, amend or cancel this permit or 11l1Y of the provisions thereof at any time by giving written notice to the
pcrmiuce. Thc permittee shall immediately remove all facilities frurn tllc right of way. Any facilities remaining upon the right of way 30 days afler writ.
ten notice of cancellation shall be removed by the County at the expense of the permittee.
The party or parties to whom Ihis permit is issued shall maintain at his or their sole CJl.I"ICnse the structure or ohject for which this permit is granted in
a condition satisfactory to the l)cpllrtmcnt of Public Works.
SPECIAL PROVISIONS,
1.
All cables shall be a minimum of 30" below existing shoulder.
2. Applicant shall be held responsible for all damages to the county road right
:',of~way"7~~('~~( ~ (!~! ~:
In accepting this permit the grantee, his successors and lIssigns,llgree that any dunmgc or injury done to the property of the grantee or any expense
incurred by him through the openltion of II contractor, working for the COUllty or illIY County employee shull be at Ihe sole expense of the grantee, his
SllCC~"3S and assign;) Ii lJ ,CA t u \" I: J t 1;"'1"
it- JI.( c(.;)~ r- U/I T64-i, ,. U vv.... '-I G; ,the unllcrsigned, hereby llcccrts lhis permit subject to the tcrllls
Ilnd eOIl~iti~IIS a: ;l~r~in set :orth. ."-' , -,
.,. .7(' -)< ,'/)/
Daled this ,fi. J day of 'O./L!
. 19'X" J'C,
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fec Paid_ Yes
No
1820 JellerSOfl StrtHlI
P.O. Box 1220
PorI Townsend, WA J8368
(206) 385.9160
kCU::'Pl Nu
AddreM Requt:~t _ Ye;._ No
Mile: PO\t l~. 1~q
AI'PLlCATION FOil I'ERMIT
To Department of Public Works,
Jefferson County. Washington.
The undersigned U S WEST
herebyappl_ for permi.\sioll /0
(Please see attached sketch)
S-26
T-28N
R-1E
Communications (PNB)
Pl ace buri ed cable ac,'oss Paradi se Bay Road and along R/W
(,.If,,J/'<"IJIlI "llId""fI/"'/III1.,' "I'UI 11<, ""'11'\ /udo)
Telephone Company Engineer, David Gi llespie, 478-6697
Port Ludlow 89-8-5542
SKETCH:
On County Road:
be/ween
,SlaIo' 11<'111,,,, /''''\\',\I''~'t '" 111/1,. ""il/ll
and agree_ to do the work ill accordance with YOllr rules and regula/ions and subject /0 your inspection and approval.
Date May 10, 19~
ISiill111ltJrt of Apl'hcmlll (CnnlrllClnrl
(If applicanl is a copartnership, set forth flumes of copartnersl
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,""hire...
Phone No.
District No.
s
Jeffcrson Co.
DEI'AKfMENT OF I'UIlLlC WOnKS
Permit No, <;C, .~.,_
SUIJCrvisor's RClwrt No.
Supervisor will make detailed report with his recommendation 011 this application_ IYhenever possible !J'how sketch of proposed
work. Supervisor will also make additional reports and }il1ol report giving date of cumpletion of work 011 this form.
Preliminary I(cport: Lu ,~' 'f ;":, /. "- c/_ '2 <-I
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Final R~rl:
P~ INSPECTION REl'OIH
Work covered by permit has been completed
satisfactorily.
Work Is not completed.
Recommend permit be cancelled.
Traffic control - adequate
- inadequate
Signed: ~"J~ 8---..:-._
REMARKS
nate:
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jcllerson Street
PO, Box 1220
POtt Townstmd, WA98368
(206) 385.9160
No
, -
0110
PERMIT
In accordance with all applicublc Revised Codes of Washington and amendments thereto, and subject to all the terms, condi.
tions and provisions written or printed below or on any part of this form
PERMISSION IS HEREBY GRANTED TO U. S. West Communications
611 6th Street Bremerton, Wa 98310
~ install 2-5 pair cables on the east side of Jefferson Place and do a road
crossing at M.P. .38
W.O. #385-031
County Road No, 541309
Franchise No.
[J
JUL
;)., 192']
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Milepost .38
No work shall be done under this permit until the party or parties 10 whom it is granted shall have communicated with and
received instructions from Don 01 in 385-9140
This permit shall be void unless the work herein contemplated shall have been completed before
Dated at July 20 ,19 89
July 20 ,1990
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CALL 48 1
HOURS
BEFORE
YOU DIG
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1.800.424.5555
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GENEIIAL l'II0VISIONS AI'I'L1CAIlLE TO ALL I'EIIMITS
This pClllllt is !>ubjecI to all upplicablt: pruvj~il)m of the Rc\ iscd ('odes of Wasllinglotl, cJ\ccpt that all) PIU\ '''111/1 III tlli~ a~rCCn1Cllt Iloll:on"l"'cnl wilh
such resolutioll shall he controlling.
A bumJ in the amount of $
i!l rcquJrcu for the !lrotcl:li(Jl! 01 thl,' COtlt1l}' ,IS ,>ct fflrth in the tCrlll'> 01 Ihl." oomL
During the progress of the wor" ~uch barricls shull be crcl,:tcd amJ lllajlllaillcJ as lIlay he llcccssar}' or as llIa) he urln;lI:d ftJf the protcl,tioll 01 the
traveling public: the barriers shall he properly lighted .il night.
In acccpting this permit thc petitioncr, his !,UCl.:c:.!'>or:. allllll!>sigll:', agrees to protect Jclfcrsoll ("ounty and S;J\'C it harmle:.s from all daims. action.s and
damagc:. of c\'cry killl.l ami dCM:riptioll which lllay accrue to or hc suffcreLl by any person or perMlllS, l.:orporatioll or property by rca.\OlI of the ~x:rf(Jf'
lTlallCC of uny such work, l,;haracter of matcrials u!'.cLl or manllcr of instaJlutiull. lllailllcllalH;e allLl operatioll or by the improper tX;l.;upancy of fight of
way or public plucc or public strUl,;tufc, allLl in case allr suit or action i:. brought against said Jefft.'rscm Coullty for dum:Jgc:. arising Oil( of or br rt.'U\WI of
uny of the above causes, the pctitiollcr, his MIl,;Cessors or ussigns, will UpOIl lIotk:e to him or them of COnlrllelll,;CllIent of ~uch actioll, Llcferu.lthe sallie at
his or their own :.olc COM unLl expell:'c unLl will satisfr anr juLlgrnent after the said suit or lll.:tiorl shall have fin:Jlly heen deterlllineLl if adversc to the Jef,
ferson CoulIty.
Except as herein authorizeLl, lIuexcavallllll shall he 1I1mle (lr ohsllll,;1c plal,;ed.... ithin the lil11ib of a CtHlnty r'kld ill sUl,;h a r1I,lrlrler as \0 interfere with
Ihe l/'Uvd {H'cr ..,aid Wolv.
Except us herein ullthori/CJ, no eJo.cilvution Shilll be made Ul ulNade p]an-d 'MIllin tour HI feCI of the cJge of thc pavcmcnt.
If the work done under this permit illlerferes in illlY way with the draillage of the county wall, the gr:Jntee ~hall whoJl~' und ut hiS OWll expense /lla~c
such provision as the engineer muy direct to Iilke carc of said uruinuge,
On complction of said work herein col\tcmpluteLl all rubbish alll.l debris shall be imlllediately rellloH'd alll.lthc roadway and road~iLle shall be left nellt
und presentahle and satisfactory 10 the cngineer.
All of the work herein COli tern plat cd shall be done under the supcrvision alll.ltn the satisfaction of the CuulllY Engineer and thc entire expenr.c of :.aiLl
supervision shull he bOflle by the purty or parties to whom this permit is isstleJ,
Thc Departlllcllt of Public Works hereby reserves the right to order the change of ltx;ation or the removal of .my l>\ructure or structures authorized b~'
this permit at any timc, said change or removal 10 be made at the sole expense of the party or partie~ to whom this permit is issued, or their successors
and assigns,
All such changes, reconstruction or relocation by the grantees shall bc done in such manner as will calise the least interfcrcnce with an}' of thc Coun-
ty work and thc County of Jefferson shall in no wise he held liable for ,lilY damage to the grantee by reason of any such work by the County of Jeffer-
son, it agcnts or rcpresclllativcs, or by the exercise of any rights by the COUllty upon roads, streets, public places or structures in question_
This permit or privilege shall not be dccmed or held to be an exclusivc OIlC and shalll10t prohibit the Coullty from granting other permits or franchi~c
rights of likc or othcr nature to othcr puhlic or private utilities, nor shall it prevcnt the CounlY frolllusing uny of its roads, streets, or puhlic places, or af-
fect its right to full supervision tlnd control over all or any part of them. none of which is hereby surrelldered.
Thc Dcpartmcnt of Puhlic WOIks may rcvokc, amcnd or cancel this permit or any of the provisions thert'of at any time by giving writtcn noticc to the
permittce. Thc pcrmittceshall immediately rcmovc all facilitics from the right of way, Any facilities remaining upon thc right of way 30 days aftcr writ-
tcn notice of cancellation shall be removed by the COllnty at the eXI'lCme of the permittce.
Thc party or parties to whom this permit is issued shalll11aintuin III hisor thcir sole expense the structure or objcl.:t for which this permit is gr,lIl1ed in
a condition satisfactory to the Dc:partmc:m of Public Works,
SPECIAL PROVISIONS,
1) All cables shall be buried a minimum of 30" below existing shoulder,
2) Applicant shall be held responsible for all damages to the county road
right of way.
In acccpting this permit the grull(CC, his succcssors and assigns, llgrec thaI allY damage or injury done to the property of the grantcc or any expense
incurred by him through the operlltion of II contractor, working for the CoulIty m lIny COUllty employee shall he <It thc sole cxpense of thc grantee, his
succesU.sors i~ assi,gn~, '\ fI ^..4-
...) lJ..J ~ . the undersigned, herehy accepts this permil subject to the terms
conditions us hercin set forth. ~
Dated this d7 day of , ]9 g9
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fcc;': Paid_ Ye> _ No
1820 Jellerson Street
P.O, Box 1220
PorI Townsend. WA 98368
(206) 385.9160
M.tl.f:lplr>iO
Addrc!.!; H.CQUC!>I_ Y~_No
Milt: POM ..~, 8
AI'I'UCATION FOI( I'EHMIT
To Department of Public Works,
Jeffetson County, Washington,
71/e undersigned LJ S
hereby app/_ for permission to
vJEST C.OM..,,^-UtJl u~TI OrJc)
(A/."llfu!J/ ~dl.J,',,'"'''' jill/J ..hulli~ "Nt... (f! .10)
PLAtE.... 6LJRJED ,,)ER\lICJ~ WIRE:.... PER AITACJIE..D
CJKLTt\-l
000 \..lE..FrE.RSO~ ,ST ' eDRT WDLOW
SKETCH:
st.\: !-\TI t\CJ-\ E..D
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JUL 111989
J~F'I'
p - "=h-
UBUC ~;o~,;;UUI\IIl'
'.,,8 D~pl.
On County Rood: '..I t,FF- t.R.5DI~ oT.
bellveen
(S,ul,./IO.."..../"''''\.,I/fp.'II''mil"I'<.!'rll
and ogree_ to do the work in accordance with your rules and regulations alld subject to your inspection and approval.
Date 0LJl'/ 10 19~
06--~ l)~ct.J
ISIIllllllUreUr ^rl'hCHOlI
(01 J t.D II-I STR c.~T or applicant is a ('nparlllcr!ihip, set fanll nllllles of cor1Urlners)
1~'(t EJ\AE.R TO tJ, W A. S (:,<-3 I 0
Phone No, 47'6- (Qj'/'6
(C(lnlrIlClnrl
^d(lre'~
JcHcrsun Co.
1)J~I'AnTMENT OF I'VIlLlC wonKS
District No,-S...-"
Permit No, (') \ \0
SUIJcnisur's n,Cporl No.
Supervisor will make detailed reflort with llis recommendation on this apfllicatiol/. ~Vhene"er possible show sketch of proposed
work. Supervisor ~vill also make additional rf!ports und filial report gil'inK daJe of completion of work all this/arm.
I)rcliminar)' nCIJorl:
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Final Report:
PERMIy INSPECTION REI'ORT
" / Work covered by permit has bcen completed
satisfactorily.
Work is nol compleled.
Recommend permit be cancelled.
Traffic control.. adequate
.. Inadequa1e
REMARKS
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COMMUNICATIONS @
peaso 17.ee'
No.3&?- ~q~
Complete by
Buried Service Wire.
Work Order
WORK LOCATION
Address 'i~O )6 Ff~r.o""
City Po/f u.tJ/OuJ-county )!tFr
,Name G-",<!!p,.,J tJ~1
CONTRACTOR'S ACCEPTANCE
Firm
Signature
Title
Unit Price D Cost Plu! D
5..,..
Stete~
Date
Flat Sum D $
ORIGINATED BY 'In lL! ~
New I:ij S/O No. AJd ~oJO?'
Repalt 0 Tel, No. "i ~ 1-'l~
Rearrange D S/O No.
Type of Service If'/Z....
eBL Pill' Color/B.P.
Date ~-i-~
Due Date +$-g-c;.
Temporized (NO
Due Date_
Bill to: U S WEST Communications
Attention
Addtess
City
Zip
Term, Addrul
t," "'- - a'J.Z"
APPROVAL For Flat Sum/Co.t Plus $
Recommended
Approvep by
Date_
Date_
A~~:~~~~
Quantity
"7 G..:::'
Desc::riplion of Work
DYes DNa
Verbal C
No,_Date_
PERMIT REQUIRED
Received from
Jutlsdictlon
n;.I-flC" fI,o..,;q, WI;e.-
t'",.'-:J;" ., v -r., ~.J
COMPLETED BY
Call
Date_
lor Service Conneclio
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1IJ."WESr'
COMMUNICATIONS @
WORK LOCATION
Address :1'8"0 J~ Ff(!,Son/
City Po;' luJ/O"/County ),eFr
. Name G-..-<!!P N VA-I
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State~
ORIGINATED BY 'If) lLt ~ . Dete ~.i-~
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CONTRACTOR'S ACCEPTANCE
Firm
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Title
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Date
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Bill to: U S WEST Communications
Attention
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0106
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jlllferson Slim:!
P.O, Box 1220
Pori Townsend, WA 98368
(206) 385-9160
N~
Dislricl No.
5
PERMIT
In accordance with all applicable Revised Codes or Washington <.Inti amendments thereto, ami subject to all the terms, condi.
tions and provisions written or prinLed below or on any pan of this form
PERMISSION IS HEREBY GRANTED TO Seton Construction
4640 S. Discovery Road, Port Townsend, Wa 98368
to install water 1 ine on the south side of Paradise 8ay Road starting at M.P. .27 goin9
east to M.P. .35 and cutting road to cross there.
~~l s:: (~~ I~~;~: g V E OJ
JUL 171989
JEFJ-t::li;:'lJi'J CUUNTY
PUBLIC lA/ORKS DEPT.
County Road No. 503609
Franchise No.
Milepost.27 to .35
No work shall be done under this permit until the pany or parties to whom it is granted shall have communicated with and
received instructions from Don 01 in 385-9140
This permit shall be void unless the work herein contemplated shall have been completed before
Dated at July 12 . 19 89
July 12,1990
~,.." I CALL 48
~t'i:~ HOURS
ilt" BEFORE
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(;ENEHAL "IIOVISIONS AI'I'UCAJlLE TO ALL l'EIlMITS
.
This permit is subjccllU all applicable llfm'biom of the Rc\'bcd ('ooes of Wa~lllllgtoll.C}l.CCpl thai all} pru\'islu/l in this a~rCCll1CllllllJt UIIl\j..tctllwlth
such rcsolutiolll\hall be controllillg.
^ bund in the amount of $
is rC4uircJ flIT the prutectiun uf the county a.. \ct furth III the terms of the txJllu.
During the progress of the work sUl.:h barriers shall he erected allo muilllalllcu as lIlay be necessary or a.. may he uucclcJ lor Ihe protection of the
traveling public; the barriers shall he properly IigtucJ at lIight.
III accepting thi\> permit tile pctitiom:r. hi!> !>Uccc~~urs and a~~igm, agrees 10 pmtect Jclfersoll COUIlI)' alld S;1\C it harulle~s frolll all c1ailfl~, actium and
damages of every kind and descriptioll which may a!.:!.:rue In or he liuffcred by allY pcr~oll or per\ons, curporalioll ur property by reason of the perfor>
mancc of any such work, chara!.:ter of materials used ur manner of illl>wlJation. fllailltellan!.:e and operatiun or by the illlprupcr IXCuIJ:.\nq' of nght of
way or public place or public structure, and ill ca'>C any !.uit or :.\l'tiutl ii> brought against !.aid Jcffl'r!.on County for darn<lges arbing uut of or by reason uf
uny of the above c:uu!.cs, thc petitioner. his sU!.:!.:ei>!.ors or assigllS, will UpOll noti!.:e to hilll or t!lellluf CtJlllmenCClllel1t of such action, lIeknd the !.:.tllll: at
his or their own .!.ole cost and expense and will sali!.fy any judgment after the !.aiJ suit ur adiotl shall havc flllaJly becn delerlllllled if alher\C to lhe Jef.
ferson County,
Except as herein authoril.ed, no excavation shall he madl.: or ohstacll.: placed within the limits uf a !.:Ollllty fO,<ld in sudl a /IIanller as 10 interfere with
the travel over said road.
Except as herein authorit':l.:d, no l.::\cavatioll shall he llIade or obstacle plm;ed wilhill four (41 feet of the edge of the pavement.
If the work done under lhis permit interferes in allY way wllh the drainage or lhe collnt y road. lhe grantee !.hall ",holly <lnd :it 1m ",",II exrcll\C rna~c
such provision as the cngineer lllay direct to take C:lre of s:lid drainage.
On completion of said work herein cOlllcmplated all rubbish and debris sh~11 be ill1JllClli<ltcly reJl\uved and the roadway llnd road\ille ShOlll be left ncal
and prescntable and satisfuc\ory to the engineer.
All of the work herein contempl:iled shall be dOlle under the supervision and 10 the sutisfaction of the County Engineer and the entirc cxpense of said
supervision shall he borne by the party or partics 10 wl10m this permit is i!.sueJ.
The Dl.:partmcnt ot' Public Works hereby reserves the right to order the change of locution or the removal of UIIY structure or structures authori/.ed by
this permit at any time, said change or removal to be made at the !;ole expense of the party or parties to wl10m this permit is issued, or their successors
and assigns.
All such changes, reconstruction or relocation by the grantees shall he done in such manner as will calise the least interfercnce with any of the Coun.
ty work and the County of Jefferson Shilll in no wise be hcld liablc for any dumagc to the grantee hy reaSClll of any such wor~ by thc County of Jeffer.
son. it agents or represellliltives, or by the excrci!.c of any rights by the County upon roads, strectS, public places or structures in qucstion.
This permit or privilege shall not be deeml.:'d or held to be uncxdusive OJle and shull not prllhihittheCoOluy from grallling othcr permits or franchise
rights of like or othcr nature to other puhlic or private utilities. nor shall it prcvcnt the County from using any of its ro~lds, street!;, or public places, or af.
fect ils right to full supervision and control ovcr all or any p<Ht of them, none of whidl is herehy surrendered.
The Department of Public Works may rev()~c, amcnd or cancel this permit or anyuf lhe provi\ions thercof at any time by giving wrillen notice 10 the
permittee. The permittee shall inllnedi~\tely remove. all fadlitie\ from thl.:' right of War. Any facililies rcmaining upon thc right of WllY JOd:tys after writ-
len notice of cancellation shall he removed by tile County at the cxpense of the pcnnit\ce.
The party or parties to whom this permit is issllcd shallm:timain:1I hi!. or their sole cxpense Ihe structure or ohject for which this permit is grantcd in
a condition satisfactory 10 the Depurtlnenl of Puhlic Works.
SPECIAL PROVISIONS,
1) Water line shall be buried a minimum of 30" below existing ditch.
2) When cutting road 1 lane of traffic shall remain open.
3) Road crossing fill shall be mechanically compacted in 6" 1 ifts and covered
with a minimum 6" asphalt patch.
4) Applicant shall be held responsible for all damages to the county road right
of way.
5) Fl aggers shall be requi red.
In accepting this pcrmitlhe grantee, his SllCCC!.Sors and as!.igns, agree that ilny dumuge or injury done to Ihe property of the grantee or any expense
\ .4 i.ncurred hy hir;n tl~rough the operation of a conlr;:lctor, working for lhe County or any ('ounty employee shall he at the sole expense of the grantee, his
.:)\ successorsllll~~SSigns. ~l--"~
~.,...J~ - , the undl.:rsigned, hereby accepts this permit suhject to the tcrms
nnd conditions IlS herein set forth.
Du:cd Ihi, I 'yf1~I>"f ~ I '780
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Mile P'-^t . 'J7 .j.~ . '3 t;-
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fee Paid_ Yes _ No
1820 Jetlerson Slre!!l
P.O, Box 1220
PorI Townsend, WA 98368
(206) 385.9160
Rco:'ipll'io
AI'I'UCATION FOI( I'EIIMIT
To Department of Public Works,
Jefferson County, Washington.
The undersigned 0 d)" C;;')J1 (..j..
hereby app/~ for permission /0 '12-0..(1 cui 6""'(
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(,.I/'II/WIlIII ...d/"""'II~'/i,/fy "hUII,1' "'\!It" 1001<1 I
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and agree_ /p do the work ill accordance with your rules and regulations and subject /0 your inspection and approval.
Date //.<j /9_
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(lr nppliclllll is a cOpllrtne,,,hip, set rorth n:llllCS or cnpllrtnersl
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JeffersulI Co,
District No, S
DEI'ARTMENT OF l'UIlLlC WORKS
Permit No. 0 I () {;,
SU(Jervisor's I(cpur. No.
Supervisor will make detailed report with his recommendation 011 this application Whenel'er possible show sketch of proposed
work. Supervisor will a/so make additional re[Jo,ls and Jillal report giving dale of completion of work on this form.
Preliminary ItejlOrl: .( or" L.oI
,41- /'1-? '"'.:;27 r'i.
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Final Report:
PERMIT INSI'ECTlON REPORT
Work covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
Traffic control - adequate
- inadequate
REMARKS
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 JeflerSOfl Streel
P.O. 80x 1220
POr! Townsend, WA 98368
1206) 385-9160
District No. 5
PERMIT
In accordance with all applicable Revised Codes of Washington and amendments thereto, and subject to all the terms, condi.
tions and provisions written or printed below or 011 any pan of this form
PERMISSION IS HEREBY GRANTED TO U.S. West Communications
611 6th Street Bremerton, Wa 98310
to do a road push and install a buried service wire on Old Gardiner Hwy. at M.P.
#5.86 to service 5870 Old Gardiner Hwy.
Dig Ii 385-021
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'JUL 10 1989
JEFFEHc,ul\ vUUI\lTY
PUBLIC WORI<S DEPT.
County Road No.
Franchise No.
Milepost 5.86
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
received instructions from Don Olin 385-9140
501109
This permit shall be void unless the work herein contemplated shall have been completed before
Dated at June 30 ,19 89
June 30
.1990
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HOURS
BEFORE
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GENERAL ('J{OVISIONS AI'I'J.ICAIILE TO AI.L l'EIlMITS
This permit is subjecl to all upplic<.Iblc provisiom of the Rcvi~d Codes of Washington, except that uny pro\'i~jfm ill thi~ agreement lIul C(JlJSI~lcnt ..... ilh
such rC~(Jluli()1I shall be controlling.
A bond in the alllount of $
is required fur the prolcctiull of the COUIllY as set forth in the tcrlll~ of the bond.
During the progrc!>.<; of the work such barriers shall be erected ul\l.ll1luinWincd as 1lI<J)' be llcccs~ry or as llIay be directed for the protection of the
(raveling public; the barriers shall be properly lighted ulllight.
In accepting this permit the rctitiollcr, his ~uccessors ami a!.!.igns, agrees to protect Jelfefsofl County and save it harmless frum all claims, action!> and
damages of c\'ery kind and description which may uccruc to or be suffered by any rcrson or persons. corporution or property by rca~Ol1 of the perfor-
mance of any such work, charucter of matc:rials used or manner of installation, maintenance and opc:ration or by the improper occupancy of right of
way or public place or public structure. and in cuse any suit or aclion is brought against said Jefferson Couruy for damages arising OUI of or by rcu\cJr! of
ally of the above ClIUseS. the petitioner, his successors or assigns, will uJlon flotke to him or them of commencement or such action. defend the !.U/lIe at
his or their own sole cost and expense and wiJl sath.fy any judgmelll after the suid sui I or aClion shall huve finaJl)' been determined if ud\'er!>e to the Jef,
ferson CoulllY.
Except us herein authorized. no excavation shall be made or ob~tacle placed within thl~ limits of a county rt>Jd in such a mallncr as to interfere with
tilt: Irave! over said rood.
Except as herein authorized. Illl excavation shall be lIladc or obstacle placed witl1in fuur (41 feet of lhc edge of the pavcmcnt.
Ifthc work done under this permit interferes ill any way with the drainage of the cOllnly road, Ihe grantee ~hall wholly and al hi!. 01,',11 cx.[)Cn!.c Illa~e
such provision as the engineer may direct to take care of ~id drainage.
On completion of said work herein contemplated all rubbish and debris shall be inunediatcly removed and the road.....ay and roadside shall be left neat
and presentable and satisfactory to the engineer.
All of the work herein contemplated shall be done under the supervision and to the sati~faction of the Coumy Engineer and the entire exrcnsc of said
supervision shall be borne by the party or parties to whom this permil is issued.
The Department of Ilublic Works hereby reserves the risht to order the change of location or the removal of any structure or structures authoril.cd by
this permit at any time. said change or removal to be made althe ~ole expense of the party or parties to whom this permit is i!>sucd. or their successors
and assigns.
All such changes, reconstruclion or rclocation by the grantees shall be done in such manner as will cause the least interference wilh any of the Coun-
ty work and the COUnty of Jefferson shall in no wise be held liable for any damage to th" gralltee b)' reason of any such work by the County of Jeffer-
son, it asents or representatives, or by the exercise of any rights by the County U(Xln nXlus, streets. public places or structures in question,
This permit or privilege shall not be deemed or held to be an exclusive one and shall not prohibit the COUIllY from granting other permits or franchise
rights of Ii~e or other nature to other public or private utilitics, nor shall it prevent the County from using any of its roads. streets, or public places, or af.
feet its right to full supervision and control over all or any part of them. none of which is hereb~' surrendered.
The Department of Public Works may revoke, amend or cancel this permit or any or the prmisions thereof at any lime by giving writtcn notice to the
permittee. The permittee shall immediately remove all facilities from the right of way. Any facilities remuining ul....m thc/ight of way 30 days arter writ-
tcn notice of cancellation shall be removed by the COUnty at the expense of the permittee. ,~
The party or parties to whom this permit is issued shall maintain at his or their sole expense the structure or object for which this permit is granted in
a condition satisfactory to thc Department of Public Wor\.\s.
SPECIAL PROVISIONS:
1) All cable shall be buried a minimum of 30" below existing ditch
2) No Asphalt cutting required
3) Applicant shall be held responsible for all damages to the county road
right of way
In accepting this permit the grafllee. his successors and assigns,lIgree Ihat any damage or injury done 10 thr property or the grantee or any expense
incurred by him through the OI'lCralion of a contraClOr, working for thc County or any County employee shall be 31 the sole expense of the grantce, his
successors and assigns.
We.st
and conditions as herein set rorth.
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. the undersigned. herehy accepts this permil subjeclto the terms
DlIIed this (p
.1964
day of
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Fee Paid_ y~ _ No
1820JelfersonStreel
P.O. Box 1220
Port Townsend, WA 98368
(206) 385-9160
Rl'.e,pl No
Addre!>!> HC/.jueM __ Ye!r. _ No
Mile Post
AI'I'L1CATION FOR I'ERI\IIT
To Dcpartmelll of Public Works.
Jefferson CoulllY. Washington.
The undersigned U S WeST C.Ol\Al\AU rJl CATI Ol\jC)
herebyappl_ lor permissioll to
PLAc.L I:)URI EJ)
57:l70
(,1",,11<<1111 "IIIJ""f/I"'/ully ..JUJI'''' "/111"1 10 d",
SERVICe.. WII~E- PeR ATIACJlffi S-t<:UGH
OLD GAi2DI UE..R J-\w'l
SKETCH:
REf' 'co: I1VED
JUN 271989
JEFFER~ ~UUNTY
PUBLIC W(v:>J,'~, OEPT.
On County Road: OU) DARD\ uLR
bel'tl1?en
ISlntl"II'U"'\I('m\I-\Ir,~"orll!lI"/>OII1/J
Date
c::il~/\V\\ ~
and agree_ 10 do the work ill accordance with your rules Gnd regulations and subject to your inspection and approval.
JLlllE- 2-") 19~
4;11 \.'IT ~ 0 )
ISlilna1Ufturl\flpliJ;lInu
<611 (oT~1 -ST
bi~uv..L:R TO tJ, WA,
Phone No, Ll76-1o:5 7'6
(If uprlicum i~ II corunl1cr!lhip. set forth 1111ITlCS of copartners,
ICnnlrllCUm
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DEPARTMENT OF PUULlC WORKS
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District No, .)
Permit No. ('10 Of,
SUllcn:isor's ItclJOrl Nu.
Supervisor will make detailed report with his recommendation 011 this application. JYhefle~Jer {Jossible show sketch of proposed
work. Supervisor ~....i11 also make additiollal re{Jorts ami filial report gil'ing date of completion of work Oil this form.
Preliminury Report: Loc:.\\.--:..A Of"
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Fin:;?1 Re ort:
PERM INSPECTION REPORT
Work covered by permit has been completed
satisfactorily.
Work is not compleled.
Recommend permit be cancelled.
Traffic control. adequate
- inadequate
REMARKS
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WOAf<LOCATION , ,,_ " GCONTRACTOR'8ACCEPTANCE
Address, S""cr-7-tl o/~ U-~ Inn
Clly1).)<'"o B:? County}4 'F SlaleW.#- Signeture
Name t. J-! It -::> Tille
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ORIGINATED BY OKS,!::. Dete ,-~
New 0 SIO No. Due Dete_
Flepalr 0 Tel. No. ~S ~ , (,/ Temporized ~
Resrrange DS/ONo, Due Dete_
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Color/B.P,
Bill 10. U S WEST Communication,
Attention
Adc'ess
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Zip
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APPROVAL Fo, FIr. Sum/Cost Ph.. $
Recommended
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Date_
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PERMIT REOUIRED
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Jurisdiction
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COMPlETED BY
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fo, Service Connection
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IJi'lricl No. 5
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 JeHerson S1reel
P.O. Bo,o; 1220
PorI Townsend, WA98368
(206)385.9160
~~~
0081
PERMIT
In accordance with all applicable Hevised Codes of Washington and umendments thereto, and subject to all the terms. com.li.
liolls and provisions written or printed below or on any pan of this form
PERMISSION IS HEREBY GRANTED TO Phil ip Zerr
31 'Petir""...! '1\'&, 'P.T.
to install a private road approach on the south side of Old Gardiner Road at M.P. .47.
501409
County Road No.
Franchise No.
Milepost .47
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
received instructions from
This permit shall be void unless the work herein cOJ1lemplated shall have been completed before
Dated at June 19 ,19 89
, 19
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CALL 48
HOURS
BEFORE
YOU DIG
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GENERAL I'ROVISIONS AI'I'UCAIII.E TO ALL PERMITS
This permit is subjccllo all applicablt: provisions of the Rc~'jscJ Codes of Washington. CAccpllhul an)' pru\ i~lun in thi, agrcclIlclllllOI c(JI1~hlcnt .....ith
such resolution shall he controlling,
A bond in the umOU/H of $
is rCljuircd for the protectiull of lhe county as set forth in the terfllS 01 the bond.
During the progress of the work such harrit:!s shall be erected uwllllaillluillCd as lIla)' be IlCCCS.~;HY or a~ lllay Ix: dirc!,;lcd for the protection of the
traveling public: the barriers shall he properly lighted al night.
In accepting this permit the pctitiom:r. his successors amI assigns. u~rees to proleet Jelferson County and save it harmless fro/ll all dairm., actiuns aml
damages of every kind ..IIld deloCription which may accrue to or be suffered by any person or persons. corporation or property by reason of the perfor.
mancc of any such .....ork. character of matcrials u!>ed or manller of imtallation, maintenance and operation or by the improper occupanC)' of right of
way or public placc or public structure. and in case any suit or action b brought again!>t said Jcffcr!>on County for damages arbing out of or by rCilsun of
any of the above causes. the petitioner, his successors or assigns, will upon notice to him or them of commencement of such action, defend the ~lIIe at
his or their own sole cost and expense and will satisfy allY judg.meflt after the said suit or action shall have finally been dr:tmnincd if ad~'er!>e to the Jcf.
ferson County.
Except as herein authorized. no excavation shall be lIlade or obstacle placed within the limits of a county road in such a manncr as tn interlcrc with
the travel over said road.
Except as herein authorized. no excavation shall he made or ohstadc placed within four (4) feet of the ellge of the pavement.
If the worl.: done under this permit interf~'res in any way with the drainage of the coullty road. the grantee ..ball wholly alld at hi.. own expc..'n..e ma~c
such provision as the engineer may direct to take care of said drainage.
On completion of said work herein contemplated all rubbish and debris shall be immediately removed and the roadway and roadside !;hall be left neat
and presentable and s:lIist'actory to the engineer.
All of the work herein contemplated shall be done under the supervision and to the sath.Faction of the County Engineer aml the entire expen!>e of said
supervision shall he borne by the puny or parties to whom this permit is i!;sued.
The Department of Public Works hereby reServe!; the right to order the change of location or the removal of any !;tructure or Mructures authori/ct..l by
this permit at any time, said change or removal to be made at the sole expense of the pUrl~' or panics to whom this permit is issued. or their succe'::o"ors
and assigns.
All such changes. reconstruction or relocation by the grantees shall be done in such manner as will cause thc least interferencc with any of the Coun.
ty work and the County of Jefferson shall in no wise be held liable for allY damage to the gralllee by reason of any such work by the Cou11lY of Jeffer.
son. it agents or representatives, or by the exercise of any rights by the County upon loaus. ~Hteets, public plnccs or structures in question.
This permit or privilege shall not be deemed or held to be an exclusive one and slJ:lllnot prohibit the County from granting other pcrmitsor franchi!>e
rights of like or other nature to other public or private utilities. nor shall it prevent the County from using any of its roads. litreets, or public places. or af.
feet its right to full supervision and control over all or any parl of them. none of which is hcreby surrcndered.
The Department of I)ublic Works may revokc, amend or cancel this permit or any of the provisions thereof at any time by giving written notice to the
permittee. The permittce shall immediately remOVe all facilities from the right of way. Any facilities rcmaining upon thc right of .....ay 30 da)'s after writ.
ten notice of cancellation shall he removed by the County at the cxpense of the permittce.
The party or parties to whom this permit is issued shall maintain at his or their sole expense the Structure or ohject for which tlli!. permil is gralllell in
a condition satisfactory to the Departmcnt of Public Works.
SPECIAL PROVISIONS,
1) ^ 12"X20' culvert shall be required with gravel approach.
2) Brush shall be removed so as to increase site distance.
3) Applicant shall be held responsible for all damages to the
county road right of way.
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In acecpting this permit the grantee, his successors and assigns. agree that any dama~c or injury done to the proper.!}' g.rfthe grantee or any expense
incurred by him through the operation of a contractor. working for the CuunlY or an)' County employee shall be at fIlc sole cspensc of the gramce. his
successors and assigns. Z
and CO"d~ as herein. 1 forlh,"""~ ~
---
'2.B dny nf J v...k.f
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. Ihc undersigned. hercby ueccpts this permit subjecllo the terms
Dated this
,19~~ .
t;' A-R-t--l s: '5 T --:z::. E; 1Z.r2-
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1820 Jellerson Slreel
P.O. BOll 1220
POrl Townsend, WA 98368
12061385.9'60
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
ltI'l.C'Pl No
AI'I'L1CATION FIJI{ I'ERMIT
To Department of Public Works.
Jefferson County, Washington.
The undersigned i-:j, /I-J? ? AI2 i2..
hereby appl...i.1::..:.S-- for permission 10 .r N:S rfl'L-I-
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of F-x',~-,- FlU,?, Ner.-u
SKETCH:
On County Road: 0'- Ie, G-rTP-.D,' tv e R- R f).
we$ r oF- C;:A-i"DiN <<.1'-. '5 T-{; ,:>e
(Sro/eIWUIl'\/I'W\\o\/rt't'/"rllllll'""i,U!
Fee Paid_ Yes __ No
Addrc.!..\ Request _ Yo _ No
Mile P~l J ;'.{-7
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!RECE.IVED
JUN 81989
JEFFER~Ut" L;uuNTY
PUBLIC WORKS DEPT,
ben"..een
US IO(
aND
/A ~ fa /
Gild agree_ to do the work il1 accordance with your rules and regulatiolls alld subject /0 your inspection and approval.
DOle 6 - 7 J9~
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ISillnature ur Al"pli~ltnll
Of llpplicalll is a copllrtncrship, !let forlh names of copartners)
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DEI'AUTMENT OF PUBLIC wonKS
District No, .:;-
Permit No. rn R I
SUI)cnisur's Ucpurl No.
Supervisor will make detailed report with his recommendatioll Oil litis application Whenever possible show ,~kelch of proposed
work. Supervisor ......iII a/so make additional reports alld Ji/wl report giving date of completioll of work on this/orm.
IJrcliminury Iteport:
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Date: 10 -, tlo~ 1:7
Final Report: ,
PERMIT ~.:cTION REPORT
C/' Work covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit be cancelled.
'~~
Signed:
Traffic control - adequate
- inadequale
REMARKS
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APPLICATION TO OPEN RIGHT OF WAY
Application is hereby made for a permit to open right of way.
cribe right of wa,y. , (Attach drawing or map)
-IhWf/ -
Please des-
Applicant agrees to perform the work in strict compliance
and conditions set out herein. and an1. special provisions
~ Appl icant Name 'Ph.lrL~ StN1-"
Address ''31 1-CtlR.lJl.., t.u."u:J- (<d I
Signature<i; J~~ ~~~f?~
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with the terms
attached hereto.
3t".I:- 3Z'"91
~-7-8 c;
Date
***ill!i!.l***
SUbject to the terms and conditions below. permission is hereby granted to
applicant to open right of way. Applicable provisions are denoted by an
(X) . ,\
/7 Applicant is authorized to. construct 'a 'prl'vate access road to his or
her property in- acc'ordance wf-th applicable standards for priv.ate roads.
The right of way will be located and staked by 'he County Engineer. The.
permit does not prevent other lot owners from USing the access road. In
the event u~ers of the road wish to have the road maintained by the county.
the users shall improve the street to minimum county road standards. or may
form a road improvement district per RCW 36.88 to pay for the costs for "
improvements. I .
L7 Applicant shall construct a roadway to county road standards. The
rIght of way will be located and staked by the County Engineer. After con-
struction to county road standards. the new road will be maintained by the
county
Applicant shall pay the county one half the mill value of timber
removed from right of way in order to offset costs to the county
for future improvements.
RECOMMENDED FOR APPROVAL 8Y
DATE
APPROVED BY
Chairman. Board of County Co~missioners
DATE
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JEFFERSON COUNTY
DEPARTMENT DF PUBLIC WORKS
1820 Jellersorl Slrlltll
PO 00;( 1220
Pori Tuwnsend, WA 98368
{206) 385.9\60
N::
0044
PERMIT
In accordance with all applicable Revised Codes of Washington and UI11CIll.hncnts thereto, and subject LO all the terms, condi.
tions and provisions written or printed below or on any part of this fOfm
Discovery Timber Co.
to
PERMISSION IS HEREBY GRANTED TO
4890 S. Discovery Rd., Port Townsend, WA 98368
Install a road approach to Block 42 of Irving Park Addition on the East
Discovery Rd. at mile post # .85 South of railroad right of way.
side of S.
601508
County Road No,
Franchise No.
Milepost .85
No work shall be done under this permit until the party or parties to whom it is granted shall have communicated with and
received instructions from Don Olin 385-9140
This permit shall be void unless the work herein contemplated shall hnve been completed before
Dated at May 22 ,19 89
May 22
,19 90
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GENERAL l'Il0VISJONS AI'!'UCAIlI.E TO AI.L l'EIlMITS
This permit i~ subject to all applicable provbiom of the Rcvj<,Co ('odes or Wasllingtoll. except tbat ,HlY plu\'hioll ill this agn:cIIll'n\ nOI r.:unsI'lcnt with
such rc!;olutioll shall be controlling.
A bUild in the UllIuUlIl of $
IS lcquilcu for the protcl:lioll of the CHUrn} as set fuull ill tile terms of lhe hondo
During the progress of the work such harriers shall he erected Lind maintained as may be Ilcccs..ary or us may be dilct.:lcd fur the protection of tbe
traveling public; the bankes shull be properly lighted at night.
In acccpting thi!; pcrmit thc petitioner, hi!; SUCl,;cssors .Illd a<;signs, agree!-' to protect Jcffcl!;OIl COUIlIY and suve it harmless fWIII all c1iJirns. actions :md
damages of every kind and descriptioll whk-II lIIay accrue tu ur be suffered by allY pcrson ur persons, corporation lJf propert}' by reason of the perfor'
mancc of any !;uch work. charactcr of malerials used or manner of imtallation. mailltenalll':c and operatioll or b}' the improper occupar1l.:}' of right or
way or public place or public structun:, und in case any suit or action is hruught against said Jefferson ('oullty for damagcs arising out of or hy rcason of
any of the above causes, the petitioner, his succ..:cs.sors or assigns. will UpOIl nolic..:c to him or thcm of c..:orlllllellcelllellt of suc..:h action, defend tht: "afllc at
his or their own sole cost and cxpense and will satisfy allY juugrnent after the said suit or actlOJl shall have finally been dl.:terlllineJ if advl.:rsl.: 10 Ihl.: Jcf.
fersoll CoulIty,
Excepl as herein uuthoriled, 110 exc..:avation shall be lIlade or ubswde placed within the limits of a t.:OUllty road in suc..:h a manlier as to imerfl.:re with
the tra\'c1 mer said road.
Except as herdn authori/ed. no e,,"c..:avtltilln !;haJl be made or obstacle placed within lour 1-1) feet of tbe edge of the pavemellt.
If the work done under tlib permit intelfelc:ot in all)' way with Ihe draillage ur the cuuJJty road. the grantee ~hall "holly and at his u........ expense make
such provision as the engineer may direct to take care of said Jraillllge.
On completion of said work herein contemplated all ruhhbh and debris shall be illlll1ediatcly relTlovcd alld the wtldway and roadioide sh..1l be Jcftncat
and presentable amI satisfaclory to the engineer.
All of the work herein contemplate'" shall be dOlle under the supervision and to the satisfac..:tiun of the CoulIty Engineer and the entire expcme of said
supervision shall be borne by the party or parties to whom this permit is issued.
The Departmellt of Public Works hereby reserves the rigl1tlO order the change of location or the removal of any structure or structure~ authori/cd by
this permit at any timc, said changc or removal to he made at the sole eKpcme of the party or partie~ to whom thi,.. permit i~ i!.sued. or their sllccessor!;
and assigns.
All such changes, reconstruction or relocation by the gralllces shall he done in ~tKh manncr as will cause the least interferellce with any of the Coun.
ty work and the County of Jefferson shall in no wise be held liable for any d<lmage to the grantee hy reason of any such work by the County of Jeffer.
son, it agents or represent<ltives, or by the exercise of any rights by the Count}' uJlon roads. ~treclS, public plac..:cs or structures in question.
This permit or privilege shall not be deemed or held to he an cKclusive one and shall not prohibit the COUllty from granting other permits or franchise
rights of like or other nature to other puhlic or private utilities, nor shall it prevent the COUnty from using any of its rmll.h. streets. or public places. or af.
feet its righl to full supervision and control over IIIl or any part of them. none of whkh is hereby surrendered,
The Department of Public Works may revoke, amend or cancclthis permit or any of the provisions thereof at .IIlY time by gh'ing written 1I0tice to the
permittee. The permittee shall immediately remove all facilities from the right of way. Any fllcilities remaining upolllhe right of way 30 days after writ-
ten notice of cancellation shall he removed by the County at the expense of the permittee.
The pany or parties to whom this permit is issued shalllllaintain .11 hi~ or their sole expcllSe the structure or ohjecl for which this permit is granted in
a condition satisfactory to the Departlllent of Puhlic Works,
SPECIAL PROVISIONS:
1.
No culvert required.
2. Trees and brush shall be cut back to allow for site distance.
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3'1,~~~ldcanbJ8ha' held responsible for all damages to county road right of way.
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In accepting this permit the grantee, his successors llTld lI!;signs.lIgree tll.1I any damage or injury done to the properlY of the grulltee or any expense
incurred by him through the opcrlltion of a contrllc..:tnr. working for the ("oullIY or any County empltlyce !'.hall he lit the sole expense of the grantee, his
slIccessors llnd u!'.signs,
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and conditions as, here!n set f~rth.
Dated this * 2.'9 TJ) da; of ->j4.
, the undersigned, herehy accepts this permit subject to the tcrms
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1820 Jetlerson Slreel
P.O. Box 1220
PorI Townsend, WA 98368
(206) 385.9160
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
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AI'I'L1CATlON FOil l'EIlMIT
To Department of Public Works,
Jefferson County, Washington.
The undersigned ~~
hereby appl-lf- for permission to
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SKETCH:
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On County Road: 5 i)~'Scoue/<'f
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beMeell C rife. C - 0,:;' J e. i<. D,
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and agree_ to do tile work in accordance with your rules alld regulations and subject to your inspection and approval.
Dale i2 19_
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ISijl.nDtur~ of APl'licHrul (Cllnlr!lI:lOrl
;.(.p;l~O .s. lIf applicant i!i a copanllcrship. set forth names of copartners)
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D1WAKrMENT OF I'UIlLlC wonKS
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District No. (;
Supervisor's I{cporl No.
Supervisor will make detailed report wilh his recommendation DlIlh;s applicGlioll. Whenever possible show sketch of proposed
work. Supervisor will also make addilional reports and filJal report gil'ing dale of completioll of work 0/1 this/orm.
Preliminary Itcport: LoC'",-/,J 0)'/ .T~(t 'LA'; IS r ~
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Final ~eport:~
PERMIT PECTJON HEI'ORT
./ Work covered by permit has been completed
satisfactorily.
Work is not completed.
Recommend permit he cancelled.
Traffic control - adequate
- inadequate
REMARKS
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JEFFERSON COUNTY
Department of Publtc Works
TRAFFIC SIGNING PLAN
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f;k: b93b19
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Project: No.
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Road Name:(;Ie-tC.ve Rp/5R.li:> Road Log No. 6'':1361'1 M.P.p,oo_to M.P.~
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STATE OF WASHINGTON
COUNTY OF JEFFERSON
In the roa tter of
x
Closing a County Road: x
Glen Cove Road (County x
Road No. 693619), From x
Milepost 0.00 to Milepost 0,24 x
RESOLUTION NO.~
WHEREAS, the adjacent landowner to Glen Cove Road, County Road No. 693619,
m.p. 0.00 to m.p. 0.24, has received permission from Jefferson County to
construct Otto Street from Frederick Street to Glen Cove Road, and
WHEREAS, Clen Cove Road will be required to be closed to make connection
with Otto Street, and
WHEREAS, the intersection of Glen Cove Road and S.R. 20 is substandard,
NOW THEREFORE BE IT RESOLVED that Glen Cove Road, County Road No. 693619,
be closed to traffic from milepost 0.00 to milepost 0.24, S.R. 20 to Otto Street
intersections, commencing August 21, 1989, and that the closed portion of said
street be effectively barricaded.
ADOPTED THIS ~hDAY OF AUGUST, 1989.
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JEFFERSON COUNTY
BOARD OF COMMISSIONERS
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George C. B~wn, Chairman
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rry . ennison, Member
SEAL:
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B.G. Brown, Member
ATTEST:
a;~t(if!j?/:#4/~~tJ;~
Lorna Delaney;
Clerk of the Board
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STATE OF WASHINGTON
COUNTY OF JEFFERSON
In the Matter of: x
Resolution No. 58-89
Changing the Name x
Of a Private Road x
WHEREAS, the Jefferson County Board of Commissioners has
been petitioned to change the name of Bay Ridge Court, a private
road located in section 13, Township 30 North, Range 2 West,
W.M., as shown on attached Exhibit "A", and
WHEREAS, a majority of property owners using said road are
in agreement regarding the name,
NOW THEREFORE BE IT RESOLVED, that the road shall be named
Bay Ridge Road.
ADOPTED THIS itJ:;t- DAY OF l.-r~.t:; ,1989.
JEFFERsZN COUNTY BOARD OF COMMISSIONERS
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SEAL:
ATTEST:
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Lorna L. Delaney
Clerk of the Board
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Section 12., T30N. Range 2.W. W.M.
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STATE OF WASHINGTON
COUNTY OF JEFFERSON
In the matter of
x
RESOLUTION NO, 69-89
Closing a County Road:
Glen Cove Road (County
Road No, 693619), From
Milepost 0,00 to Milepost 0.24
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WHEREAS, the adjacent landowner to Glen Cove Road, County Road No, 693619,
m.p. 0.00 to m.p. 0.24, has received permission from Jefferson County to
construct Otto Street from Frederick Street to Glen Cove Road, and
WHEREAS, Glen Cove Road will be required to be closed to make connection
with Otto Street, and
WHEREAS, the intersection of Glen Cove Road and S.R. 20 is substandard,
NOW THEREFORE BE IT RESOLVED that Glen Cove Road, County Road No. 693619,
be closed to traffic from milepost 0,00 to milepost 0.24, S.R. 20 to Otto Street
intersections, commencing August 21, 1989, and that the closed portion of said
street be effectively barricaded.
ADOPTED THIS 14thDAY OF AUGUST, 1989.
JEFFERSON COUNTY
BOARD OF COMMISSIONERS
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rry . Dennison, Member
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B.G. Brown, Member
SEAL:
ATTEST:
a;~<{tj?~#4~iJ~tJ;~
Lorna Del aney.
Clerk of the Board
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ADCRESB. 2-/1 A l co / rA LcD,) t2rA PHONE NO. - I 3A"'5" - ;Jt1-(,4-
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PRO.JEcT- PAO.JECT TITLE I3Lt::-(l)~ 4- C) /2 ';(3 '1J'1I/1~EcT NLW3ER-
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REVIEWED BY. DATE.
CCNTAcn:O REQLESTER 0 IN PERSON ~'BY PHONE 0 BY LETTER CXlNTAcTED BY- 3J1r.17
RE~TIClN..
PREPARE EST I MATE . FOR..
RDl1rE TO- INITIAL
0 DIREC"I"aI - 0 CONSTRUCTION ENG. - 0 ACcxx..NTANT
0 ASSISTNlT D'R. - 0 PLANNING ENGINEER - 0
0 FOAD SlPERV I SOR - 0 ADMIN, ASSIST~T - 0
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BAYSHORE LEASE LEGAL DESCRIPTION
6-7-83
BEGINNING AT THE QUARTER CORNER BETWEEN SECTIONS 8 AND 17, TWP. 30 N., RGE.
1 W.W.M., WHICH IS 2629.16 FEET EAST OF THE SECTION CORNER COMMON TO SECTIONS
7 AND 8 AND 18 AND 17, TWP. 30 N., RGE. 1 W.W.M.; THENCE NORTH A DIST~lCE OF
1322.55 FEET TO THE NORTHWEST CORNER OF THE SOUTHWEST QUARTER OF THE SOUTHEAST
QUARTER OF SECTION 8, TWP. 30 N., RGE 1 W.W.M.; THENCE EAST ALONG THE NORTH LINE OF
THE SOUTHWEST QUARTER OF THE SOUTHEAST QUARTER A DISTANCE OF 220 FEET, WHICH IS
THE TRUE POINT OF BEGINNING; THENCE SOUTH ON A LINE PARALLEL TO THE WEST LINE OF
THE SOUT~~EST QUARTER OF THE SOUTHEAST QUARTER A DISTANCE OF 250 FEET; THENCE EAST::
ON A LINE PARALLEL TO THE NORTH LINE OF THE SOUTHWEST QUARTER OF THE ;OUTHEAST
QUARTER A DISTANCE OF 250 FEET; THENCE NORTH ON A LINE PARALLEL TO THE WEST LINE OF
THE SOUTHWEST QUARTER OF THE SOUTHEAST QUARTER A DISTANCE OF 250 FEET TO THE NORTH LINE
OF THE SOUTHWEST QUARTER OF THE SOUTHEAST QUARTER ; THENCE WEST TO THE TRUE POINT
OF BEGINNING.
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STATE OP WASHINGTON
COUNTY OF JEPPERSON
In the matter of
x
Contract No.
x
A Contract ~ith Bayshore Enterprises,
For Operation of the Jefferson County
Recycle Center
Inc.
WHEREAS, Bayshore Enterprises, Inc" hereinafter
referred to as "BAYSHORE" proposes to furnish services for
operation of the recycle center at the Jefferson Coubty Landfill
on behalf of the County of Jefferson, a municipal corporation of
the state of Washington, hereinafter referred to as the "COUNTY",
in compliance vith all procedures and description of vork, terms
and conditions hereinafter described.
WHEREAS, BAYSHORE represents that it has the expertise
to perform the services described to the standards required by
the COUNTY.
I.
SCOPE OF WORK
BAY SHORE shall provide the labor force to operate the
recycling center as required on behalf of the COUNTY, to collect,
process and ship recyclable materials as per the Jefferson County
Public Works instructions as sho~n in Section III.
II.
PERIOD OF PERFORMANCE
This agreement shall be effective as
of November, 1988 and shall continue in full
until mutually terminated by vritten agreement
set forth in Section XIII.
of the first day
force and effect
or terminated as
I II.
OBLIGATIONS OF BAYSHORE
A. BAYSHORE shall provide the necessary labor, supervision
and management to:
1. Pick up in a timely manner all drop box sites vhere
recyclables are collected as designated by the COUNTY; and
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from contractually arranged sites in the City of Port
Townsend.
2. Process, prepare for shipment, and load outgoing ship-
ments of recyclables collected and received on vehicles
furnished or arranged for by the county.
3. Load and deliver such processed recyclables as can be
economically hauled with county-owned specialized vehicles.
4. Purchase recyclables at the recycling center premises in
accordance with the instructions issued by the Director of
Public Works.
B. BAYSHORE daily schedule shall be from
P.M., Monday through Saturday. It shall
following holidays: New Years Day, Presidents
Fourth of July, Labor Day, Thanksgiving
Thanksgiving, Christmas Day, the last working
mas or the day following Christmas Day.
8:30 A,M, to 5:00
be closed on the
Day, Memorial Day,
Day, the day after
day before Christ-
Bayshore shall operate such hours as are necessary to keep
the accumulated materials within limitations established by the
written instructions of the Department of Public Works.
C. BAYSHORE shall maintain an accurate accounting system
which will include records of receipts from all sources as well
as all disbursements made. Bayshore's books, with respect to the
recycling operation shall be subject to audit at any time by
authorized representatives of the County of Jefferson.
D. BAYSHORE shall maintain such daily, weekly and monthly
operating data as shall be required by the Department of Public
Works.
IV.
OBLIGATIONS OF THE COUNTY
A. The COUNTY shall
equipment for processing
recycling center, and shall
COUNTY shall also maintain
the utilities.
furnish, purchase and maintain, all
of the recyclables brought to the
furnish operating fuel for same. The
the recycling building, and furnish
1. The COUNTY recognizes that the curbside and drop box
pickup must be done on a schedule, and that the processing
of the recyclables is a production operation; and shall
prioritize the maintenance of the recycling equipment to
minimize the production down-time. BAY SHORE shall not be
held accountable for lost production in the event mainten-
ance is not timely performed.
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B. The COUNTY shall negotiate with purchasers of recyclables
for the price and terms to be received by the County.
C. The COUNTY shall negotiate with suppliers of transportat-
ion as to the freight charges for hauling processed recyclables
to market. BAY SHORE shall schedule the loading of authorized
haulers, and shall ensure the proper shipping documents are
prepared and forwarded to the County. The COUNTY will pay the
hauler for the freight performed.
D. The COUNTY may enter into contractual agreements with
cities within the county limits for the pickup of recyclables,
and assign the responsibility for servicing to BAYSHORE.
v.
COMPENSATION TO BAYSHORE
Inasmuch as the COUNTY receives all the proceeds from the
sales of recyclables, BAYSHORE is to be pAid for its services by
the COUNTY.
BAYSHORE shall bill the COUNTY monthly for all of its costs
associated with providing the contract services as specified in
Article III above, plus a management fee consisting of $300.00
plus 15\ of its operating expenses.
BILLING PROCEDURE
It is mutually understood that the COUNTY cannot advance
funds to BAYSHORE for BAYSHORE to administer the contracted
operations for the COUNTY. Therefore; it is mutually
understood and agreed by all parties that BAYSHORE shall
from time to time present invoices due from the COUNTY to
the BANK as collateral for advances under a Line of Credit
not to exceed $40,000 outstanding at anyone time. The
COUNTY shall remit payment of these invoices directly to the
BANK with proceeds applied directly to the outstanding loan
balance with any residual to be credited to BAYSHORE'S
Checking Account Number 1357-107760 titled "Jefferson
Recycling Project Account".
Interest incurred in using the Line of Credit for the
administration of this contract shall be payable by the
COUNTY to BAYSHORE.
VI.
INSURANCE
Prior to beginning work under this contract, the parties hereto
shall each provi~e Certificates of Insurance to the other as
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evidence that po1iciee providing the following coverage and
limits of insurance are in full force and effect.
A. BAYSHORE
GENERAL COMPREHENSIVE LIABILTY: With respect to liability
for injuries to or death of persons and with respect to
liability for destruction of or damage to property, the
insurance coverage shall be $1,000,000 combined single limit
and such coverage shall include the special provisions
listed below:
11 The COUNTY aha11 be named ae additional ineured and
the coverage shall be applicable to and protect the
COUNTY from any liability arising from or relating to
BAYSHORE'S activities relating to thie contract. Such
insurance shall be primary and other insurance main-
tained or carried by the COUNTY shall be separate and
distant and shall not be contributing with the insur-
ance listed hereunder.
2: Such insurance shall include a "Cross Liability" or
"Severability of Interest" clause.
3: Such insurance shall not include explosion,
collapse or underground exclusions commonly referred to
"XCU" hazards.
B. COUNTY
GENERAL COMPREHENSIVE LIABILITY: With respect to liability
for injuries to or death of persons and with respect to liability
for destruction of or damage to property, the insurance coverage
shall be $1,000,000 combined single limit and such coverage shall
include the special proviSions listed below:
1: BAYSHORE shall be named as additional ineured and
the coverage shall be applicable to and protect
BAYSHORE from any liability arising from or relating to
the COUNTY'S activities relating to this contract.
Such insurance shall be primary and other insurance
maintained or carried by BAYSHORE shall be separate and
distant and shall not be contributing with the insur-
ance listed hereunder.
2: Such insurance shall include a "Cross Liability" or
"Severability of Interest" clause.
3: Such insurance shall not include explosion,
collapse or underground exclusions commonly referred to
"XCU" hazards.
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VII.
BAYSHORE'S WAGE & BENEFIT STRUCTURE
BAYSHORE shall pay its employees the wage rates and benefits
as are generally found within the area. The salary, wage and
benefit structure as applicable to the employees of the recycling
operation shall be submitted to the Director of Public Works for
review and approval. Should there be no agreement between the
COUNTY and BAYSHORE as to the proposed structure, the matter
shall be referred to the American Arbitration Association under
its rules.
VIII.
WAGE AND HOURS LAW COMPLIANCE
BAYSHORE shall comply with all applicable prOViSions of the
Fair Labor Standards Act and any other legislation affecting its
employees and shall, at all times save the COUNTY free, clear and
harmless from all actions, claims and expenses arising out of
said Act and rules and regulations that are or may be promulgated
in connection therewith.
IX.
SOCIAL SECURITY AND OTHER TAXES
BAYSHORE assumes full responsibility for the payment of all
payroll taxes, and other forms of taxes or other payments
required by any County, City, Federal or State legislation which
are now or may during the term of the contract be enacted as to
all persons employed by BAYSHORE in performance of the work under
this contract and shall assume exclusive liability therefore, and
meet all requirements thereunder pursuant to any rules or
regulations that may apply.
X.
DAMAGE CLAIMS
The parties hereto shall indemnify and hold harmless the
other from and against all claims for damage, including but not
limited to claims for damage to property or claims of misrepre-
sentation in negotiations, due to the negligence of either party
or its employees, including court costs and attorney's fees, if
any.
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XI.
NON-DISCRIMINATION
BAYSHORE shall comply with the regulations relative to
non-discrimination, vhich are herein incorporated and made part
of this contract.
BAYSHORE shall not discriminate on the grounds of handicap,
race, color, or national origin in the selection of employees.
BAYSHORE shall not participate
in discrimination prohibited by
including employment practices
program set forth in the respective
either directly or indirectly
the respective Regulations,
~hen the contract covers a
Regulations.
XII.
OTHER OBLIGATIONS
The parties shall conduct monthly meetings to review and
plan operations.
Upon written notice, BAYSHORE shall correct any deficient
work performed by it on the contract within a reasonable time.
XIII.
TERMINATION OF THIS CONTRACT
Either Party, for any reason whatsoever, may terminate this
contract by giving written notice to the other party by certified
mail. The contract shall terminate ninety days after the notice
is given. During the interim period the contract shall remain in
full force and effect. The COUNTY shall be obligated to reim-
burse BAYSHORE for services performed and expenses incurred
at the rates set forth in the contract, less prior interim
payments, if any, during that period.
Further,in the event of termination of the contract, neither the
COUNTY nor BAYSHORE shall be obligated to relinquish its respect-
ive rights under the terms of the Referendum 37 grant provided
for initial start-up of the Project.
Upon termination of the contract, all documents, records and
file materials shall be turned over to the COUNTY by BAYSHORE.
XIV.
ASSIGNMENT OF CONTRACT
RAYSHORE shall not assign this contract in whole or in part,
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Page 7
nor shall BAYSHORE subcontract any of the ~ork to be performed
hereunder ~ithout prior ~ritten consent of the COUNTY.
xv.
INDEPENDENT CONTRACTOR
BAYSHORE shall at all times
not an employee of the COUNTY,
compensation or benefits of
provided herein.
be an independent contractor and
and shall not be entitled to
any kind except as specifically
XVI.
AMENDMENTS
The COUNTY shall make changes within the scope of this
contract by giving notice to BAY SHORE and subsequently confirming
such changes in ~riting. If such changes affect the cost of, or
the time required for performance of the contact, an appropriate
adjustment shall be made. No change by BAYSHORE shall be
recognized ~ithout written approval of the Board of Jefferson
County Commissioners. Nothing in this article shall excuse
BAYSHORE from proceeding ~ith the performance of the contract as
changed hereunder.
XVII .
CONTENT AND UNDERSTANDING
This contract contains the complete and integrated under-
standing, agreement or negotiation between the parties. Any oral
or ~ritten representation not set forth herein is excluded.
Amendments hereto shall be set forth in ~riting and executed by
both parties.
XV II I .
ATTORNEY'S FEES
If the COUNTY brings any action or suit relating to the
enforcement of this contract or asking for any relief against
BAYSHORE, declaratory or other~ise, arising out of this contract
or if BAYSHORE brings any action or suit against the COUNTY for
enforcement of the contract or asking for any relief against the
COUNTY, declaratory or other~ise, arising out of this contract,
then the prevailing party in any of these events shall be paid
its reasonable attorney's fees and costs and expenses extended or
incurred in connection ~ith such suit or action.
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pa ge 8
XIX.
GOVERNING LAW
This contract and the right and obligations of the parties
hereunder shall be governe by the laws of the state of Washing-
ton.
XX.
AUTHORIZED REPRESENTATIVE
In reporting the services defined herein, BAYSHORE shall
report to:
Gary A. Rowe
Director of Public Works
1820 Jefferson Street
P.O. Box 1220
Port Townsend, Washington 98368
BAYSHORE'S authorized representative and address is:
Charles H. Adams
Executive Director
P. O. Box 1159
Port Townsend, Washington 98368
XXI.
NOTICES
Any notice given by either party to the hereunder shall be
served, if delivered in person, to the office of the representat-
ive authorized and designated in writing to act for the respect-
ive party, or if deposited in the mail, properly stamped with the
required postage and addressed to the office of such representat-
ive as indicated in Paragraph XX. Either party hereto shall
have the right to change any representative or address it may may
have given to the other party by giving such other party due
notice in writing of such change.
XXI I.
CONFLICT WARRANTY
BAYSHORE warrants that it has not employed or retained any
company, firm or person, other than a bona fide employee working
solely for BAYSHORE, to solicit or secure this contract, and that
it has not paid or agreed to pay any company, firm or person,
other than a bona fide employee working solely for BAY SHORE any
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Page 9
fee, commission, percentage, brokerage fee, gifts or any other
consideration contingent upon or resulting from the award of
making this contract. For breach or violation of this warranty,
the COUNTY shall have the right to annul this contract without
liability.
APPROVAL OF CONTRACT
This contract shall become effective on November 1, 1988.
Executed this 7?::!- day of \;Jz~-.~_,.tt-l.4/' , 1988.
BOARD OF COUNTY COMMISSIONERS
SEAL:
a8~,~/
B. G. Brown, Chairman
L~~;;'/7$) .
-a/b.' '~
Larry wo10ennison, Member
~~-e {!~~.............
George Cc1Brown, Member
ATTEST:
(2, j, rP.7/?
~rd-tne C. Bra'gg')/7.b"J
Clerk of the Boara-
A:;;:;;;?M: _
("59R"n F. Ra]'mobd
~rosecuting At ney
By:
fl~~
Bayshore Enterprises, Inc.
~
Secretar
Bayshore Enterprises, Inc.
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
SPECIFICATIONS FOR TWO USED PASSENGER VEHICLES
1987 MODEL YEAR OR NEWER
Bid call for furnishing the Jefferson County Department of Public
Works, Equipment Rental Division, with Two (2) used passenger
vehicles.
GENERAL SPECIFICATIONS
It is the intent of these specifications to describe a passenger
vehicle in sufficient detail to secure bids on comparable vehicles.
All parts not specifically mentioned, which are necessary to
provide a complete vehicle, shall be included in the necessary to
provide a complete vehicle, shall be included in the bid and shall
conform in strength and quality of material and workmanship to what
is usually provided to the trade in general. The vehicles shall be
a 1987 model year or newer.
Any units not conforming to these specifications will be rejected.
It is the responsibility of the bidder to conform with the
requirements unless deviations have been specifically cited by the
bidder and acceptance made on the basis of the exception.
PICKUP AND DELIVERY
The bidder shall indicate on the proposal the time for pickup or
delivery after award of the contract. The time indicated shall be
a factor in determining the successful bidder. The bidder shall
indicate where the county can take possession of the vehicles or
whether the vehicles will be delivered to the county maintenance
facility in Hadlock, Washington.
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JEFFERSON COUNTY - USED VEHICLE BID SPECIFICATIONS
REQUIRED MINIMUM SPECIFICATIONS FOR V:".:!CLES
1.
ENGINE:
(a) 3.8 liter. 6 cylinder minimum
2.
DRIVE:
(a) Front wheel drive. preferred.
3.
TRANSMISSION:
(a) Automatic.
4.
SEATING:
(a) Front bucket-type seats preferred.
(b) Rear Bench-type seat.
5.
MILEAGE:
(a) Total miles on 1987 model year vehicles shall not
exceed 35.000 miles on anyone vehicle proposed with
the average for all four vehicles not to exceed 32.500
miles. Lower mileage is preferred.
(b) Total miles on 1988 model year vehicles shall not
exceed 30,000 miles on anyone vehicle proposed with
the average for all four vehicles not to exceed 27,500
miles. Lower mileage is preferred.
6.
WARRANTY:
(a) The bid proposal shall indicate the type of warranty
proposed and the duration thereof.
7.
CONDITION
(a) Vehicles will be acceptable with normal wear and tear.
Total cumulative damage to the vehicle body and
interior shall not exceed $1.000.00. Jefferson County
reserves the right to inspect vehicles and obtain
expert opinions from third party individuals as to the
condition of the vehicles. inclusive of all mechanical
parts.
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JEFFERSON COUNTY - USED VEHICLE BID SPECIFICATIONS
(b) The bidder shall provide maintenance history on
vehicles upon request of the county.
8.
COLORS:
(a) Bidder shall state color on proposal. Jefferson County
reserves the right to reject vehicles based on color
alone.
9.
TYPES OF VEHICLES:
(a) The proposal shall be for two vehicles of the same make
and model. Alternatives for different vehicles may be
proposed but must be for Two vehicles of the same make,
model, and year.
10,
OPTIONS:
(a) Bidders shall submit an itemized listing of the vehicle
options included with each vehicle bid.
(b) Substitutions: Bidder may, at his options, substitute
vehicles that exceed the specifications of the units
bid provided that no increase in the bid price will be
allowed. Substitutions shall be approved by the
county.
11.
SALES TAX:
(a) The bid is subject to Washington State Sales Tax,
12.
ACCEPTANCE:
(a) Jefferson County reserves the right to inspect all
vehicles and accept or reject the vehicles upon
inspection.
(b) The bidder may make such repairs or modifications as
deemed necesaary in order to make the vehicles
acceptable to the county.
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JEFFERSON COUNTY - USED VEHICLE BID SPECIFICATIONS
PROPOSAL
Alternate No.
To:
Board of Jefferson County Commissioners
Courthouse
Port Townsend, WA 98368
Commissioners:
The undersigned hereby certifies that he has read and understands
the specifications, and offers to furnish Jefferson County with:
TWO (2) USED PASSENGER VEHICLES, 1987 OR NEWER
as specified for bid. Any deviation form the specifications is
shown on a separate sheet and is made part of the bid.
Make
Model
Year
(Please attach specifications and options included on a separate
sheet. )
Warranty period
Total price $
Sales Tax $
GRAND TOTAL PRICE $
l____J Vehicles to be picked up by Jefferson County at the
following location within _____ days after award of
contract:
[____J Delivery to Jefferson County within _____ days after award
of contract.
COMPANY NAME
ADDRESS
Signature of Authorized Official Title
Dated this ______ day of 1989,
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JEFFERSON COUNTY -. USED VEHICLE BID SPECIFICATIONS
PROPOSAL
Alternate No.
To:
Board of Jefferson County Commissioners
Courthouse
Port Townsend, WA 96366
Commissioners:
The undersigned hereby certifies that he has read and understands
the specifications, and offers to furnish Jefferson County with:
TWO (2) USED PASSENGER VEHICLES, 1967 OR NEWER
as specified for bid. Any deviation form the specifications is
shown on a separate sheet and is made part of the bid.
o Row;.)
Make 'Fa RD Model VI'c.7o~/.-'1 L)(. Year ("'I ~k
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GRAND TOTAL PRICE
$ 13,'103.3;;>"
[~l Vehicles to be picked up by Jefferson County at the
following location within ~ days after award of
contract:
[____1 Delivery to Jefferson County within _____ days after award
of contract.
COMPANY NAME f/€K'72. e/!-/f S/7lL.~S
ADDRESS
/f(.,:;L.s; "Deo:;. /"1U,.....V8 S !A/,04-V So,
IE,;? 77'<-6
W/l. '1 !?/4-!?
Signature of Authorized Official
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Dated this ~ day of /'-1"I.V , 1969,
Title
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JEFFERSON COUNTY - USED VEHICLE BID SPECIFICATIONS
VEHICLE OPTIONS INCLUDED IN BID:
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April 3, 1989
Gary Rowe, Director
Jefferson County Public
P,Q. Box 1220
Port Townsend, Wa 98368
Works
Dear Gary:
It has been several months since I discussed with you the
possible need to replace one of our jail vehicles. The Plymouth
4 door (white whale) was taken off line in March due to carbon
monoxide fumes entering the car, making it dangerous to officers
and prisoners. John Shold has been unable to determine from where
the fumes are entering the car and does not feel it would be a wise
investment of parts and labor for a car with this many miles. The
vehicle was originally purchased from WSP for a minimum amount, two
years ago and has served its purpose well transporting prisoners
from allover the State and has many times been used during our of
state extraditions from as far away as New Mexico.
I understand that one of your concerns is "why does the
Sheriff need two jail vehicles", Let me assure you that there are
many days when we have two, and sometimes three, corrections
officers transporting adult prisoners, juveniles, mentals and
alcoholics by court orders allover this State. It is not
uncommon, on Friday's Superior Court calendar to have the jail van,
jail car and the civil deputy's car filled with prisoners in route
to the courthouse.
At present, the jail is using the civil deputy's car and Woody
is using one of the patrol units, because we have one deputy
attending an 11 week Basic Law Enforcement Academy and he chose to
take his own personal car at no cost to the county.
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April 3, 1989
Page Two
In January, Ed Sasser and John Shold personally checked with
WSP and found that they are eliminating the small Ford LTD IIs,
like the one Pete Piccini is driving, from their fleet. The LTD
II is considered, by many, to be too dangerous to drive on wet or
icy roads because of its erratic characteristics and therefore, we
don't want one.
My suggestion would be to purchase a used midsize 4 door car
from one of the major car rental companies for the civil deputy and
install a screen because the car will continue to be used in
transporting of prisoners when needed. The jail would then
continue to use the Ford that has been assigned to the civil
deputy. Considering the Ford's condition, it should be serviceable
for maybe two more years.
The County Commissioners also authorized the hiring of a full
time detective starting July 1, 1989, so the Sheriff's Office will
also be needing another vehicle equipped with radios, etc. I
suggest that this car be a used mid size purchased, if possible,
from a rental company.
I would like to discuss the vehicles and explore options with
you. You can call me at home or stop by at your earliest
convenience.
)t~r; your..
l~l;~fford' Sheriff
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National
Car Sales
National Car Rental System. Inc.
19707 Pacific Highway South
Seattle, WA 98188
(206) 433-5509
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l]b"ti'~U11f.ill.UlW@LS
500 NORTH MERIDIAN STREET
INDIANAPOLIS. INDIANA 46204.1275
POBOX 1636,46206.1636
PHONE (317) 262.6288
BOILER & MACHINERY
July 31,
19RC/
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Jefferson County
Courthouse
Port -rownsend, Washington 98368
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Re: Policy: BM 993-952
Location 001: Jefferso" St. at Walker St.
Port Townsend, Washington 98368
I t em : 00 1
Gentlemen:
On June 14, 1989,
Fire Tube Boiler.
found.
we performed an inspection on your West Coast,
The following unsatisfactory condition was
WA 11388/52W - West Coast - Fire Tube Boiler
An accumulation of loose scale was observed in both water
legs. This scale should be removed and the boiler thoroughly
washed before being returned to service.
May we please have your cooperation in the completion of the above
recommendation. When the recommendation is completed, please
notify this office so our records can be cleared.
Sincerely,
TE5 IN5URANCE COMPANY
Department
ALG/tag.ROI
cc: Homer Smith Insurance, Inc.
Bill Round
Vivienne Fields
AMERICAN STATES INSURANCE COMPANIES
AMERICAN STATES INSURANCE COMPANY . AMERICAN ECONOMY INSURANCE COMPANY . AMERICAN STATES LIFE INSURANCE COMPANY
AMERICAN STATES INSURANCE COMPANY OF TEXAS . AMERICAN PREFERRED INSURANCE COMPANY
AMERICAN UNION INSURANCE COMPANY OF NEW YORK
A Membor at Lincoln National Corporation
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MASTER LEASE CORP< ~ r ~?J ~
ONE PRESIDENTIAL BOULEVARO . BALA CYNWYD. PENNSYlVAI s:/u.,,~.
eo I.,
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RE:
Lease Number:
Equipment:
A'5' "'10. 9~ II
fV\eal-\.N P\-\br...JtS
4;>",,=^,,-
Dear
AOIi?'.cANNE
I am writing you in reference to the above lease which has recently
reached expiration. You indicated that you would like to
return the equipment to Master Lease. Please use the enclosed
shipping labels and ship the ~E~l--\;" :
MASTER LEASE CORPORATION
2162 Reiser Avenue SE
New Philadelphia, OH 44663
The equipment on the enclosed schedule would have to be
properly packaged so that it is not damaged in transit. All
equipment must be returned in good working condition. YoU-Wi11
be required to compensate Master Lease for any damaged or
missing equipment. Ship the equipment via the United Parcel
Service (UPS) and prepay all shipping costs. Please enclose
the yellow packing list inside the box.
As you know, the current amount due to Master .ase along with
the return of the equipment is S -z..z.. '2..'3 An invoice is
enclosed for your convenience. ~ paym-ents would have to be
mailed to Master Lease at One Presidential Blvd. Please do not
enclose any payments with the shipment of ~he phones.
If you have any payment questions or need assistance with
packaging, identifying, shipping or disconnecting the phone
system please call me at 1-800-535-2200, extension '395
Sincerely,
7~~
~~~
Customer Sales Representative
-~-'19Il<1~~\i~.l}\t~1I#.1iio11,g;~,.1~'i>ll'.D~~~~'"E'}~~~'Jt\!.~.oo;m~~'W'i/~'jj~W'..-.n'''''''' l ""
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MASTER lEASE CORPORATION
EQUIPMENT RETURN AUTHORIZATION AND PACKING LIST
@)
NQ
8842
FROM: J e F'r-E!/Z<<"D!'J (..olhNl"-l ?" o'>ClC.....
2.. 0 C\ G?v. ,..i c-'-\
f'~\ -r~~\'!r...t::>. 'NA C\1>~Io~
TO:
DATE: c.. /, 1't'9
MASTER LEASE CORPORATION
2162 REISER AVENUE S E
NEW PHILADELPHIA, OHIO 44663
RE: LEASE #; AS' "'\ o. C\1,1\
LESSEE: ..)e=,:re,<c;.D.-J ~.
The following Is a list of phone equipment to be returned to Master Lease Corporation from the above
referenced lease.. Please Insure that the phone equipment is safely packed to avoid any damage to the system.
Ship the equipment to Master Lease Corporation via United Parcel Service (UPS) by using the enclosed
shipping labels. If you have any questions. please call Barbara Phipps at 1-800-535-2200.
OFFICE USE ONLY
.
PRODUCT
Merlin 5 Button Phone
3160-111
Merlin 10 Button Phone
3161 -172
Merlin 10 Button HFAI
3161-161
Merlin 34 Button Deluxe
Phone
3162-417
Merlin 34 Button Phone
3162-412
Merlin Hands Free Phone
3163-HFU
206 Control Unit
6106-CU1
410 Control Unit
6110-CU1
820 Control Unit
6120-CU1
1030 Control Unit
6130-CU1
Feature Package 1
6100-FC1
Feature Package 2
6104-FC2
Music on Hold Cartlidge
6101-MOH
Music on Holdl
Paging Cartridge
6102-MHP
Additional Equipment
CUSTOMER
. TO BE CHECK. NUMBER INVENTORY CONDmON
RETURNED RETURNING RETURNED NUMBER A OR B
L.\
COLOR- (please note
number of each coIoq
BK WH BR BL Cl BU GF
r r
(I)
UNE CAPACItY
CARTRIDGES
.
.
.'
Date Received:
TU - SI ~ RECV - 8.0.
Any Additional Information:
.Color Cod~ 61< . Black, WH . White. BR . Brown. CI . Cinnabar. au . Burganc
GR . Gray
Distribution: while - file I yellow - pack IIsl I pink - lessee copy I goldenrod - warehouse
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==-=,= ServicePlan'"
ServicePlan Offerings
~
ServicePlan Offerings Selection Page
International Business Machines Corporation (IBM) is pi eased 10 offer the Customer (you) the
SelvicePlan Offerings listed below. You may select one or more ServicePlan contract Otrerings by
initialing the spaces indicated and signing below. IBM will issue a confirming document for each
Offering 10 confirm your selected service coverage. Contracts previously executed and sUII in effect
will continue until expiration or termination, and need nol be initialed. The information in parentheses
below indicates the current contract version number for each Offering you initial.
~
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IBM MA IMA V327S-02)
MUltiple Vendor Services
(MVS V4,SO.01)
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l\lA FinalH.'i:11 Options
EMO (EMO V4140.01)
CSA (CSA V3927-03)
MRSA (MRSA V4035-01)
VMA (VMA V3777-01)
CFMS (CFMS V3333-03)
-C:;o
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hnoicing Options
Estimated Billing
(EB V4116-00)
12 J..L e9 12: 2il
SM Service mark of InletnaUon..1 Business M..chinl!s Corporation
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Nelwork Support
(NS V4173.01)
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Professional S('n'kc.c;
(Including Customized Operational
Services)
~ Agreement for IBM
- Professional Services
(PS V4193-QO)
~
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Information Network Ser\'icl'.";
IBM Information Network
Agreement (18M
IN V3242.03)
THE PARTIES ACKNOWLEDGE THAT THEY HAVE READ EACH AGREEMENT AND AMENDMENT
DESIGNATED BY YOUR INITIALS, AND INCLUDED HEREWITH, UNDERSTAND THEM, AND AGREE TO
BE BOUND BY THEIR TERMS AND CONDITIONS.
Accepted by:
International Business Machines Corporation
::monk' Ne~, Yor2. 04
Dave D. Despard
Namo (Typo or Print)
7/12/89
Oall!
AglPl!ment No.: ND58931
IBM Branch Ollicn No.: 410
IBM NSD 410
lAM Branch Orhcl!Addres!. 4800 South 188th Way
Seattle, WA 98188
SP 2125-4204-00 1/89
Jefferson County Courthouse
Cu!.tomerNaml!
BY~~ ~z::.. .
Authorized Signature
~&/'/&" .t3.r<"'JA1-n
Name (Type or Print)
~ ..J:l.4-7
, Date
Customer No.: 4715123
Customer Addreu: Jefferson County Courthouse
1820 Jefferson St.
Port Townsend, WA 98368-0920
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ServicePlan'M
Professional Services
6d'
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'!- ~~:;~
Agreement for IBM Professional Services
You .and IBM Olgree 111<11 the terms ilnd condilions in this Agreement and <lny applici1ble Statement of Work
(SOW) will apply 10 IBM Professioll,11 Services (Services) which IBM provides 10 you.
1. Associated Contract Documents every effort 10 honor your specific requests reg:lrding the
nssignmcnt of IBM personnel; however, IBM reserves lhe
sole righl 10 determine the assignment of its personnel
IBM personnel shall not be restricted or prevented from
performing services for olhers that are similnr 10 the
Services provided for ;any Project
The SOW will describe your project (Projccl) including
the Scope of Services thilt IBM will provide to you in
response to your request for Services and any other
applicable terms. A sepilr..te SOW will be required for oilell
Project. The SOW will become subject to this Agreement
when signed by you and IBM. IBM will IlHHlilge each
Project unless the SOW specifics th:lt you will m:ln:lge the
Project and IBM will only provide Services to assisl you.
The SOW will specify an Estimated Schedule for eilch
Project. The Eslill1nted Schedule is provided for planning
purposes. Both pnrties agree to make rcason[lblc cfforts to
perform their responsibilities in accordancc with such
Schedule. Services will begin on or about the Sli'lrt Dale
specified in the SOW and will end llpon accomplishment of
the Complelion Criteria as set forth in the SOW. The term
"Completion Criteria" means detailed, written conditions
thaI IBM is required to meet to satisfy its obligations under
thi s Agreement.
2. Changes to Statement of Work
Either party may request a change 10 a SOW. Either
party, if requested by the olher, will submit its change
request in writing. IBM will prepare a written Change
Authorization which will describe the requesled change llnd
set forth any modifications to the terms of the SOW. Any
change In the SOW may result in a change to the Charges,
Estimated Schedule 01' other terms.
Depending 01) the extent and complexity of the
requested change, IBM may charge you for the effort
required 10 analyze a requested change. In such instances,
IBM will notify you in writing of the estimated charges for
such analysis. You must notify IBM in writing to proceed
with such analysis.
Either party may require that the Change Authorization
be signed by both parties. Otherwise, the change will
become part of the SOW when IBM provides you with a
copy of the Change Authorization. The Change
Authorization will modify and take precedence over llny
inconsistent lerms of either the SOW or any previous
Change Authorizations.
3. Charges
Each SOW will specify the Charges applicable for the
Services that IBM will provide to you. IBM will invoice you
as specified in the SOW, You agree to p;ay such Charges as
specified in the invoice. Such Chnrges will be exclusive of
any taxes.
4. Taxes
Vou agree to pay <'lmounts equal 10 any tm:es, including
personal property laxes, resulting from this Agreemont.
Such t4'1X<'5 will nol include taxes bi'tsod on IBM's net
Income.
5. Personnel
Each pnrty will designate an individual for each Project
who will hjive the authority to represent their respective
party il) ..II mailers concerning such Project. All Project
related communications should be addressed to Ihe
flppropriilto ueslgnated individual. If eithor party replaces
its designated Individual. thilt p;lrty Shill! promptly notify
the other In writing 01 such rCl'lilcomenl.
Each pnrty will be responsible for the supervision.
diroction and control of its own personnel. IBM will make
PS Z125-4193-00 1/A9
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6. Confidential Information
The pilrties agree thai all information oxchnnged will he
nonconfidcntial. If a Project requires the exchange of
confidential information, such exchange will be mi1do lJndr>r
a separate IBM agreement.
7. Ownership and License
IBM may deliver materials to you for a Project under
this Agreement. Materials include, but are not timited to.
programs, program listings, programming tools.
documentation, reports and drawings. IBM will Identify in
the SOW Ihe materials 10 be delivered to you as "Type I
Materials" or "Type II Materials."
IBM grants YOll title. including ownership of copyright,
to lhe materials identified as Type I Materials. IBM will
retain one copy of all Type I Materials Clnd you grant IBM
an Irrevocable. nonexclusive. worldwide. paid-up right and
license to use, execute, reproduce. copy and display such
Materials and 10 prepare derivative works b<'lsed upon such
Materials, IBM will also have the right to sublicense SUell
Materials and any such derivative works created by IBM.
In addition, IBM may market and distribule copies of such
items.
IBM or third parties retain litle, including ownership of
copyright, to all materials identified as Type II Materials.
However, IBM grants you title 10 the copies of Type II
Materials IBM delivers to you. No license is granted or
implied with respect to Type II Materials delivered to you.
Such copies arc subject tn the provisions of the Copyright
Laws of the United States.
Those materials delivered to you. not specifically
identified in the SOW as Type I Materials or Type \I
Materials, will be deemed to be "Type III Materials." To the
extent that IBM has an interest in Type 111 Materials, such
Materials, including any intellectual properly rights therein.
will be jointly owned by you and IBM without accounting.
Any ideas, concepts. know-how or techniques which
rei ale to the subject matter of this Agreemenl and are
developed or provided by either party or jointly by both
parties during the course of a Project may be used by
eilher party in any way lhey deem appropriate.
8. Inventions
The term "'nvention" shall mean any idea, concept,
know..how or technique that either party first conceives or
reduces to practice while in performance of Services during
the term of a Project and for which a patent application is
filed, Inventions will be treated as follows:
1. if made by your personnel. it shall be your property.
You grant IBM a nonexclusive, irrevocable, worldwide
and paid-up license under such invention, patent
application and illl patents issued thereon;
2. if made by IBM personnel. it shalt b~ IBM's property.
IBM grants you a nonexclusive, irrevocable, worldwide
and paid..up license under such invention. palent
application ;llld all p.,tents Issued thereon: and
3. if made by the personnel of both p:uties. it and all
patent applications filed therefor and all patents isslling
thereon shrlll be jointly owned by the parties without
Page 1 of 2
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'!CCOllllling. E,ilr.h pill!Y shall !l:wo lhe rlulll 10 grnnt
licenses 10 1hlrd pill lies 01 Il!'>sinn ils rights therein
without the COil sent 01 the olhe/.
All licenses grnnlcd 10 either pnrly will include Iho riOll1
10 Illilke, have made. use, hi1vC used, lease, sell nnd/or
otherwise trnnsfcr ,my ilppmillu5, ilnd/or practice [Inti have
p~ncliced m,lY method and sh<111 include tho right to 9r[ll1l,
dlrcclly or Ilu.hrcclly, revocable or irrcvoc:nblc sublicenses
to such party's Subsidiaries.
Nothing cont.lined ill Ihis Agl cement Shilll bo deemed
10 granl any license under .my pntont or plltonl applications
mising out of any other invcntiolll; of either pnrty.
9. Subsidiary
For the purposes or this Agreement the term
"Subsidiary" shall moan n corporntion, company or other
entity:
1. more than 50% or whose outst:mding sh:1rcS or
securities (representing the right to vote for the
election or directors or otller rnc1nngillg authority) arc
now or hereafter owned or call trolled, directly or
indirectly, by a party hereto; or
2. which docs not have outstanding shnres or securities,
as may be the case in a pnrtnership, joint venture or
unincorporated association, but more than 50% of
whose ownership interest representing the right to
make the decisions for such corpornlion, company or
other entity is now or herenfler owned or controlled,
directly or indirectly, by a p<lrty hereto.
Such corporation, company or olher entity shall be
deemed to be a Subsidiary only so long as such ownership
or control exists.
10. Termination of Projects
You may terminate a Project by providing wrillen notice
to IBM. If you fail to meet your ob1ignlions under this
Agreement, IBM may terminnte j] Project by providing
written notice to you. Upon your or IBM's receipt or such
notice, IBM will terminate all tasks for such Project in an
orderly manner, as soon as practical or in accordance with
a schedule agreed to by you and IBM.
You agree to pay IBM for Services provided through
the termination of all tasks for Ihe Project. Such payment
will include any terminaUon charges set forth in the SOW
and <lny charges IBM hilS incurred in terminating
subcontracts.
All Materials developed through the lermination of all
tasks for the Project will be delivered to you in accordance
with Section 7.
11. Disclaimer of Warranties
THIS IS A SERVICE AGREEMENT. THERE ARE NO
WARRANTIES. EXPRESS OR IMPLIED. THIS DISCLAIMER
INCLUDES, BUT IS NOT LIMITED TO, THE IMPLIED
WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A
PARTICULAR PURPOSE.
12. Limitation of Remedies
IBM's entire liability and your exclusive remedy for
dmnages resulting from IBM's performance or
nonpcrform;ll1ce, wt1ich is relnted in ;my way to the
Services provided under a SOW under this Agreement, will
be your recovery of aclual damages to the limils set forth
in this Section. IBM's linbility for aclutll damaRos from any
cause whatsoover will be limited to tho groater of 1}
$100,000 or 2) an amount eqlJillto the Chnrges invoiced for
the Servico!'. which ilro Iho subject maltcr of, or "1'0 directly
relaled to, tho cause of action. Tho Iimitl'llion will apply,
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PS Z125-419~-OO 1189
L
oxcept as otherwisc staled in this Sectioll, regnrdJcss of the
form. or ar.ljon~ w.he.lfle! in ~ontracl or in tort including
negllge~ce.. :rhls Ilmllallon will not apply to c1ilims by you
for bodily lI1Jury or dilln.lgC 10 real property or InngibJo
persol1al property for which IBM is legally liable.
In no event will IBM be liable for llny lost profits. losl
si1vings, incidental damages, or olher economic
consequential damages, even if IBM hns been advised of
the possibility of such damages. In addition, IBf..1 will not
be liable for any damagcs c1r1imed by you bascd on any
third parly claim. In no event will IBM be li;lble for any
d;lmagcs caused by your failure to perforrn your
rcsponsibilities.
13. General
The term "Professional Services" in this Agreement
does not mean that IBM personnel are licensed by any
governmental body or agency to perform the Services
lInder this Agreement.
You may not assign this Agreemcnt or rem,uket
Services provided by IBM under Ihis Agreemenl without the
specific wrillen permission of IBtA. Any attempt 10 assign
any of the rights, duties or obligations under this
Agreement is void.
You agree to provide furl. free and safe access to IBM
for the performance of Services. You represent that you
arc not aware of the presence of any unsafe condition or
hazardous materials at any Project work location. If you
become aware of the existence of any unsafe condition or
hazardous material, you will promptly notify IBM in writing.
IBM may provide Services by the use of IBM.selected
independent contractors.
Neither party will be prohibited from entering into
similar agreements with others or from developing and
providing materials or services which are similar to those
Services provided under this Agreement.
Ench party shall be released from its obligations under
this Agreement or a SOW to the extenl that the parly is
prevented from performing its obligations due to
circumstances beyond its control.
~Jeither party may bring an action, regardless of form,
arising out of this Agreement, more than two years after
the cause of action has arisen. IBM m<lY not bring an
action for nonpayment more than two years after the date
the last payment was due.
IBM may modify the terms and conditions of this
Agreement upon written notice to you, Any such
modification will apply to any SOW which both parties sign
after the date of notice. Otherwise, only a written
agreement signed by authorized persons can modify 1I1is
Agreement.
Either party may lerminate this Agreement by providing
one month's wrillen nolice to the other following the
completion or termination of all Projects. Sections 3, 4, 5,
6, 7, 8 and 12 and any other provisions of this Agreement,
which by their nature extend beyond the completion or
termination of a Project or the termination of this
Agreement, shall remain in effect beyond such completion
or termination until fulfilled and shall apply to either parly's
successors and assigns.
In the evenl of conflict between this Agreement and a
SOW, the terms and conditions of the SOW shall prevail.
The laws of the State of New York govern this
Agreement.
, The parties agree that the complete and exclusive
statement of the agreement between the parties relating to
this subject shall consist of 1} thIs Agreement, 2) any other
applicable IBM Agreement(s}, 3) any Statement(s) of Work
and 4) Change Authorlzatlon(s), ThIs statement of the
agreement supersedes all proposals or other prior
agreements, oral or written. and all other communications
between the parties relating to this subject.
Page 2 of 2
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Statement of Work
(Custom Services)
Name nnd Address 01 Customer:
Jefferson County
P.O. Box 1220
Port Townsend, WA
IBM Branch OUicG Address:
Courthouse
Agreement No.:
ND58931
Y1363
Contract No.:
98368-0920
IBM Branch Office No,: 410
IBM Services Provider's Address:
Customer No,: 4715123
IBM NSD 410
4800 South l88th Way
Seattle, WA 98188
Estimated Schedule
51m! Dale, 06/26/89
End Dale' 06/26/89
Scope of Services, Completion Criteria. and olher applicable terms:
Charges, $250.00
(Described below)
You have selected the following services from IBM:
Machine Relocation/Rearrangement Services
The detail of these selected services are described in the
attached pages.
This Statement of Work will be withdrawn if IBM is not authorized
by 08/21/89 to perform these services.
-C,;D 'ilu _,
12 Jul 89 12: 2iJ
Page 1 of -L
The parties acknowledge that they have read this Statement of Work, understand it, and agree to be bound by its terms and
conditions. Further. the parties agree that the complete and exclusive statement of the agreement between the parties relating
to this subject shall consist of 1) this Statement of Work, including any attachment referenced herein, 2) the referenced
Agreement. 3) any other applicable IBM Agreement(s) and 4) any Change Authorlzation(s). This statement of the agreement
supersedes all proposals or other prior agreements, oral or written, and all other communications between the parties relating
to this subject.
By
Jefferson Countv Courthouse
Customer
BY~~K'
Authorl1:('d SIgnature
Dave D, Despard
4-/,6 -"..Ie;- ...?r6~.n'
Namt' (Type or PrlnO
~S:fAy
, Date
Name (Tyre or Prll1l)
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Servicos to be pedormed ill th(' following Locntion(s):
MACHINE RELOCATION/REARRANGEMENT SERVICES ATTACHMENT
Jefferson County Courthouse
1820 Jefferson St.
Port Townsend, WA
98368
1. SCOPE OF SERVICES
IBM will provide Iho following Relocation/Rearrangement
Services for the Machinc(s) and Customer Locnlion(s}
identified in this Alt3chmcnt.
The term "Machine" as used here refers to IBM lni1chines
andlor their features. and to selecled non~IBM machines.
Installation Services: IBM will assemble your Machine,
including the removal of any internal packing materials and
the interconnection of required IBM c:Jbles. IBM will lest the
Machine, including active IBM features, and install or
reconfigure the Machine diagnostics.
Discontinuance Services: IBM will prepare your Machine for
shipment in accordance with IBM's standard practices. IBM
will assist you in identifying Ihe items normally shipped with
the Machine, and, at your request. will place manuals,
diagnostics, covers, cables, small units and other items in
Shipping containers.
Rearrangement Services: IBM will disassemble and
reassemble your Machine in accordance with IBM's standard
practice for rearrangement of a Machine within the same
room. Cables, terminators, and other items will be
repositioned, as required. Such a move does not include
complete discontinuance and installation services and must
qualify for this service. IBM will test the Machine after
installfltion, including active IBM features.
Relocation Services: IBM will disassemble and reassemble
your Machine in accordance with IBM's standard practice for
movement of fl Machine within the same building. Such a
move does not include complete discontinuance and
installation services and must qualify for this service. IBM will
provide assislance to you in identifying lhe items which are
3. MACHINE LIST
Machine
Type
Model
Install
Quantity
Discontinue
Quantity
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5360
5225
Contract tJo.' Y1363
Service Brand) Office No.: 410
CUslomer No.' 4715123
Work Complelion Dale, 06/26/89
Charges: $250.00
(valid for 90 d:1Ys from Acceptance Date)
normally moved with lho Machine. IBM will tcst tho Machine
after instilllation, including active IBM features.
Physical Planning Services: IBM will provide Physical
PIi1nning Assistance in conjunction with Inslnllation,
Relocation, and/or Rearrangement Services provided under
this Statement of Work. Included will be recommendations
nnd advice on floor planning, cable requirements and layout,
air condilioning requirements, electrical requirements, and
safety requirements. This does not include the design or
testing of communications or instrumentation facilities.
Pre. Move Full Feature Test Services: IBM will tosl prior to,
and in conjunction with, Discontinuance, Relocation andlor
Rearrangement Services provided under this Statement of
Work. Testing will include all active IBM fcalurcs and selected
non-IBM alterations and attachments.
2, CUSTOMER RESPONSIBILITIES
You are responsible to ensure that your Location(s) is
ready for the Services described in the Section entitled
"Scope of Services."
IBM will honor your request lhat non-IBM personnel lay,
remove connect or disconnect the interconnecting cables
betwee~ Machines. However, any repair, delays or other
costs resulting from such non-IBM activity will be charged to
you at IBM's hourly service rates and terms.
You are responsible for charges for repairs to 1) correct
machine malfunctions, unless such repairs are covered by an
existing IBM agreement, 2) correct the results of repair or
reconfiguration work done by others, 3) correct the results of
warehouse deterioration or visible transit damage. and 4)
replace missing parts or parts not furnished for the Machine
by IBM that require replacement.
Physical Planning (YIN)
Rearrange
Quantity
Relocate
Quantity
Pre.Move
Test
1
1
(This page may be duplicated If additional pages are required)
PS Z150.0429.01 3/89
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GOODMAN SEPTIC DISPOSAL
P.D.BOX 233
PORT TOWNSEND,WA. 98358
206-385-2557
J,=lnu,~H~.Y ;:3.'6~ 19tJ9
JEFFERSON CUUNTY PU8LIC WORKS
P_ 0_ BOX 12i::~lD
PORT TOWNSEND, WR. 9B3GB
3B~'-91 61ll
RE: CARTER BRUBKINS
\ GOODMAN SEPTIC DISPOSAL, l."i s'lbJ,'''ct t.:. ,'c'"K'V''' ,.11 "ff J ,.."",t
sludqe, ant1 ul'lwanted WZ....':5t€".::' f~~~onl thr~ lj,~jIlIV) Gal. SL'?pt ie l"loldi'ng
tc1.nk at ttle llHad],.:,ck COl~~"'eC't)('ll~.S CEn.tf:Jl~ll )Y1 Hadl.:)ck, W"i.
\f,:n... a pet"'llJd ,;)f, eVE't...y 5i;( (G) to t:?lf1ht (8) nK,nths , ':'t...
when evelM necessary, and no longer thaYI one yea," fror~ the
~bove date as agreed.
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JThe price for this service will be c,ur basic cOMmercial rate
at . 11 cents pel.... (-~vEn..y ga 1. p'~lfJlped.
That will include the
.~4 cents a gal. t"'equir~d by the JEFFERSOI~ CO. LANDFILL.
In the event of an increase in the JEFFERSON CO. LANDFILL
I will be forced to raise the LRNDFILL Charge accordingly.
GOODMAN SEPTIC DISPOSAL
BOBS 1" .JEVNE/ l...wnf3r-'
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\Repr-'esent<:'t.ive/PleasE~ sign arId r-'etIJt"l""l to thE:."? above add..
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Thanh: you {:..1gl~.in for~ ]1:~t:f;.in!J u.s S~€n"'Vi2 yell.l.
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GOODMAN SEPTIC DISPOSAL
P.O.BOX 233
PORT TOWNSEND,WA. 98368
2136-385-2557
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JAN 3 0 1989
JEFFERSON COUNTY
PUBLIC WORKS DEPT
JEFFERSON COUNTY PUBLIC WORKS
P. O. BOX )2<':0
PORT TOWNSEND, WR. 983GB
385-'" 1 G0
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GOODMAN SEPTIC DISPOSAL, is subject t", ,'er"".ve
all effluent
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sl udge, and I.\nw.:\nted wc:\ste ft~':'rn the 4::j1ll1Zl Gal.
septic h.:,lding
tal~d-<. c\t th~;. "Hcldlocl<. C:r::q~l~eC't:i':lrl!:=-' Cel'd;c'l~" in
Had l.:'ck, We\.
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f':'l~ a pet"i.:od 1:lf, eVl?I'Y s1>< (5) tel ei!]ht (8)
nlonths , ':'1"
when evet" necessBr"y, al""ld r.o:o }.:.ngel'''' thal~1 1:IY'lE' yea I'''' ft"':'m the
":'.
abovE' date as agr~eed.
The pt"icE? fen" thi.5 set"vice
will be OUt" basic commercial rate
at .1:1 cents pet~ evet~y gal. pumped. That wi}] i'r'"lcll.tde the
f'.
{
.04 cants a gal. required by tt18 JEFFER8DI~ CO. LANDFILL.
In the event of an increasE' in the JEFFERSON CO. LANDFILL
(~t,
I will be forced to raise the LANDFILL Chat"ge accordingly.
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SaSSI JEVNE/ owner'
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Thc..lrlk y...,1..I ~lgc..1in for" let:t.ing us st-"'?r"vt? you.
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GOODI'lAI>l SEPT I C [) I Sr:'OSnL
P.O. BOX 23:;
PORT TOWNSEND, WR. 983GB
(206J 385-2557
SHnEf'IENT DRl E:
Qll/,,:f,/8'~
ACCOUNT I>lU~18ER:
88"11213(11
P>lGE:
Jeff.Co. Public Wo).ks
P. O. B.:.x 122(11
Had 1 I:'C I-t. J ail
Port Townsend, Wa 983GB
REFERENCE
Dt=lTE
DESCR I PH ON
CHt=lI/GES
CREDITS
BALANCE
IN~2101
Bt=lLRNCE FOHWt=lRD
01/26/89 CHt=lRGE
1293.50
0.0""
1293.60
o - 3(11
1293.60
31 - 60
0.0""
51 - 90
0.0121
OVER 90
0.00
AMOUNT DUE
1293.60
TER~IS: Net 30
Due Upon Invoice Receipt
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COPIER MAINTENANCE TECHNOLOGY ~l:?
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5009 PACIFIC HWY E. SUITE 12 FIFE, WA 98424 922-8516 874-1428 1-800-962-6506
AcountNam"j'EFf(~DN CO. lit,.. Pen:.., WK.'5>,
Address
Problem or Complaint
stJD
Zip Code
rJ<.,r-
MAIIJ 0-,,)1'"""-01- f'W,B.
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Customer P.O. #
Account #
.s-.vS I.
P,M. Due
L}-C! C-'OO
Time Repair Iifne
I."::>
Parts Used
Supplies Used
Oty,
Description/Part No.
Price Oty. Desctiptlon/Lot. No,
Price
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Total Paris Cost
Ne....
Total Supply Cost
Order
Parts Total.
Total Order Cost
Order Total
Labor
Tolal
labor
Hours
x$
Sub Total
%
Tax
I acknowledge that the unit has been satisfactorily repaired.
Work performed is guaranteed for 15 days of this report,
Maximum late charge as allowed by law will be applied to
past due accounts.
Pay This Amount
Terms Net 15 Days
Invoice Total
NC-
Customer Signature
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CONTRACT NUMBER:
CONTRACT TITLE:
FOR USE BY:
CONTRACT PERIOD:
E7i::./"?. 03.
i'~::.',~'{'11'1~r
RECEIVED
STATE OF WASHINCTON
DEPARTMENT OF GENERAL ADMINISTRATION
OFFICE OF STATE PROCUREMENT
FEB 2 7 1989
JEFFERSON COUNTY
PUBLIC WORKS DEPT.
CONTRACT CHANGE NOTICE NO, 4
135-87
COMMODITY CODE: 9170
Bulk Asphalt Products
Departments of Transportation and Corrections
and Political Subdivisions
July 1, 1987 THROUGH December 31, 1989
PURPOSE: Add New Vendor and Products
VENDOR CONTACT: See also, Attachment "A" ~ Vendor Identification
of Contract Change Notice No. 2
EfFECTIVE DATE: See Below
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CONTRACT PRICE: See also Attachment liB" of Contract Change Notice No. 2 for asphalt
products and FOB Plant Prices. Prices are maximums and Vendors may
extend voluntary discounts for specific orders.
PAYMENT TERMS: Net 30 Days
DELIVERY: See also, Attachment "A" - Vendor Identification
of Contract Change Notice No. 2
FOB POINT: F.D.B. Plant; F.O.B. Destination - freight prepaid and added; or F.D.B.
Destination - freight collect.
REFERENCE: Department of Transportation Requisition 6R 2143 and memorandum dated
November 7, 1988; completed contract with Idaho Asphalt Supply and
vendor letters dated November 16, 1988 and November 17, 1988.
EST. CONTRACT VALUE: $400,OOO,00jYEAR
REMARKS:
MW8E PARTICIPATION: $400,OOO.00jYEAR EXEMPT - 100% EXEMPT***
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CHANGE NOTICE NO, 4
NO. 135-87
1. Rubberized Asphalt: Special Asphalt Products #1153 Crack and Joint
Sealant. Heets ASTH 01190 and AASHTO H173 requirements, Price:
$ .285 per pound F.O.B. Portland, OR.; or $ .29 per pound F,O.B. Seattle,
lI"A.
2. Rubberized Asphalt: Special Asphalt Product #3453 Crack and Joint
Sealant., Heets ASTH 03405-78 and Fed. Specifications SS-S1401B, Price:
$ .355 per pound F.O.B. Portland, OR; or $ .36 per pound F.O.B. Seattle,
lI"A.
4. All other vendors, products and prices remain unchanged.
STATE OF WASHINGTON
DEPARTMENT OF GENERAL ADHINISTRATION
OFFICE OF STATE PROCUREHENT
R~~.~~&a
Robert Paulson, Jr., .P.M., Buyer
Purchasing and Contract Administration
Phone: (206) 753-1040 Public
234-1040 SCAN
RP:dls
*AS DEFINED IN RCII 43'.19.190(2)
**THOSE PROPERLY REGISTERED WITH OSP IN
ACCORDANCE lI"ITH RClI" 39.34 & OSP POLICY
***NONCOHPETITIVE CONTRAGTS
~
Co.. t'(;;l"l:. Chl" jC Not:< ~
,,, . ,,"'...,tftI -0"
'''ii:t BID CATALOG
COHTRACT 810 HO,~
ASPHALT PRODUCTS
1. L1quld Asphalt
Hedlllll-Cur Ing (MC)
Me-70
Me-250
MC-800
MC-3000
Rapid-Cur Ing (Re)
RC-70
RC-250
RC -800
RC-3000
II. Paving Asphalt
AA-2000W
AR-4000W
111. Emulsified Asphalt
51 ow-Sett Ing
C5S-1
CSS-Ih
I'\<Jdil.l11.5etting
CMS-2
CMS-2h
Rapid-Sett Ing
CR5-l
CRS-2h
CR5-2
CM5-2s
HFE-9O
HFE-1OOs
HFE-ISO
Special T~ck
STE-l
IV. Rubber 1 zed Aspha It
Produc t: C;e.S~:LP
;1/0. If
Compan) MlIIIe: GA. o..h.v As P#AL7
Plant Loclt Ion: "r "A~ . 'PAN.,S <.II',
M::d V32..r P;-!/t!/ii' .;'.".
--...
Order Phone: (208) 77 '3 - 01> '...:i
S /~O.oO/ton
~O..- Iton
o. h Iton
". - Iton
S /60." Iton
~ /(. o. ""/ton
S /~D,"'lton
S /60." Iton
s I~o.'. Iton
S I '10." Iton
S /~... Iton
S /1-0.~. Iton
S 12,). ". Iton
S /7.0. or Iton
S / ;lo. ,o/ton
S /2. o. o. Iton
S /2 O. r~ Iton
l /zt.>. 00 Iton
S-LZO.'" Iton
S No /JIo Iton
S /2..0. "" Iton
S Alo alP Iton
rllJ.h..,~%.J) Q,.,J5I~>- S / t 0.00 I~ 70N
V. Other
-';;I!F /" /3..,11<
c f!. "olAF. d I~fo ,$'9.J..., d"'rwk
Above prices are F.O.B. Plant.
or F.O.B. Destination prices.
of prices.
S p3. 5"olton
l 7/. ge Iton
S Iton
Contact vendor for estimated freight charges
Vendor may vOluntarily allow freight equalization
-
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NUMBER:
135-87
COMMODITY CODE: 9170
FOB
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CONTRACT CHANGE NOTICE NO. 3
CONTRACT TITLE:
Bulk Asphalt Products
FOR USE BY:
Departments of Transportation, Corrections and
Political SUbdivisions
CONTRACT PERIOD:
July 1, 1987 THROUGH December 31, 1989
PURPOSE: Vendor Name Change, Price Change and
Price Correction - See Below
VENDOR/CONTACT:
EFFECTIVE DATE: See Attachment "B" of Change
Notice No. 2
See Attachment "A" - Vendor Identification of Change
Notice No. 2
CONTRACT PRICES:
See Attachment "B" for asphalt products and
Plant prices. Prices are maximums and Vendors
extend voluntary discounts for specific orders.
Reference Contract Change Notice No.2.
PAYMENT TERMS: Net 30 Days
DELIVERY: See Attachment "A" - Vendor Identification
FOB POINT: Plant, F.O.B. Destination, Freight Prepaid and
Added or F.O.B. Destination, Freight Collect
REFERENCE: Vendor's letter of price decrease received May 9,
1988 and telephone call from U.S. Oil & Refining.
EST. CONTRACT VALUE: $400,OOO.00/YEAR
MWBE PARTICIPATION: $400,000.00/YEAR EXEMPT - 100% EXEMPT***
REMARKS:
1. ORDERING PROCEDURES:
*State Aaencies: This is a MANDATORY use contract for the Washington
State Departments of Transportation and Corrections. Only this
contract shall be utilized to procure items/services listed herein.
Orders may be placed with the Vendors either by telephone, from an
authorized agency representative, or in writing through the use of
Form A-17 (Field Order). Minimum order quantity is full truckload.
Less than truckload not covered by this contract. Send copy of order
to:
Commodity Code Supervisor
Office of State Procurement
216 General Administration Bldg., AX-22
Olympia, washington 98504-0622
**Political Subdivisions: Submit orders directly to vendor referencing
State of Washington Contract No. 135-87. See Attachment "A" Vendor
Identification.
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GIIANal~ NO'I'IC1~ NO. 3
COWI'HAC'J' NO, '13!)-O'/
l'^aJ~ 2
2,
"'"o.l.t1o l~mlllllionB hus changed their name to Elf Asphalt, Inc, The!
to:! "phono numbtn" and address remain the same, Effective April 30t:
l!lIJlI, Jal: MJphalt lowered their asphalt prices. New prices at:~
11"1:",<1 on tho onclosed attachment.
J,
1'1011"" ml1ke the following price correction on your copy of Contract
Chl1n<)a Notloo No, 2, On Attachment "B" page for U.S. oil and
Hoflnin'l Company, the price effective April 20, 1988 for CMS-2 should
hnvo b,,,," $122,.IO/ton and the new price for CRS-2 should have been
$111..IO/ton. All other price changes were correct as shown.
4,
All oth'H' contrl1ct prices, terms and conditions remain unchanged,
STATE OF WASHINGTON
DEPARTMENT OF GENERAL ADMINISTRATION
OFFICE OF STATE PROCUREMENT
~~~,I~B
Robert Paulson, Jr. C. .M., Buyer
Purchasing and Contract Administration
Phone: (206) 753-1040 Public
243-1040 SCAN
RP:nw{13S-S7C.089
AAS DEFINED IN HCW 43.19.190(2)
u't'tIOSE ~>ROPE,!U.Y REGISTERED WITH OS? IN
ACCO.-RD,>"'lCE WITH RC~I 39.34 S. OS? FOLICY
'. UNONCOL'lPE'l'I'l'IVE CON'rRAC'l'S
/
,rTACtt4ENT .8"
810 CATALOG Company NMle: Elf i1l~~/~ t<!.
' CONTRACT 810 NO. 135-87
CIIAIJ6f. NorlCE. NO~ Plant Locatlon:(~b N~ ~j L~Z(})
ASP HAL T PRODUCTS Order Phone: (~6J) '17F bb ~~
I. Liquid Asphalt Effective Effective
7/1/87 4/30/88
Med Il1'11-Cur lng (He)
Me-70 S Iton
Me-250 S Iton
Me-BOO f Iton
Me-3OO0 Iton
Rapid-Curing (RC)
RC-70 S Iton
RC-250 ~ Iton
RC -BOO S Iton
RC-3000 S Iton
11. Paving Asphalt
AR-2oo0W S Iton
AR-4000W S Iton
111. Emulsified Asph'alt
Slow-Setting
C5S-1 S Iton
C5S-1h S Iton
Med hm-Sett 1 ng S Iton
Oo1S-2
Oo1S-2h $ Iton
Rapid-Setting Iton
CRS-l S
CRS-2h S Iton
CRS-2 S Iton
Oo1S-2s ) Iton
IF E-90 S I~o,oo Iton $lOO.OO/ton
IFE-loos $ ;1IS". 00 Iton $210.00/ton
HFE-I50 $ }).1>. 00 Iton $lOS.OO/ton
Special Tack Iton
5TE-l
IV. Rubberized Asphalt
Product: /lb,
V. Other J/;
- 'FE -:Joo
FF-FosC
J.lFE-JooS
4c-P
Above prices are F.0.8. Plant.
or F.0.8. Destination prices.
of pr Ices.
$ J;J.S, DO Iton $110.00/ton
) ;;1.;10.011 Iton $210.00/ton
) o:lOlo. 1>0 ~lton $21O.00/ton
I (PS.t:1O I+o~ $14S.00/ton
Contact vendor for est lmated freight charges
Vendor may voluntarily allow freight equalization
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L
CONTRACT CHANGE NOTICE NO. 2
CONTRACT NUMBER:
CONTRACT TITLE:
FUR USE BY:
135-87
COMMOD!TY CODE:
917U
Bulk Asphalt Products
Departments of Transportation and Corrections
and Political Subdivisions
July 1, 19B7 THROUGH December 31, 19B9
PURPOSE: Price Changes/Add New Vendor/Complete Contract Update
EFFECTIVE DATE: See Attachment "B"
VENDOR/CONTACT: See Attachment "A" - Vendor Identification
CUNTRACT PERIOO:
CONTRACT PRICES: See Attachment "B" for asphalt products and FOB Plant Prices
Prices are maximums and Vendors may extend vol untary di scounts
for specific orders.
PAYMENT TERMS: Net 30 Days
UELIVERY: See Attachment "A" - Vendor Identification
F.U.B. POINT: Plant, F.O.B. Destination, freight prepaid & added or
F.O.B. Destination, freight collect
REFERENCE: Vendor price change letters dated January 6, 1988,
January 19, 1988 and February 17, 1988. Al so,
completed contract from Albina Fuel Co. dated March 4, I9B8.
EST. CONTRACT VALUE: $400,OOO.UO/YEAR
MWBE PARTICIPATION: $400,OOO,DO/YEAR EXEMPT IOO~ EXEMPT***
REMARKS:
1. ORDERING PROCEDURES:
*State Agencles: IhlS is a MANDATORY use contract for the Washin9ton State
Departments of Transportation and Corrections. Only this contract shall be
utilized to procure items/services listed herein. Orders may be placed with
the Vendors either by telephone, from an authorized agency representative,
or in writing through the use of Form A-I7 (Field Order). Minimum order
quantity is full truckload. Less than truckload not covered by thlS contract.
Send copy of order to:
COMMODITY COOE SUPERVISOR
Office of State Procurement
216 General Administration Bldg., AX-22
Olympi a, Washington 98504-0622
**Politica1 Subdivisions: Submit orders directly to contract vendors referencing
State of Washlngton contract No. 135-87. See Attachment "A" Vendor Identi fication.
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CHANuE NOTICE NO. 2
CONTRACT NO. 135-87
PAGE 2
2. Several contract vendors during the spring of 19UO have changed their
customer prices. These changes have been passed through to the State
in accordance with the price escalation clause of the contract. The
effective dates and changes have been listed on Attachment "B" Bid
Catalog,
3. A Federal Superfund charge for applicable asphalt products may be
listed on the invoice as a separate line item provided the rate does
not exceed $.40 per ton.
4. CHANGE IN WASHINGTON STATE TAXES:
Effective January I, 1988, a new "Hazardous Substance Tax" was imposed
upon the privilege of possessing hazardous substances in the State of
Washington. The tax rate is 0.8 percent of the wholesale value of the
substance. Asphalt products are considered ,to be hazardous substances.
To minimize the administrative effort and expense associated with passing
this charge through to the State, in-State suppliers who have already
been assessed the tax, may identify this tax on their invoices as a
separate line item titled "Washington State Superfund Charge". Out-of-
State suppliers are not obligated to pay the tax and thus, are not
permitted to pass such a charge through to the purchaser. The purchaser
must remit the tax directly to the Department of Revenue on their
Combine (Monthly or Quarterly) Excise Tax Return.
The charge may not exceed a rate of U.8 percent (,U08) of the product's
contract purchase price. Since the Department of Revenue considers this
charge/tax to be part of the purchaser's product cost, when listed on
the invoice, it should be added before calculation of applicable State
and local sales tax.
STATE UF WASHINGTON
DEPARTMENT OF GENERAL ADMINISTRATION
OFFICE OF STATE PROCURE~NJ ,
~~~~Ias
Robert au son, r., uyer
Purchasing and Contract Administration
Phone: (206) 753-1040 Public
234-1040 SCAN
RP:nw
*AS DEFINED IN RCW 43.19.19U(2)
**THOSE PROPERLY REGISTERED WITH OSP IN
ACCORDANCE WITH RCW 39.34 & OSP POLICY
***NONCOMPETITIVE CONTRACTS
L
~
CONTRACT NO. 135-87, BULK ASPHALT PRODUCTS
ATTACHMENT "A" VENDOR IDENTIFICATION
See At.lachmenl liB" Bid Cat.alog fOl" vendor's plant locations, tl.sphall products
invent.ol"ied, r.O.B., plant. prices, and ordering t.elephone nwnbel's.
L
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Vendor Name, Address, Etc.
Albina ~uel Company
3246 NE Broadway
portland, OR 97232
Delivery within 10 calendar days.
Political Subdivision Pa~ticipation:
CheVl"On U.S.A.
Asphalt Division
PO Box 220
SeaLLle, WA 98111
Delivery within 1 calendar day.
Political Subdivision Participation:
Koch Materials Company
PO Box 6226, Hi,llyard SLaUon
Spokane, WA 99207
Delivery within 1 calendar day.
Polit.ical Subdivision Part.icipation:
Pacific Emulsions
409 NW Cherry Lane
PO Box 0
Madras, OR 97741
Delivery within 2 calendar days.
Polit.ical Subdivision participation:
Special Asphalt products, Inc.
PO Box 03305
Portland, OR 97203
Delivery within 10 calendar days.
Political subdivision Participation:
U.S. Oil & Refining, Co.
3001 Marshall Avenue
Tacoma, WA 98421
Delivery within 1 calendar day.
Political subdivision participhtion:
Contcact Administration:
Contact Person: David Goglin
Telephone No.: (503) 281-1161'
Yes
Cont.TlIIct. Administ.ration:
Contact Person: Tom KatyryniuK or
D.W. Gunn
Telephone No. (206) 542-3121 01'
(206) 628-5207
Yes
Contract Administ.rat.ion:
Contact. Person: David M. Lynch
Telephone No,: (509) 487-4560
Yes
Contract Administ.ration:
Contact Person: Owen S. Hill
Telephone No.: (503) 475-6638
Yes
Contract Administration:
Contact. Person: Ed Cook
Telephone No.: (503) 295-6490
No
Contract Administration:
Cont.act. Person: Gene Damstad
Telephone No.: (206) 383-1651
Yes
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CIIANCE NOl'ICE NO.: 2
CON'rrUlC'I' NO, 135-U7
PACt; 3
5. ()(,Olivcl'Y: MiphalL ffidY })o ordcn.'d:
6.
*8.
h.
v.
(0'01' i:J.YCIlCY pickup lit vcndOl,lD plant (1"011 plaut.) I
DelJv~red. whure vendol' pl"cpayu fL'cight.. chllrCJ(,06 dnd tiCpcJ"llLcly
idenLiflcu In'oduct nnd fn.dghl chanjca on t.heir invoices (1 .e., }o'OB
Destinat.ion), 01"
Delivcn~d, where delivery by cheapest couunon Cdrr.1.er is L"cqucsl,ed and
frei ghL company fJCpel'atoly invoices the agency fOl" freight.... (i.c. F .0.13.
Dest.inal-ion freight. collect...
c.
spfOcjfjco.t.ions: A6 upecified 1n t.he Wtllihington SUite Depal'tmenl of
Tl'anspol'lalion publication 111984 Standard Spec! Clealions fOl' Road.
Bridge and Municipal Const..l'uct.lontl. or most rec€'>nl. cd! L10n. Rub};el-j z.ed
Asphal~ shall be, .. blend of 25% 9ranul..~ed rubber and 75% liquid
8sphalL AR2000, prepackaged in 30 pound packages ready for heat..ing and
applicat..ion. Contact. vendor fOI' copy of spec! fic product specifications.
7.
Spill Clean-Up: The Vendor shall be responsible fOI' spillage attribut.able
to t.heir negligence which may oceUI' dUl'ing t.ransit. or unloading
operat.ion. They shall lrnmediat..ely report.. and clean-up any spillage.
Upon faj lul."C' to do 50, t.he purchase]" shall t..ake C01Tcct..ive act-ion
and back charge the Vendor for all relat.ed cosl-S.
cont..ract. F.O.D. Plant.. prices are listed in Alt..8ctunent. uB" Bid Catalog.
Given t.he order quant..it.y. prices are La be at.. least equal 1.0 vendo! 's
l"egulal"ly maintained customer price list. or lOWel". DUl'jOg t..he cont.l"acl
period for specific orders 01" inqui1"ies, vendor may volunt.arily ext.end
t.emporary discounts or competi.t.ive freight. allowances as they wish.
Thus, act.ual invoices may be processed at leas lhan est.ablished
cont.l-act product pr ices.
9.
Pricing: Price Escallation:
cont.ract prices may bc".chnnged dUl"ing the life of t.he contract. upon
submission of a pl"operly document.ed writt.en request. 90 days before
Lhe dat.e they are applicable 1..0 t.he State. Document,alion may include
a copy of the manufacturer's published price list or print.ed not.ice of
price change 01. a copy of t.he vendor's revised/updated reference cust.omer
price list. shall be that. price schedule regularly maintained by the
vendol" which st..ales prices at. which sales are made t..o buyers
const.i tuLing the genel'al public (i. e., ethel' gove1"nment enLit.i es,
const.ruction COnL1"actol-S, eLc.). A copy of the reference price list..
should be 5ubmH.,led with t.he bid aLt.ached t~o ALlachmcnt.. "a".
Approved price changes or ot.her arnendment.s t.o t.he cont~ract. shall be
document~ed through t.he publicat.ion of a Cont.ract:.. Change Notice by the
St,at.e purchasing Division.
Dud ng the cont:ract. pc,.iod. any price declines shall be
rC'flect.ed in a l"educt.ion of the contract price to the State
ret.roactive t.o Vendort(.l effective date.
}~~.
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"B" changfi Notice No.: 2
,Company Name: AI hina FliP] Conoanv
Plant Locat1on: Vnncouvpr WA
Order Phone: bo) ) 281- 116 I
I. Liquid Asphalt Effective
4/15/88
Med i un-Cur i ng (MC)
MC-lO $ Iton
MC-250 $ Iton
MC-BOO i Iton
MC-3000 Iton
Rapid-Curing (RC)
RC-lO $ Iton
RC-250 S Iton
RC -800 $ Iton
RC-3000 $ Iton
II. Pav i ng Asphalt
AR-2000W $ Iton
AR-4000W $ Iton
III. Emulsified Asphalt
Slow-Setting
CSS-l $$110.00 Iton
CSS-lh $ I 15.00 Iton
Med i un-Sett i ng $ Itan
CMS-2 I 15.00
CMS-2h $ I 17.00 Itan
Rapid-Setting
CRS-l $ I 15.00 Iton
CRS-2h $ 115.00 Iton
CRS-2 $ 109,CO Itan
CMS-2s S I 15. co Itan
HFE-90 $ Iton
HFE-IOOs $ Iton
HFE-150 $ Itan
Special Tack Itan
STE-l
IV. Rubberi zed Asphal t
Product: AR 2 ,2 I 5 /lb.
V. Other $ Itan
S Itan
$ Iton
Above prices are F.O.B. Plant. COntact vendor for estimated freight charges
or F.O.B. Destination prices. Vendor may voluntarily allow freight equalization
of prices.
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ATTACIfoIENT . B"
BID CATALOG
CONTRACT BID NO.~
Company Name: Chevron U.S,A., Asphalt Dlvl
Plant Location; 5501 N.W. Fro"t Sl. - OIl>>.
Portland. OR
Order Phone:
ASPHALT PRODUCTS
1, Liquid Asphalt
fo'edlll11-Curlng (MC)
Me-70
MC-250
MC -800
Me-3000
Rapid-Curing (RC)
RC -70
RC-250
RC-800
RC-3000
11. Pav ing Asphalt
AR-2000W
AA-4000W
11l. Emulsified Asphalt
Slow-Sctt ino
CSS-l -
CSS-lh
!'ediU'l-Sct t ino
OIS-2 -
OIS-2h
".~ic-Sctt ing
O<S-1
C'<S-2n
C:;'S-2
OIS-2s
~FE-9O)
~E-WJ.'s
~FE-l50
S:.eciJ.l T~,i..
51:'-1
!t;~ ::J;.;t~ert:.!.;: As~i"r.al:
?::-c.:oc: :
'f. ~h,,,r
( ) I-BOO-547-01l7
(503) 221-7811
Effective
7/1/87
Iton
160.00/ton
160.00/ton
____ Iton
s
s
1
Iton
Iton
S iton
s--==-/ton
s
s
Iton
Iton
Effect be
4/5/813
158. SO/ton
158. SO/ton
Effecti',e
~/8/e8
!15.00/t.en
118.W/tr..<l
118..00/':/"'...r._
115.00/~'
115aOOl:.CJ:~
llZaClJ/:.ail
itcr.
Jl~.
r--
i~;;;
itc,r.
,.It.,...! ~~ices !,~e ::.01..:. :=~r~:. C::fl~!Ct "4e~':.:'" fc~ ~stf.n,!t.e~ ft'eJs~~ '~~ll't-!"S
c.r f.G...:.. CEs:_i~.l:fc..., Cl"ic!'s. rleel:'~'" ;n,!,.. Tclt.,":<tl'ri11 111/;,. frei;;",': e-04',tllU,t.1c,1'''''
cf 'C,.ic.!'s.
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107.00/ton
110.oo/ton
110.00 iton
Iton
S los.co/ton
S Iton
S 10; (",/ton
~ '1~r."^/tGn
S I~n
S~-/ton
S lur,
s
s
S
r'
J~ '
Cpoml aPnatnyocNllI1latelo:n '. Chevron U,S.A. A6phlllt Dlvl610n
L 20555 Rlchmond.JkW Drive
Richmond Beach, W A
Order Phone: ( ) I-BOO- 562-9294
(206) 542-3121
Effective Effective
7/1/87 4/8/88
NO. 135-B7
ASPHALT PROOUCT~
1. Liquid Aaphal~
l'ed i lJ1l-Curl ng (MC)
MC-70
MC-250
MC-BOO
MC-3000
Rapid-Curing (RC)
RC-70
RC-250
RC-BOO
RC-3000
S Iton
$ 155.00 Iton 155.00/ton
S 155.00 Iton 155.00/ton
S Iton
S Iton
S /ton
S Iton
$ Iton
Iton
Iton
II. Paving Asphalt
AR-2000W
AR-4000W
III. Emul s i fied Asphalt
Slow-Sett ing
CSS-I
CSS-Ih
I'edill11-Setting
CMS-2
CMS-2h
Rapid-Sett ing
CRS-I
CRS-2h
CRS-2
CMS-2s
HFE-90
HFE-150
Special Tack
STE -I
IV. Rubber i zed Asphalt
Produc t:
IV. Other
107 nn Iton
Iton
$ 107.00 Iton
S Iton
S Iton
S Iton
S 10<; 00 Iton
S Iton
S Iton
S Iton
105.00 Iton
Ilb.
Iton
Iton
Iton
115.00/ton
118.00/ton
115.oo/ton
115.00/ton
Above prices are F .O.B. Pl ant. Contact vendor for estimated freight charges
or F,Q.B. Destination prices. Vendor may voluntarily allow freight equalization
of prices.
~~~,,~~~.
A TI AClflEtH . B"
'BID CATALOG
COtHRACT BID HO...!li:!Q
ASPHALT PRODUCTS
1. LIquid Asphalt
,..."d hl1l-Cur In9 (MC)
MC-70
MC-Z50
MC-BOO
MC-3000
Rapid-Curing (RC)
RC.70
RC -Z 50
RC -BOO
RC-3000
11. Paving Asphalt
AR-ZOOOW
AR-4000W
111. Emulsified Asphalt
Slow-Setting
CSS-1
CSS-1h
"",dI ulII-Sett Ing
CMS-2
CMS-2h
Rapid-Sell Ing
CRS-1
CRS-2h
CRS-2
CMS-2s
HFE.90
HFE-100s
HFE.1S0
Spec ial Tack
STE .1
I V. Rubber; zed Aspha 1t
Produc t:
V, Other
ii
"
I:
:'1
II
II~
'1---" .,..".- ,,,,,,,,.,,
Above pr ices are F .0. B. Phnt,
or F.O.B. Destination prices.
of prices.
L
Company Hame: r.oc tt M. tH I a I s Compa~
Plant Loc41107i:,iH~O
_1,/;, ~h inqto.!l.--._
Order Phone: (',09) ~4~-ge~4
I~t tvet 1 vu
'/11I1l7
Silo Bid Iton
Silo Bid Iton
S I/o Bid Iton
S .JJD..!iU1.-1 to n
S '10 Bid Iton
rllo Bid Iton
SNoBid Iton
SlIoeld Iton
SilO Bid
S140.00
Iton
Iton
$125,00 Iton
S.l?2.~/ton
S125.00 Iton
fJ 25, 00 Iton
S '10 Bid Iton
SI25,OO Iton
$] 25. 00 Iton
~]?5 00 Iton
SNrl Rirl Iton
Silo Bid Iton
SNo Bld Iton
SUo Bid Iton
$Uo Bid lIb.
SNo Bi d Iton
SNo Bid Iton
SNo Bid Iton
Contact vendor for est imated freight charges
Vendor may voluntarily allow freight equal hat Ion
..TTACtf'lENT . B"
810 CATALOG
CONTRACT BID NO. 135.B7
Company Name: Koch Materials Company
Plant Location: Soohne
Wa sh I noton
Order Phone: (509) 4B7.4560
Effective
7/1/87
ASPHALT PRODUCTS
I. Liquid Asphalt
Medll.rn-Curing (MC)
Me-70
MC-250
MC-BOO
MC-3ooD
Rapid-Curing (RC)
RC-70
RC-250
RC-BOO
RC-3oo0
$ 165.00 Iton
$ 165.00 Iton
1165.00 Iton
1 fiS 00 Iton
$ 165.00 Iton
$165.00 Iton
$ 165 00 Iton
$ 165.00 Iton
II. Paving Asphalt
AR-2000W
AR-4000W
Ill. Emulsified Asphalt
Slow-Setting
CSS-l
CSS-1h
Mediun-Setting
CMS-2
CMS-2h
Rapid-Setting
CRS-1
CRS-2h
CRS-2
O<1S-2s
HFE-9O
HFE-loos
HFE-150
Special Tack
STE-l
IV. Rubberi zed Asphalt
Product: Koch 9000
V.~
$ 140.00 Iton
$ 140.00 Iton
S 125.00 Iton
S 12 5 00 Iton
S 125.00 Iton
S 125. 00 Iton
$ 125.00 Iton
S 125 00 Iton
S 125.00 Iton
~ l?~ nn Iton
S 125 00 Iton
S 175 00 Iton
S 125.00 Iton
$ No Bid Iton
.25 /lb.
S No Bid Iton
$ No Bid Iton
S No Bid Iton
Pbove prices are F .O.B. Pl ant. Contact vendor for estimated freight charges
or LO.B. Destination prices, Vendor may voluntarily allow freight equalization
of prices.
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ATTACtf4EHT . a-
BID CATALOG
COHTRACT BID HO. 135.67
ASPHALT PRODUCTS
\. LIquid Asphalt
Hedll611.Curlng (MC)
Me.7D
Me.250
He-800
HC.3000
Rapid-Cur lng (Re)
RC-70
RC-25D
RC-800
RC-3000
II. Paving Asphalt
AA-2000W
AA-4000W
11 \. Emulsified Asph'alt
Slow.Settlng
CSS-1
CSS-1h
lied IlIll.Sett i ng
OIS-2
OIS-2h
Rapid-Setting
eRS-1
eRS.2h
eRS-2
OIS-2s
HFE - 90
HFE-1OOs
HFE-1 SO
Special Tad
5T[-1
IV. Rubber I zed Asphalt
Product:
Company Hotne:111C; F:c _Ji~J! ~?"OIJ S'
P I ant Loc at 10 n : JmTA:l,t-_DJl-.5..,'j.!P
l'if8 NIAJ . H!Jl.,....kAtJr:)
Order Phone: (~oJ) ..'I.:Jr: hb JK
Eftt;cti'l<:
7/1/87
, Iton
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I Iton
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S Iton
S Iton
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, Iton
S Iton
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S Iton
, Iton
S Iton
S Iton
S Iton
S Iton
S Iton
sT~jton
s-,:T~jton
S I;;'~. 1>0 Iton
Iton
/lb.
V. Other
- :I{;:;~c
1/ F(f- Joo!:.
4E-P
I>bove prices are F.O.B. Plant.
or LO.8. Oestinatlon prices.
of pr Ices.
s I ;l.~. 00 Iton
S ...;_.;!!2,_!!!.J ton
) ;;J.~."o Iton
I f.I~.DO /1'0#
Contact vendor for est Imated freight charges
Vendor may voluntarily allo" freight equallutlon
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Contract 135-87
Pacifl ~16ion6
ANIONIC [H\1.SlTl[O ASI'IW.1S Madras, Oregon
c.n.ral ReqJ1r_l1lll
the 1lt'\1onlc ...uhHhd ..phalt. rurnhhed under thh lpecHlclUon ahdl be Wl ..yhton 0'
..pttall Clf..nl. water Mnd ..... e~uhlryln", 8Qont.. 'hi effluhifi..d ..ph.lt Ith.tl b, e--.o.ogenlolA. It
atl..l1 allow no IOplrltion of UIJhI1t .rt.r t.horoUCalh .b1l"l9 \dthln )0 dlY' -'tlr deUv.ry. It ,hdl
_oel the following requirement. when talted 1n MCcordllOCll 'IIIlth AASH10 Kethod r S7 .. _edified.
1f'C-90 ~ ~
!.lli. ~ ~ !!!!!:.. !!!2.:.. ~ ~
Viacollty, SuyboJt rural. 122Or., eec. ~O ~O )()
Sieve leat (No. 20 Sieve) I Rot.toed " 0.10 0.10 0.10
5tor8l:jc Stabl11ty Tnt. 1 DIY, I 1 I
Distill.tion lest:. Reeidue from
Dht. leet. to ~ooor., : 6~ 6~ 6~
Oil Ohtilhte, by Vallone ':
DCIIluhibility, N/SD Clle12 '0
Reddue Penetration. nOr. 90 1~0 ,~ '00 '00
Coating Teel ) .inute8, Btono ; .1nutoa, .tone
cOllted thoroUl)hly coated thorouqhly
rlo8t Teet .t 140or.. Second.. 1200 1200 1200
(9)
~!, ,,' ,"
,~_~_\lmllllm("';;JiIil!>...__"'~..
L
Pll.
~ Kool'I[D ANIONIC [KI,UI' I[D ASI'tiAl'~
Contr..ct l~~
'..cHic e:rr."l..
Madra", Or"<Jo~
(Anne1 l8Q1J1rc..ntl
pol yn~~I:~m~~I~~I~'io~~. ~~:o b~~~~I~ ~t r~. ~:,,:.~to~~1 d~:~y~lt.~~t"'\~t:~~~l:\~..~:~ ~.
polraorlud prior 10 ",,"101(&<.1100. It .".11 ...t tho 'ollo.lng ..",iro.onlo .""n t..l.d In
.ccord.nc:., "Uh M5HIO J ~Y, tI. .Dd1fhd.
If'[. I 005 lre_8DSC IH-l~
I...tl on (lIIuhion: ~ ~ ~ ~ ~ ~
\li,co.ity Q \220, I 5~ 50 511 50
5tof'UJIl ShbiUty, , dlllY, ~ I,D 1.0
TO. lI,tllrhl ,fUr letting urdhturbcd
ror 24 houri .hdl anoN no whH., .Uk)'
acp.ntion. but ,h.ll btl 9lIoot.h ..nd
homP9cnCOU. throut)hout.
5h'lD hal, ~ 0.1 0.1 0,1
OLlJauh1b111ty, 0.02 H C."Z' 40
A.ph.lt Coott~\ br Dhtilhtloo 65 65 65(7)
ca 4000r Of ~
OU in Dht1l1..t, by Yo\u:n~. ~ 2.0 2.0 7,0
leatl on RceitJuc rroo 01f1tillotion1
t"unctrwtion Q ,,"'r. 100 Q" ~ IUC.t "'0 .... 9U 140 60 110 lOll
flout hut Q ,,-oor. M:C. 1200 1200 ~2oo
[)yeti.lity ca 77of, CIIl. IH 75
~Dlub1\il)' in l;jCllloroet.hylenc, =- ".5 ~7. 5 97.5
lend Ie St!"'OBl. Q BOO~ 2 2,5 2.5 a.ls
(1 OOOllt ion I l'J. 20r I ~O clD/min.. Kales
(1) M~HIO I ~9 wilh .000ificllt1on. to include a ,,!Xl. toOr .....1m\M t.clIlpauture
t.o bt: held (or ,~ lIi.outU. -
(2) A~IH 0 412 -'en.ion 'ut1nq of Vule.nixed Rwbburll.
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A~ID~IC tHlI.SITltD ASl'HAl.IS
'ontcact 135-87
Pacific Emulsions
Madras. Oregon
Genital ....CJ.jlu..nl.
'hi .nionic ...uhHhd ..phalh (urnhtMtd undu thh IpClcHlcll10n .".11 b, In Mulaion of
....,.n cr.llnt., ",.t~r I.nd IMl enlJ\IUy1n'tl .~ont. thl ..",I,Ui.d .,ph,1t 1iM1l b. hoIIOIfeneoue. It
,hill aha'" no np.reUan of Ul-lhl1t .rtet thoro\JCilh .hi..n9 'Within )0 dlYI .rtlr ddhlry. It ,hdl
.get. thl (0110_109 nquirP'llcnt.1 ",hen teat.ad 1n IlCcordancl with AASH10 Kathod I S7 .. .odUlcc1.
!!f.:!!! ~ !!!.:l!!!!
~ ~ !!!! ~ ~ !lli!:. !!!!.:.
Y18eol1 t y, 5aybolt furol _ 122or_, lec. ~O ~O )0
Sieve Teat. (No, 20 Sieve), Roto1ned ~ 0.10 0.10 0.10
Sto,"~e Steblllly I..t. 1 D.y, I 1 1
Distillation Teat: Relidue I'M
Diat. Ie ist to ~DOor., ': 6~ 6S 6~
Oil Ohtil htr.:, by Volune ~
D~lfluhibiUty, N/~O CilCI2 JD
Roddu" Penetration II 17of. 90 ISO ISO )00 ]00
Costing leet ' ainutel, IItone ) .inutu, ,tone
co.tad thoroughl y eDited thoroughl r
noat Teat .t ,,,oOr.. Second.. 1200 1200 1200
(g)
L
l~Jpllclflc EmulsIons
PYCIIIO [mullion,
~OQ N.W. ChillY t.".
".0. II"' 0
M.<J,... OlOgo" U77~ I
MlI'IIAL'" E/1UI.!lIFIED PHII1E
Ag - P
-,Ledet 135~
hie 1 t ic f".ltlUla1.)
t'vJtkt:a.o I Orf..~onon-.
l"IClphCJoe
~O)/~ 7~~3b
Vincouity. saybolt purol. at 122"F., Socondu,
Settlement 0 24 houru. ,
Dintillation Tent:
Rcuidue from Dintillation to 500. F.. \
Oil Dintillate by Volume \
Solubility
11J I.. 110;0:.
rr- r5D
1
(is
25
'j7 . 5
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08" compant: HMIle:
Special Asohalt Products
HO, 135.87 Plant ocat Ion: '7~n ~ ~~iA~ntA'
SpR.ttlPr tJA
~ALT PROOUCTS Order Phone: (206) 623-3316
Effective Effective
.. Liquid Aaphalt 7/1/87 6/19/88
Medlun-Curlng (MC)
MC-70 S Iton
MC-250 ~ Iton
MC-800 S Iton
MC-3000 S Iton
Rapid-Curing (RC)
RC-70 S Iton
RC-250 S Iton
RC-800 S Iton
RC-3000 S Iton
II. Paving Asphalt
AR-2000W $ Iton
AR-4000W ) Iton
III. Emulsified Asphalt
Slow-Sett Ing
CSS-1 S Iton
CSS-lh ~ Iton
Med i un- Sett i ng Iton
CMS-2
eMS- 2h Iton
Rapid-Setting S Iton
CRS-l
CRS-2h S Iton
CRS-2 S Iton
CMS-2s S Iton
HFE-90 S Iton
HFE-150 S Iton
Special Tack Iton
STE-1
IV. Rubber i zed Asphalt
Produc t: Special Asphalt t.rod. 111323 S ,21 /lb. .24/lb.
Asphal t Rubber Crack ana Joint Sealant
IV. ~ Iton
S
S Iton
S Iton
f>b6ve prices are F .O.B, Plant. Contact vendor' for estimated freight charges
or F.0.8. Destination prices. Vendor may voluntarily allow freight equalization
of prices.
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ATTACIt4EHT "8"
810 CATALOG
COHTRACT 810 HO.~
Company HMle: Sp<>c1al Allphl'll t Prodll~ta
Plant Location: 1~17 N \I C;, Hplpno Rd,'
Portland, OR Q7210
Order Phone: (503) 295-6490
Effective
~
A5PP~LT PRODUCTS
1. Liquid Asphalt
Medlin-Curing (MC)
MC-70
MC-250
MC-BOO
MC-JOOO
Rapid-Curing (RC)
RC-70
RC-250
Re-BOO
RC-JOOO
Effect i ve
6/19/88
s
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Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
Iton
/lb. . 235/1b.
Iton
Iton
Iton
s
s
s
s
11. Paving Asphalt
AR-2000W
AR-4000W
111. Emulsified Asphalt
Sl ow-Sett ing
CS5-l
CS5-lh
s
s
Mediln-Settlng
CMS-2
CMS-2h
Rapid-Sell lng
CRS-l
CRS-2h
CRS-2
CMS~2s
IiFE-90
HFE-lOOs
IiFE-150
s
s
s
~
s
s
s
Special Tack
STE-l
lV. Rubberized Asphalt
Product: Sppdal A'lph"lt ~'ni 111323 S .205
V. Other Asphalt Rubber Crack & Joint Sealant
S
~
S
Pbove prices are F.O.B. Plant. Contact vendor for estimated freight charges
or F.O.B. Destination prices. Vendor may voluntarily allow freight equalization
of prices.
-
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--J
COI1.pany KlIIl1e:U. 5 OIL , REf'I N 1 NG CO,
phnt Location: ;l001 Marsha 11 Avenue
:racoma. wp. 98421
Order Phone: (206) 'R,-1 F;~1
Effective Effective
7/1/87 4/20/88
Medll111-Curlng
MC-70 S NIP. Iton
Me-250 S 1~0.00 Iton l60.00/ton
MC-800 1 l50.00/ton
Me-3000 ~ I . Iton l60.00/ton
Rapid-Cur Ing (RC)
RC-70 S NIp. Iton
RC-250 S' N/. Iton
RC-BOO S N/n. Iton
RC-3000 S NIl'. Iton
IL Paving Asphalt
AR-2000W S NIP. Iton
AR-4000W $ 11o.oo/ton l30.00/ton
IlL Emulsified Asphalt
5low-Sett ing
C55-1 $ I 1 0 . Oo.Jton 115.00/ton
C55-1h S N/. Iton
I-'edill11-Setting $ n nj ton
015-2 J'c. 117.00/ton
CMS-2h $ tl/r. Iton
Rapid-Setting
CRS-l $ NIl'. Iton
CRS-2h $ N/. Iton
CRS-2 $ 1 I 0 00 Iton 122.40/ton
CM5-2s S- NIl'. Iton
HF E-90 S N/A Iton
HFE-l00s $ NIT:. Iton
HFE-150 $ NIl'. Iton
Effective
Spec I al Tack 1/1/88
5TE-l $ ,.,n oojton lO5.00/ton
IV. Rubber i zed Asphalt
Produc t: $ NIl'. /lb.
V, Other
-SME-l $ Iton 150.00/ton
S Iton
$ Iton
Above pr ices are F .0. B. Pl ant. Contact vendor for estimated freight charges
or F.O.B. Qestinatlon prices. Vendor may voluntarily allow freight equalization
of pr Ices.
will freight equalize to Richmond Beach where applicable.
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COUNTY OR MUNICIPALITY
R ECOMMENDA nONS
.;,;......
State of Washington
Department of
Natural Resources
Olympia. WA 98504
SURFACE MINING
TO BE COMPLETED BY APPLICANT
Applicant (type or print)
Description .0,1 site
/Ow;':e'" c: KC. E<' r:)U4..ee J
SA C!.(Jc '5';'- 76:.
'5 e.;:" :;; IV %
/
See )t
23
':;,~1TE
!::
OF WASH,-
:U,N, R.
Address
12. j?T. GOX' '37?
Neilfcst comhlun'ity
-
,!-o/Z At"S
County
I--Ot<.KS, I'VA, 1833/
V~,;:-~sotV
.l ,I
Oistance'"'-
Telephone No.: (2-0.0)
::J74- 01 3: I
23 ,\.I/.
Indlcate proposed subsequent use of site upon completion of reclamation
.1/0 7V'1"v.RE.
"~-'l4IcO
c/:;:,6'
Signature (applica.~ts) ,:,/
-I,;;:;' /
/2-28,88
Title /)1$ "t J!:!$ 1-'
t;l#T)"'-~>C.>~
TO BE COMPLETED BY APPROPRIATE COUNTY OR MUNICIPALITY
To: Departmentaf Natural Re,~ources, , , '~ .~
Subject: Aecommendatio~s on surface mining permit application for a new'~'perator commencingioperations
Date
Yes No
1. Is the proposed subsequent use legal under current toea I zoning regulations?
2. Does the applicant have an appropriate permit to conduct surface mining if requirl!d ,tiy local
regulations? (Please attach a copy of the permit, written order or ordinance.)
3. Recommendations and comments: ' ' (
\
'1'"
X
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.I ~ j, ",
Signature (planning director
,
,,,t,.. \, )' ..
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/r'
'I, ::"",,'
" ,<'
Telephone No.-: ,,'/,,:
Date:
J-/I. '..
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NOTE:
R Cw, 78.44 requires evidence that the proposed subsequent use would not be
illegal under local zoning regulations,
Permit No.
2"2...3
L
Copy Distribution: White. Olympia, Yellow, District, Pink. Operator, Grad' County or Municipality
,
.-------..J'
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WASHINGTON STATE DEPAR1MENT OF
N af h;-" ....~c:ources
7 C<S" 6-72/< as-"
t.GJNA6.7-i:::' N'1'
BRIAN BOYLE
Cornrnissioner 01 Public Lands
OlympIc Region Office
Route 1. Box t375
Forks, WA 98331
-----
--
January 18, 1989
Mr. Robert Nesbitt
Jefferson County Public Works Dept.
P.O. Box 1220
Port Townsend, WA 98368
Dear Mr. Nesbitt:
Enclosed is gravel removal contract No. 49911, which has been
executed by the Olympic Region Manager.
Also, I enclosed a material removal contract for the period of
February 1, 1988 to February 28, 1989. Please complete and
return on March 1, 1989 to this office, together with your
remittance to the address shown on the removal statement. If no
material has been excavated during a reporting period, a report
nust still be submitted showing that no material has been
excavated. Additional forms will be sent automatically according
to the reporting period in the agreement.
Attached is additional information bearing on the reporting
procedure.
Sincerely,
.4'4- ~%~..--
riECEH/fEr;
Alex P. Nagygyor
N.R.E. I
J,QN 2 5 :CC9
JEFFE ' ,
r->/J811t~jJO'~R,l.j~UI\JT y
J "..,. OFp'r
For: John Calhoun
Olympic Region
Equal Opportunity/Affirmative Action Employer
Department of Natural Resources
BRIAN J. BOYlE
('ul1lll11~"i(I/l,'r 01 l'ulJlu: l.;mu.,
INSTRUCTIONS TO CONTRACT HOLDERS
When submitting removal statements for sand, gravel, rock, etc., re-
moved under your contract with the State of Washington, report all
volumes sold, used, or stockpiled that have not been removed from
other sources. Volumes sold, used or stockpiled that, upon audit, are
found not to be otherwise accounted for will be considered as removed
from State Lands.
Removal statements will include the following:
1 . Remova I s to acco unt for:
a. Material sold,
b. Material stockpiled.
c. Material used in the manufacture of concrete, asphalt
and/or other products.
d. Less: Materials purchased or removed from non-State
sources.
2. All overburden removed from the site shall be considered as
valuable material and invoiced at the contract rate.
3. Receipts, invoices and removal records by load and source must
be retained for audit.
~-,,")., ,
STATE OF WASHINGTON
DEPARTMENT OF NATURAL RESOURCES
BRIAN J. BOYLE, Commissioner of Public Lands
CONTRACT FOR REMOVAL OF GRAVEL
CONTRACT NO. 49911
This contract made by and between the STATE OF WASHINGTON, actin9 by and throu9h the
Department of Natural Resources, hereinafter called the "State" and Jefferson County
hereinafter called the "Purchaser."
The State in and for the considerations and upon the terms, conditions, and provisions
herein mentioned, does hereby grant unto the Purchaser rights to the material described in
paragraph 2.01 situated in the sale area (the "Property") described as:
Winfield Pit, SW S,I, Section 35 T27N, R12W, W.M.
SECTION
OCCUPANCY
1.01 Term. This contract shall commence on the 1st day of February, 1989, and continue
to the-rst day of February, 1992.
SECTION
USE OF SITE
2.01 Permitted Use. The Purchaser shall have the right to enter upon, excavate, take and
remove 19,500 cubic yards of State-owned material from said sale area under the
jurisdiction of the State.
SECTION 3 PAYMENT
)\, \i
oG r;
2.02 Nonexclusive Rights. Nothing herein contained shall be deemed as a grant of the o~
exclusive use privllege of the premises herein described. ~i
3.02 Unit Payment. The Purchaser shall and does hereby agree to pay the State $1.36 per
cubic yard for all valuable material removed by the Purchaser from said premises.
3.03 Reporting. Purchaser shall keep an accurate record and account of all such material
removed or taken, and render to the State at the end of each month an itemized account of
the respective quantities or amounts thereof taken or removed during such preceding month
and at the time of rendering such statement or account, shall pay to the State the full
sum for all amounts of material taken or removed during such precedin9 month. All
materials shall be reported and paid for with the removal statement that covers the
reporting period during which the material was removed whether or not the material was
stockpiled at the pit or elsewhere.
3.04 Reappraisal. The unit price of the material is subject to reappraisal not more
often than every two years.
SECTION 4 ROADS
4.01 Authorization. Unless otherwise provided herein the Purchaser is authorized,
subject to prevlous rights conveyed by the State, to use all existing roads on State land
and to construct and maintain on State land all roads, with written approval by the State,
needed for the removal of the material included in this sale.
4.02
roads
road.
State
Easements. Purchaser shall provide valid easements to the State of Washington for
acquired or used by the Purchaser for access to State land from a county or state
State shall allow to the Purchaser right of way access in approved locations across
land.
4.03 Maintenance. At all times during the term of this contract, Purchaser shall keep
all roads constructed on this contract area land open and in such state of repair as to
permit normal operation of a motor vehicle.
-1-
Contract No. 49911
4.04 Reservations. The State shall have the right to use, without charge, all existing
roads and/or any road constructed or reconstructed on State lands by the Purchaser under
this contract for any and all purposes deemed necessary or desirable in connection with
the control, management, harvest and administration of State-owned land or the resources
thereof and further, the State may extend such rights and privileges to others;
PROVIDED, That use by others shall be controlled by the State so it will not, in the
opinion of the Department, interfere unduly with the use of the road by the Purchaser;
PROVIDED, However, contractors using these roads for the removal of timber or other
resources must, as the State directs, pay their proportionate share of maintenance of
these roads based on thei r use of them. Th i s requ i red payment sh a 11 not reI i eve any
Purchaser from liability for repair of damage to said roads, including bridges and
culverts, due to overloading trucks, carelessness or negligence on the part of the
Purchaser, his employees, subcontractors and their employees.
SECTION 5 RESERVATIONS
5.01 Default. Should the Purchaser violate or default on any of the covenants and
proviSions contained herein, including the obligation to pay for the fixed annual payment,
if so agreed to in this contract, then the State may terminate this contract provided that
the Purchaser has been notified of the violation or default fifteen (15) days prior to
such cancellation and such violation or default has not been corrected within such time.
Upon such cancellation the State shall have the right to take control of all valuable
materials belonging to the State, but not withstanding such cancellation or termination
the State shall be entitled to recover the full cost for material removed pursuant to this
agreement. Further, the State shall be entitled to all damages and costs arising out of
termination of this contract and a resale, if occurring, of any valuable material rights.
5.02 Audit. The State shall have the right to Inspect the books and accounts of the
Purchaser, make such investigations and secure or receive any other material or
information necessary to determine whether or not the State is being paid the full amount
payable to it for the removal of materials, and in furtherance of the operations of said
Purchaser who hereby covenants and agrees to make available such books and accounts for
such State inspections at all reasonable business hours at the Purchaser's normal place of
busi ness.
5.03 Compliance. The Purcllaser shall comply with all rules, regulations and laws of the
United States and the State of Washington. Violation of the rules, regulations and laws
of the United States and the State of Washington, or failure to pay any damages due the
State, or noncompliance with any rules, regulations, or laws of the State shall constitute
grounds for the forfeiture of the contract rights outlined in the laws of the State and
the provisions in this contract.
5.04 Restrictions on Use. In connection with the use of the site, the Purchaser shall:
Comply with all public authority concerning planning, zoning and other laws which
may affect the contract area in the same manner as if the land was leased from a private
owner.
Take all reasonable precautions to protect the land and improvements on the contract
area from fire, make every reasonable effort to report and suppress such fires as may
affect the contract area, and shall be subject to appl icable fire laws affecting the
contract area.
Not allow debris or refuse to accumulate on the contract area.
5.05 Higher and Better Use. This contract is subject to cancellation upon sixty (60)
days' written notlce ln the event the area covered thereby is included in a plan of
development to a higher and better use in the opinion of the State.
SECTI ON 6 REQU I REr1ENTS
6.01 Assessments. The Purchaser shall pay the annual payments on all assessments and
taxes that are charged now or may be charged in the future to the land or personal
property thereon.
-2-
Contract No. 49911
6.02 Plan of Operations and Reclamation Plan. State will furnish a plan of operations
and a ~eclamatlon plan, WhlCh provlslons shall become a part of this contract. All
oper~tl?nS of ~he Purchaser under this contract shall be so conducted to re-establish on a
con~lnulng basls the ve$e~ative cover, provide soil stability, protect water conditions,
avold dal~age to productlvlty of the land, maximize uti lization of the site for the removal
of materlals, ensure site appearance and safety conditions appropriate to the intended
subsequent use of the area. All topsoil disturbed shall be stockpiled for redistribution.
Purchaser shall arrange with the contract administrator to review this contract and to
examine Winfield Pit before beginning any operations. A plan of operations shall be
developed and agreed upon by the contract administrator and Purchaser before beginning any
operations.
6.03 Condition of Premises and Liability. The premises have been inspected by the
Purchaser and are accepted ln present condition. Purchaser will protect, save and hold
harmless the State, its authorized agents and employees, from all claims, costs, damages
or expenses of any nature whatsoever arising out of or in connection with the use of the
Property. Further, the Purchaser shall be responsible for any fines or penalties charged
against the premises as a result of his action in not complying with laws or regulations
affecting the premises.
6.04 Unnecessary Damage. Any damage to existing timber and/or reforestation potential
deemed by the State to be excessive or unnecessary shall be paid for by the Purchaser at
triple the appraised value as determined by the State. The Purchaser may have the right
to remove such timber upon payment thereof if such removal is authorized in writing by the
State.
6.05 Assignment. Any rights created by this contract may not be assigned, sublet or
transferred wlthout written permission from the State. Permission to assign, sublet or
transfer rights under this contract may be conditioned by charging additional payment
based upon the present market value of such rights. The State may condition or deny the
granting of a request for an assignment based upon its opinion of the financial
reliability and capability of the proposed assignee or transferee. Further, if the
Purchaser shall be a corporation or partnership and if at any time during the term of this
contract any part or all of the corporate shares or partnership interests of the Purchaser
shall be transferred by sale, assignment, bequest, inheritance, operation of law, or other
disposition so as to result in a change in the present control of the contract by the
person or persons now owning a majority of the corporate shares or change in the holding
of the partnership interests, the transfer shall be deemed as requiring an assignment.
6.07 Termination. Should the Purchaser wish to terminate the contract provisions
contained hereln, he shall notify the State, and specify reasons for the termination
request. The State may consider a negotiated termination of this contract, however the
Purchaser shall be liable for the cost of any valuable material removed before final
termination of the contract. Further, the Purchaser shall be liable for any damages to
the property from which the valuable material is removed.
6.08 Attorney Fees. Each party shall be responsible for his own attorney fees in the
event of a dispute arising out of this agreement except as provided for in
Subsection 2.06. Venue for resolving such disputes shall be in Thurston County Superior
Court.
SECTION 7 MISCELLANEOUS
7.01 Improvements Belonging To The State. The Purchaser has thirty (30) days after the
termination of thlS contract to remove from the Property or portion thereof, all
machinery, trade fixtures, tools or other equipment. Any machinery, equipment, trade
fixtures or tools which are allowed to remain on said Property or portion thereof shall
become the property of the State upon expiration of such period.
Dated at P,;<:K.1 , Washington, this day /(J-I11 of JANVIif!Y
19~.
STATE OF WASHINGTON
DEPARTMENT OF NATURAL RESOURCES
J~A!~ eg/~
O'lympi c Regiona I Manager
For BRIAN J. BOYLE, Commissioner
BRIAN J. BOYLE
Commissioner of Public Lands
Jefferson County
~/ Y..~ f7~L#
'{~n C;;-uXty O'.....~~ /:.--""?,rnu,,,--
-3- Contract No. 49911
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jefferson Street
P.O, Box 1220
Port Townsend. WA 98368
(206) 385,9160
Gary A. Rowe, P.E.. Director
Robert G. Nesbitt, P.E., County Engineer
January 6, 1989
Kathy Stafford, Administrator
Jeffcrson County Health Dcpartmcnt
802 Sheridan
Port Townsend, WA 98368
Dear Kathy,
Several months ago wc requested that dcpartmcnt heads at the Multi-
Servicc Building have their employees refrain from parking in the
main parking lot (closest to the building). It was also requestcd
that county vehicles park e1scwherc. The main lot is designated
for public UGC.
Could you please remind the Health Department staff and users of
thc county vehicle ~o park elsewhere?
I realize that the parking situation is other than perfect, but the
main lot is to remain for public use only.
Thanks for your cooperation.
$incerely,
&r~
M. Carter Breskin
Property Manager
Xc: ERR 02.50
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jefferson Street
P.O, Box 1220
PorI Townsend, WA 98368
(206) 385.9160
Gary A. Rowe, P,E.. Director
Robert G. Nesbitt, P.E., County Engineer
May 26, 1989
Ms. Shirley RudOlph
ERA Real Estate
2219 Sims Way
Port Townsend, WA 9836B
RE:
Eisenbeis Plat, Block 317, Lot 4
Dear Shirley,
The county is currently reviewing its property holdings
throughout the county. Part of the goal of this process is to
place some parcels of property back on the tax rolls by including
them in a land auction.
At the present time, the only procedure we have for an
individual to acquire county owned property would be through an
exchange process. The process requires that the property be
appraised by a licensed appraiser, and the exchange must prove to
be of equal or greater value to the county, and be advantageous to
the county. The person (or group) proposing the exchange must bear
the cost of appraisal. The exchange then goes through the Superior
Court.
In the future, as I mentioned above, we will be placing
parcels for auction. It is possible, because the lot is isolated,
that it would be put up for auction. Consequently, at this time,
the only avenue I can offer is that of exchange. Please contact
me if you wish to discuss the matter further.
Sincerely,
~~;L-
Carter Breskin
Property Manager
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JEli'E'ER.':30l1 com,'ty
PUBLIC HOSPITAL DIS'I'IUCT 1:0. 2
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. January 28, 1975
.. !t:R~Sml 't.mJ,,:;i( .
'i.!)r.::D ~;. '~fSS~':
Hon. Board of:. County Commissioners
Jef:f:erscn Count.y
Court House
port Townse:>d, Washington 98566
Re: .H.,~~ta1. Building acquisition
Gentlem'en:, :
I~h"ve been instructed by the Board of' Commissioners of' Jefferson County
public Hospital District No. 2 to advise you that they are willing, to sell
to you the four story portion of' Jeff'erson General Hospital (formerly st.
John Hospital) in port Tamasend, f:or the total price of $175,000.00.
AS you know, it w:Ul be necessary for an agreement to be reached by "hicb
the' County and . the Hospita1.are both assured of' the necessary use cf' the
heating and power plants, and for the partial use of' the 10l'1est 1:10or of
the building by the hospital. We have discussed this many times, and I
believe that all partie a agree that there will be no real probleo in
'l7orking out mutual use of the f'acilities mentioned. '
AS yeu knew, I have served as attorney to the Board. of hospital cOJ:ilJissicr,ers
throughout the acquisition 01: ,the facilities in question, and have been
authorized by the C=ission to negotoiate for them in regard thereto. If
I can be of fUrther assistance, please. feel free to call cn me.
R~_
GLENN/ABRAHAM .' ,
Attdrney,' Je1:ferson County
HOs{rl.tal. District lIo. 2
.,.i
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,VOL 1 rAI,' 175
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jeflerson Street
P,O, Box 1220
Pori Townsend. WA 98368
(206) 385.9160
Gary A. Rowe, P.E., Director
Robert G. Nesbitt. P.E., County Engineer
July 13, 1989
Mr. David cunningham
Pope Resources
19351 Eighth Ave. N.E., suite A
P.O. Box 1780
Poulsbo, WA 98370
Dear Mr. cunningham:
On behalf of the Jefferson County Parks Advisory Board, I would
like to express our appreciation of your trail plan.
It is important that, as development occurs in Jefferson County,
we do not lose sight of the need to protect and enhance the
environment.
The Parks Advisory Board again expresses its appreciation of your
plan, and, should you wish the advice of the Board, please feel
free to contact us though the Department of Public Works.
s;n~
Rick Tollefson, Chairman
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jeffelson Street
P,O, 80x 1220
Port Townsend, WA 98368
(206) 385'916~ ~ ~ ~ ~ W ~ rill
Gary A. Rowe, P,E" Offecl tlli
Robert G, Nesbitt, P,E" cl~ Engi.neer 0 1989
MAY J '
JEFFERSON COUNTY
BOAllD OF COMMISSIONERS
MEMORANDUM
TO: Board of County Commissioners
--
FROM: Public Works Department ~
DATE: May 2, 1989
SUBJECT: Bid For Self~Propelled Vibratory Roller
All bids were reviewed and the low bid was Suhlberg Equipment at
$57,027.07.
This price is about $6,000 higher than the original estimate, but I
do not feel we will receive a lower bid by re-advertising.
I recommend that the award for the Self-Propelled Vibratory Roller
be given to Sahlberg Equipment.
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Approve'd bY Hie Board, of
Jefferson County Commissioner:>
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Continuation
US. Department of Labor
Mine Safety and Health Administration
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HECEP/ED
611 HACHELClF< nOp,D
GARDINEn, WA, 98382
{~iF'r~ 1 L.. 20, 1989
P.PR 2 '!, 1989
JEFFERSON COUNTY
PUBLIC WORKS DEPT
MS. M. CAf~TER BRESKIN
,] EI~FEF'SON COUNTY
DEPARTMENT OF PUBLIC WORKS
P.O. BOX 1220
PORT TOWNSEND, WA. 98368
DEAR CAFaER,
AS YOU F'EQUESTED IN ClUr, ~IEETII"G OF ('\1="F~lL, 17, I {,\11 ENCLOSING A SI<ETCH
OF THE TWO ONE WATER LINES THAT THE CENTER NEEDS FOR PLANT WATERING.
EACH LINE STARTS AT EXISTING BIBCOCKS. THE 131 FOOT LINE WOULD RUN TO
THE PLANT I NGS AnEA ABUTT I NG THE STATE HI GHW?\Y AND THE 45 FOOT LINE TO
THE PLANT I NG ARf"A ON THE F3ANf'~ OF THE NEW PI\FW,; I Nr3 Lor. I BEL I EVE THEF'E
IS ENOUGH NATURAL SLOPE TO DRAIN THE LINES BACK TO THE BUILDING. THIS
WOULD PROTECT THE LINES FROM FREEZING IN THE WINTER MONTHS.
IF THE COUNTY COULD LAY THE LINES, TIE THEI1 lI"TO THE EXISTING WATER
LINES AND INSTALL SHUT OFF AND DRAIN VALVES, THE COMMUNITY WOULD
SUPPLY MATEI,114L (,\ND LABOI, 100[': A PLANT DFUP SYSTEM.
THE GARDEN CLUB f~ECENTL,Y SPENT :r1000 IN PL,ANTING TO THE I\REAS THAT WE
ARE REQUESTING WATER LINES. BECAUSE WE HAVE NO OTHER MEANS OF
WATERING THESE AREI\S AND THE DRY SEASON WILL BE ON US IN A FEW WEEKS,
WE WOULD APPRECIATE YOll CONSIDERING THIS AS A GENUINE NEED OF OUR
COMMUNITY THAT MUST HAVE IMMEDIATE ATTE~ITION.
SINCEHEL.Y YOURS"
,LJ /,-,; -- .-.L--
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GEOF~GE GATCHEl'
pr~ESI DEI"T
GAHDINER COMML~ITY CENTER
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jefferson Street
P,O, Box 1220
Port Townsend, WA 98368
(206) 385-9160
Gary A. Rowe, P,C., Director
Robel! G. Nesbitt, P.E., County Engineer
May 17, 1989
Mr. George Gatchet,President
Gardiner Community Center
611 Bachelor Road
Gardiner, WA 98382
Dear George,
I have discussed with Bob Nesbitt, County Engineer, the
Community Center's request for water lines to be laid for a
sprinkling system. As you recall, Bob was with me on our latest
trip to the center to inspect the main floor.
While we appreciate the need that you have expressed, and
certainly agree that your plantings should be protected, the item
was not budgeted for 1989. ,Any capital improvements to the
community centers must be budgeted. Otherwise, I am forced to use
monies budgeted for other capital projects at other facilities. I
will budget this item for 1990. If the center has any other
capital projects it feels are required, please inform us as soon
as possible. Preliminary budgets are begun in July.
After June 1st, Bob Nesbitt will be in charge of maintenance
and operation of the county facilities. If you have any questions
or needs, they should be directed to him.
I have enjoyed working with this community center in
particular, as it is quite well-organized, and willing to work with
the county to the best interests of its users.
Sincerely,
~
M. Carter Breskin
Property Manager
cc: Bod Nesbitt, County Engineer
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File No. '
WASHINGTON STATE FIRE MARSHAL
INSURANCE BUILDING - OLYMPIA, WASHINGTON 98504
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FIRE ALARM SYSTEM
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Address: 71 D~ Rei City ~_//J#L7/J..a#1
County: @J-'l~./7AA?f./ ziP3f5 33? Telephone
Building Designation (if more than one building)
Inspection by: 4d. J'l-di'.a.~ /JJ/n .s;;.liJeY' Title "'j;;;.d, ~P5.
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Date of inspection: 3-b?/S?';1
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Occupied as:
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Type of Test: Monthly [] Quarterly [] Semi-Annual [] Annual g
Type of system: Noncoded ~ Conmon coded [] Selective coded 0 Dual coded 0
(as pertaining to chapter 212-14 WAC)
Local Fire Department: ' ~~~~
Fire Department Official Contacted: -/21/;1-
Test Received at Fire Department: Yes [] No ~ ;LI~~
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8. Control Panel
9. Manual Station
10. Heat Detectors
11. Smoke Detectors
Auo1ole Alarm
12. Devices
Visual Alarm
13. Devices
14. Code Transmitters
Automatic Door
15. Releases
16. Trouble Indicators
17. Master Alarm Box
18. Bat ter i es
19. Charoer
20. Generator
21. Ventilation Control
f1re Department
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(;entral ~tatlon
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Exter10r :'prinK~er
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Sprinkler Water
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28. Automatic Time Delay of General Alarm Minutes. None Installed)81
29. Test of alarm system on emergency power, satiSfactory? Yes a No 0
30. This is to certify that this fire alarm system has been properly inspected for
reliability coverin9 the items listed in this report and is consistent with NFPA
Fire Alarm Maintenance Standards.
A. Signature of Owner or Representative
B. Signature of Fire Alarm Firm Representative ~~~
C. Name of Firm ~S/~,o)..X '~e 4~er d.
D. Mail ing Address :715) AI. 37't2 cS"e:;~ uk 9$/03 Phone No. ':::;'32-1,I~2~
ORIGINAL FORM TO BE RETURNED TO STATE FIRE MARSHAL
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11ay 2, 1989
Mel Mefford, Sheriff
Jefferson County
Post Office Box 1080
Hadlock, Wa. 98339-1080
Re: Jefferson County Correction Facility _ Energy Audit
Account No. 8401-2239-002-3
Dear Sheriff Mefford:
An energy audit and analysis of various conservation
alternatives has been completed for your facility. A detailed
report with specific recommendations to permanently reduce
facility electrical energy consumption is attached for your
review.
If you wish the county to proceed, please complete the form
"Grant Application Request,. attach a copy of the property
legal description, and forward the two documents to me in the
envelope provided.
Upon receipt of this material, I will proceed with preparing Bid
Design Criteria for the conservation measures to be installed at
your facility.
If you have any questions, please call me at 454-6363, extension
2213 .
Sincerely,
6i:~
Energy Management Engineer
cc: F. Byron Swigart
Attachments
RECEIVED
MAY 9 1989
JEFFERSON COUNTY
PUBLIC WORKS DEPT
The Energy Starts l-fere
Puget Sound Power & Light Company POBox 9701.1 BBItE:VIJ(~, WA 98009.9734 (206) 454.6363
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PUGET SOUND POWER & LIGHT COMPANY
ENERGY MANAGEMENT REPORT
o AUDIT
o ENERGY USE PROFILES
o ANALYSIS
o RECOMMENDATIONS
o GRANT PROPOSAL
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Jefferson County Correction Facility
Elkins Road, County Jail
Hadlock, Wa. 98339
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Prepared by
Ray Burton
Project Engineer
Ma y 2, 1989
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TABLE OF CONTENTS
ENERGY AUDIT 1
ENERGY USE PROFILES 4
OPERATIONAL ITEMS 7
ENERGY ANALYSIS 8
SUMMARY CHART 9
RECOMMENDATIONS . . 10
GRANT PROPOSAL 11
GRANT FINANCING REQUEST 12
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ENERGY AUDIT
The purpose of the audit is to determine the electrical energy
consumption characteristics of your facility. Information was
collected from a variety of sources during the audit, and esti-
mates may have been necessary wllere data was not available.
please review the following for your information and to help us
assure the accuracy of the energy audit.
General Facility Description
The Jefferson County Correction Facility is a one story jail
located in Hadlock, Wa. The total conditioned floor area is
15,030 sq. ft.
The facility is occupied 24 hours a day, 365 days a year. The
administration area is only occupied from approximately 7:00
a.m. to 5:30 p.m. Monday thru Friday, with deputies entering and
leaving this part of the facility at all hours of the night and
weekend.
The building is only three years old and is made of tilt-up
concrete wall sections, and concrete floor and roof.
During the past 12 months the all electric facility consumed
828,240 kWh of energy and had a peak demand for energy of 221kw
which occured in January. The annual energy consumption of 55
kWh/sq.ft./year is above average for a building of this type and
size.
Electrical Costs
Jefferson County Correction Facility is subject to the service
charges of Schedule 24. The calculated cost for energy based on
the 1988-89 energy consumption is $0.041 per kWh. Energy costs
account for approximately 80% of the total billing.
Demand charges for Schedule 24 are no charge for the first 50 kW
of billing demand and $5.19 per kW above 50 kW. Demand costs
accounted for approximately 18% of the total billing.
A current copy of the rate Schedule 24 for your facility is
attached.
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Building Th.rmal Characteristics
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Ceiling: The majority is R-30 rigid insulation on top of
8 inches of concrete with 1/2 inch fiber board, built-up
roofing with gravel on top.
The southwestern part of the building has earth-bermed
concrete walls and roof, with the roof having R-IO rigid
insulation on top of 14 inches of concrete.
Interior is finished with dropped ceiling tile.
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Walls: Walls are two layers of concrete totaling 9
inches with a layer of R-12 rigid insulation sandwiched
between them. Overall effective thermal resistance is
R-13.6.
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Floor: Entire floor is concrete slab on grade with one
inch of rigid insula ton under entire slab.
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Glass: Windows are double pane in a metal frame.
Shading coefficient is .75. R-value is .61.
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Lighting: Most of the interior lighting load of 20.8
is fluorescent. There is some Mercury Vapor lamps as
well (vestibule, sally, recreation area). All
fluorescent lamps are the energy efficient type.
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Exterior lighting consists of 30 - 175 Watt Mercury Vapor
fixtures for a total load of 6.3 kW. These fixtures are
controlled by photo-electric cells.
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Heating, Ventilating, and Air-Conditioning (HVAC): The
HVAC system is fairly complicated with the cells and rest
rooms needing 100% outside air and the remainder of the
facility only needing a minimum amount of outside air.
The cells/rest room system incorporates a 70% efficient
air-to-air heat exchanger to preheat the 100% outside air
with the warm out-going exhaust air. This system needs
to operate 24 hours per day.
The lobby area and the common areas of the detention area
(hallways, meeting rooms, kitchen, etc.) are all being
served by one main air-handler with reheat coils and
their respective thermostats located in various areas
throughout the facility. It should be pointed-out that
although this system also runs 24 hours per day, the area
that needs to operate 24 hours compared to the area that
needs-rDbe conditioned during "office hours" is only 5%
of this area.
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GRANT FINANCING REQUEST
Ray Burton
puget Sound Power & Light Company
600 - l16th Avenue NE
Bellevue, WA 98009-9734
Re: Energy Audit - Jefferson County Correction Facility
Dear Mr. Burton:
I have reviewed the analysis and other material forwarded to me
concerning the installation of energy conservation measures in
my facility and wish to apply for a grant for items checked
below. Attached is a copy of my property legal description. I
understand that this application does not in any way
contractually bind either puget Power or myself.
Desired measures (please indicate "XII)
Description
X Night Set-Back
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~ Ilea t Pump \'later lIeater
;( Heat Pumps for Space Heat
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....L lIigh Pressure Sodium
Tax I.D. No.
Legal Description Enclosed
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Dated
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The southwest portion is designed to be the control
center for the sheriff's dept. in case of emergency. At
present it is used for the administration portion of the
jail. It's heating and cooling equipment consists of two
split system units. One unit is to condition the interior
of that space while the other unit conditons the
perimeter. This is the only space that is
air-conditioned.
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All of the remaining portions of the facility are
conditioned by a standard terminal re-heat system.
Thermostats controlling their respective zones are
located in the supply air ducts. The only exemption to
this is the administration area which use two
wall-mounted thermostats.
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It should be mentioned here that there has been previous
studies performed on the facility and their major
recommendations have concerned the IIVAC system. A copy
of this report is attached for your review.
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Hot Water: Domestic hot water is supplied by four
electrically heated tanks. Two are located in the
machanical room and tile other two are located by the
laundry room. All are 120 gallon capacity set between
130 - 140 degrees F. Approximate usage is 600 gallons
per day.
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ENERGY USE PROFILES
The following profiles illustrate energy consumption data for
each of the facility's electrical energy-consuming systems
The profiles are derived from information obtained during the
audit and then correlated to your facility's past energy
consumption.
The information developed within these profiles establishes a
basis for the engineered analysis and directs further efforts to
those systems and measures with the greatest energy savings
potential.
Electrical Energy Profile
End Use
Heating
Cooling
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Fans
Indoor Lighting
Outdoor Lighting
Hot Water
:
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Kitchen Equipment
Control Rm Equip.
Office Equipment
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kwh/yr
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8,911
240,894
86,785
32,423
87,016
12,571
26,280
19,303
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OPERATIONAL ITEMS
Part of the audit's purpose was to identify maintenance or
operational practices which may be adversely affecting your
facility's energy consumption.
Following is a list of pertinent items which should be reviewed
and corrected in your facility:
o Calibrate all DVAC controls.
o Keep exterior boundary doors closed. Especially on cold
days.
Kitchen Recommendations
o Utilize small capacity appliances for small volume
cooking.
o Avoid long idling periods, particularly at high
temperatures. As long as water boils, the temperature
remains the same. High heat that results in furious
boiling does not speed cooking.
o Do not use the dish washing machine for a small number
of dishes, unless it is the last load.
o Pre-rinse dishes and cooking utensils in cool water.
o Partially thaw frozen foods in cooler --- this will aid
cooling, and when cooked, will use less energy.
o Check coils on condensers to be sure they are clean.
o Allow hot foods to cool slightly before placing them in
coolers.
o Heat only sections of the griddle for the volume of food
to be cooked.
o Every second a oven is open, a 1 degree drop in
temperature occurs.
o Check water supply system and repair all leaks. Just
one drop per second adds up to about 650 gallons of
water per year.
o Keep a maintenance and operating log of all equipment.
This is the best way to detect a drop in effiCiency.
-7-
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ENERGY ANALYSIS
The energy analysis evaluates the energy savings potential of
specific conservation measures. The predicted energy savings
are derived using accepted engineering practices, including
computer modeling~ Many conservation measures were considered
but full analysis was given to those with the best energy
savings potential.
Following is a brief synopsis of each of the measures
considered:
o Measure 1: Night Set-Back
This measure involves reducing the night-time thermostat
settings in the administration area to 55 degrees F and
in the remainder of the facility to 60 degrees if code
allows (except cell area). It is recommended that a
small, separate, air-conditioner be installed to serve
the control room since this area has to operate 24 hours
per day. This measure may be accomplished by either
manual set-back of the thermostats, or by installing
programmable thermostats.
o Measure 2: Heat Pump Water Heater
This measure consists of installing a heat pump to
pre-heat all your hot water. This equipment utilizes
well-proven technologies in transfering heat from the
surrounding material (air) to your hot water system.
The condenser portion of the heat pump has an added
benifit in that it acts like an air-conditioner for the
space it is located in, extracting waste heat and
transfering that heat to the hot water tank. An
excellent location for the condenser unit would be in
the kitchen or the laundry room.
o
Measure 3:
Heat Pumps for Room Heat
This measure consists of replacing all of the HVAC main
air handling equipment with heat pumps. The principle
is the same as Measure 2, in that the heat pump will
transfer unusable heat to the interor of the building
were it can be used. This measure involves all of the
facilities air handling equipment. -
o
Measure 4:
High Pressure Sodium Fixtures
This measure involves replacing all of the exterior
Mercury Vapor fixtures with 100 Watt High Pressure
Sodium fixtures.
NOTE:
Most of these measures will reduce your "demand"part
of your bill, but energy savings (not demand savings)
is the sole criteria for determining grant amount.
-0-
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REC0l111ENDATIONS
Listed below are the energy conservation measures (ECI1) that
were found to be cost-effective and are recommended for
installation. Engineering and financial assistance to install
these measures is discussed in the Grant proposal.
o ECI1 1: Night Set-BacK
o ECM 2: Heat Pump Water Heater
o ECM 3: Heat Pump for Space Heat
o ECI1 4: High Pressure Sodium Fixtures
-10-
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GRANT PROPOSAL
Application:
To apply for a grant, please complete the attached application
form and provide a copy of your property legal description. The
description is necessary for puget to verify legal ownership of
the property. These two items should be returned in the
enclosed envelope before June 1, 1989.
Implementation:
Upon receipt of your application and property description, we
will prepare bid criteria for the items you have selected.
These will be returned for your review and submittal to
contractors for bid. When bids have been received, we will
assist you in a review to select mutually agreeable contractors.
Puget's contracts administrator will then prepare financing
documents for your signature. When the financing contracts are
signed and returned, you may award bids to the successful
contractor(s) so that work may proceed.
puget will provide engineering and administrative assistance
during the course of the project, but your expected
participation during the bidding, review and construction phases
will help ensu,e a mutually satisfactory installation. We will
assist in verification of the work upon completion in order to
ensure compatibility with design criteria.
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Mel Mefford, Sheriff
Jefferson County
Post Office Box 1080
Hadlock, WA 98339-1080
March 28, 1988
SUBJEC'f:
Jefferson County Jail-Hadlock, Wl\
Dear Mel:
As a fallow-up to our past meetings relative to the energy
consumption and comfort levels at the above facility, Puget's
engineers in cooperation with the Bowlin Company have concluded
their investigation of the heating, ventilation and air-conditioning
(HVAC) systems to determine their ability to achieve comfort and
energy efficiency. In addition, the plans and specifications have
been analyzed in an effort to determine the capability of the STAEFA
electronic control system installation. This investigation has
revealed areas that can be improved and the following comments and
recommendations are outline below.
1. One of the wall mounted electronic sensors controlling
the heating and air conditioning system in the office
area is outside of the space served by the heating and
air conditioning unit. We recomment installing a new
sensor to improve the control of this heating and air
conditioning system and to put a blank cover on the
abandoned wall mounted sensor.
Estimate cost of tIlis revision is:
$
275.00
2. We recOmmend that a night set-back system be installed
on the two heating and air conditioning systems serving
the office areas. The appropriate way to do this is to
install a time clock, relays, and resisters in order to
maintain a night set-back temperature of approximately
60 degrees for the two systems and to disable air con-
di tioning devices for night set-back operation. (See
Item 6 for further requirements.)
Estimated cost for this revision is:
$2,400.00
3. There are several cell zones that are not operating
correctly at this time. The HVAC system serving the
individual cells either have a wiring problem or a
defective device such as a magnetic contactor or pilot
relay. This occurs in approximately 3 locations and it
is anticipated that a repair to each of these zones would
cost approximately $700.00 each.
Estimate cost for this revision is:
$2,100.00
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4. The energy consumption could be reduced for the system
serving the entry area and several of the jail cells if
the control is changed from discharge temperature control
to return air temperature control. At this time a discharge
temperature control maintains a colder temperature than
required and each of the terminal electric reheat coils
reheats the cold air to maintain the temperature for each
zone. If the control was changed to return air control,
the reheat would be minimized or eliminated. The cost
for these revisions requires relocation of return air
sensors and some very careful set point calibration and
adjustment of the central controls.
Estimated cost for this revision is:
$2,300.00
5. Since the system has been in operation for some time, it
is likely that many of the control system components need
to be recalibrated and adjusted. These devices also need
to be checked for proper operation. This thorough check-
out and recalibration of the control system would be done
for all devices except for the zone controls in the cells.
Estimated cost for this revision is: $1,000.00
5. To incorporate a night setback in the office areas, it
will be necessary to remove the control/dispatch room
from the main HVAC system. A separate heat pump/air
conditioner is recommended for this application.
Estimate cost for this revision is: $2,500.00
The estimated total cost of the above recommendation is $10,575.00
plus tax. If only a few items are selected for correction, the cost
per item may increase due to the size of the job.
Should the County decide to proceed with the recommended modifications,
Puget Power will be willing to help prepare job specifications and
quidelines to achieve qualified bidding consistent with the recommend-
ations suggested. In addition Puget Power will help develop a main-
tenance specification manual featuring the modifications to the,
system for future reference. It is important ~hat any contractor
selected by the County to work on the STAEFA electronic control
system have hands-on experience with this system due to its design
capabilities and operation.
l.
Consideration by the County of the recommendations should include
cost, compatibility of employee environment, overall comfort level
of the entire facility, maintenance and energy savings. Projected
energy savings alone may not provide adequate justification be6ause
of State requirements for ventilation. Puget Power can provide an
energy savings analysis on certain recommendations through some
modeling assistance to project the economic benefits. This process
will require a number of assumptions and may.not be entirely accurate.
Ilowcver, we feel confident that if the modifications are completed,
some energy savings will result.
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Once you have had an opportunity to fully evaluate the reconunend-
ations listed, puget will be willing to meet with representatives
of the County to answer questions you may have relative to this
proposal and how we may be of further assistance. I may be
reached at 385-1004.
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District Man~!{e;
cc: Gary Rowe
Tom Kerfonta
Art Mi1e1sen
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------
STATE OF WASHINGTON
BOARD OF NATURAL RESOURCES
ANNUAL IN,;PECT] ON hEI'OHT
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PER~nT NO. ,!-f} / f? / _ MINE NAr1EAI?v-?!:5Z1.J!?~___ COUNTY TAX 110.
1.
INACCURACIES OF AND RECOMMENDATIONS FOR THE OPERATOR'S ANNUAL HEPDRT:
--,~I! ~
2. CORRECTIVE ACTION TO BE COMPLE~'ED BY:
3. REVISED BOND
- $_~_ X
ACRES: TOTAL BOND REQUIRED:
$
~. REQUIRED CHANGE (IF ANY) IN THE AMOUNT OF THE BOND TO BE COMPLETED BY:
5. REASON FOR BOND INCREASE:
INSPEC'fED BY ~ rf:.~
/ ' D R REPRESENTATIVE
/..7 1Oc,/4ur/ t?:..f kl'CS"tb-
TITLE
Lj-.5 -8f?
DATE
, RES 90-1501
1/8~
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. CEFAKT~ENT OF N~TURAL RESOURCES
~NNUAl SURFACE ~INJNG CPERATOR'S FEPCRT AND AN~U~l BILLING ST~TE~ENT
~f&!!g~_~ FRC~ JANUARY 01, 1989 TO JANU~KY e1, 1990
PER~~T NC. 7C-01(179 LCC~TED IN CCUNTY DESCRIBED
AS S.c 17 T~N ~c R~G 010w ~INE NAME (IF ANY>_~~r~mL______________
COUNTY TAX ACCCCNT NC. _____________ DNR C2 1 UfIT
OPERATCR:' A~E~ DISTRICT ,-
ADDRESS: -~-~-~-------~-----~-~~~___________~_______________~__
----~-------------~~--~--------------~-------------~--
---~-~-~-------------~~--------------------------~-~--
e
PHONE .~C: ::::::::::::::::::::::::::::::::::::::::::::::::::::::
SUBMIT NO LATER THAN: C1/01/1989
12. FILL OUT ANC SIGN SECTIONS E A~C C.
. SE~C ALL 3 (CPIES ~NC AMCUNT OF FEE AS INDICATED O~ LINE (~. ,.-,
3. SE~C CCPY OF 8 1/2 X 11 SKETC~ ~APS SHCWING ITEMS E1, !, 4, 5, & 7.
RETURN TC: 8E~~Fit ~~J~3~Lo~~Ig~RCES
RT 1 90X 1375
FORKS WA >E331
IN CASE CF QUESTIC~S CALL: (206j~74-6131
.****..*.*~***.**..**********.**.~*****.**.*****..**.*.*******i.**..****i
~f&!l~~_~ OPE~AI0R'S STATEMENT
1. TOTAL ACRES FERMITTEC:____~__________________________________________
2. CATE OF MOST RECENT MINING:~_~~~~____________________________________
3. TOTAL ACRES CISTUREEC TO DATE: ____~_________________________________r-
4. TOTAL ACRES OISTLREEC lAST 12 MCNTHS: __~____________________________
5. ACRES TO aE CISTUREEC NEXT 12 ~ONTHS:____________________~___________,~
6. HA~ RECLAMATIO~ STARTED? NC ____ YES _~___ CATE __l~________
7. Nu~aER OF AC~ES ~eClAIMEC --~~-___~_~~_~___________________________~"
8. HAS RECLAM~TION eEEN COMPLETEC~ NO_~__ YES____ DATE____~___________
I CERTIFY TO T~E BEST CF MY KNOWLECGE THE INFO~MATION CONTAINEr
HEREIN IS CO~PlETE AND ACCURATE. ~ ~
Robert G. Nesbitt ~~ '
-----"fll''EO-1l'l;-l''R'IY;Ut:-Y;lll''E---------- -- 'En l11fir~- 11 un---------'"
~*~***...***~....***.***..*.**'*.*..***.*.**..*.*.**.*********.**********
~5&!!Q~_~ BILLING STATEMENT I~YCICE NC. 142S4t
1. eASIC FEE $2SC.CC
2. A :FH OFSS.CC FCR E~CH ACRE ClSTURBEC IN EXCESS OF 10 ACRES
CURING THE LAST 12 MCNTHS $
3. TCTAl (lINE 1 8 2) $
RES 90-1501 1/84 (SM-7>
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.
.
:)
RECEIVED
..
DEe 12 1988
JEFFERSON COUNTY
PUBLIC WORKS OEPT
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PEHfH'f NO.
1 .
STATE OF WASHIIJG110N
BOARD OP NATURAL RESOURCES
RECEIVED
APR 14 1969
JEFFERSON COUNTY
PUBLIC WORKS DFPT
jt2.i8.z- _ MINE NAf1E 5,f/;e I!l ~.,_ COUII'I'Y 'I'M: no. .,.._
ANNUAL INSPECTION HEl'OH'j'
INACCURACIES OF AND RECOMMENDATIONS FOR THE OPERATOR'S ANNUAL REPOH'I':
_~d.f'
.A/A-
2. CORRECTIVE ACTION TO BE COMPLE'I'ED BY:
"
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3. REVISED BOND - $
x
ACRES:
TOTAL BOIID REQUIRED:
q. REQUIRED CHANGE (IF ANY) IN THE AMOUNT OF THE BOND TO BE COMPLETED BY:
5. REASON FOR BOND INCREASE:
RES 90-1501
L
INSPEC'fED BY ~~ ~
DNR REPRESENTATIVE
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TITLE
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DATE
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STATE OF~ASHI~GTC~
CEFART~ENT OF ~~TURAL RESOURCES
MINING CPERATOR'S ~EPORT ANt ~NhUAL BILLING STATE~ENT
FRO~ JAhUARY 01, 19E9 TO JA~UARY Cl, 1990
ANhUAL SURFACE
gf!!Q!!-.!
PERMIT "c.
AS SEC 32
COlJNTY lAX
CPERATCR:
ACORESS: ::::::::::::::::::::::::::::::::::::::::::::::::::::::
\iii
7C-Cl01~2 LCCATED IN CCUNTY DESCRIBED
TWN 2E RhG alOE ~lhE NAME (IF ~NY)__~~D~_________________
ACCClNT NC. ONR 02 1 2
------------- AREA DISTRICT UhIl
tl.I,
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------------------------------------------------------
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PHCNEhC:::::::::::::::=::::::::::::::::::::::::::::::::::::::
i~BM~lltOob~Ti~CT~~~~ ~~l~16~~8~ ANt c.
2. SE~C ALL 3 CCPIES ANt AMOUNT OF FEE AS I~OICATED O~ LINE C3.
3. SEND COpy OF d 1/2 X 11 SKETC~ ~APS SHeWING ITEMS 81, 3, 4, 5, & 7.
RETURN TO: gE~~F~E ~~J~~~Lo~~jg~RCES
RT 1 BOX 1375
FORK5 W~ 98331
IN CASE OF QUESTIONS CALL: (20e)374-e131
.**.*.t*.*****.~**.**.******....*~.***.*******.*.*****_._.*.,........*."
J~fllQI_1 OPE~ATOR'S STATEMENT
1. TOTAL ACRES FERMITTE[:_______~_______________________________________~
2. CATE OF MOST RECENT ~INING:__j=~~~_________~_____________~___________
3. TOTAL ACRES CISTUREEC TO DATE: ~_~_________~___~_________~___________r-
4. TOTAL ACRES DISTURBEC LAST 12 ~C~THS: _0______________________________
5. AC~ES TO BE CISTURBE[ NEXT 12 ~ONTHS:Q~jJ~c~~QQ~o~_QQ~_______________,-
e. HAS RECLAMAlION STARTED? ~O X YES DATE
7. Nu~eER OF ACRES RECLAIMED ,___:D::___________:::::______::::::::::::::"
8. HA5 RECLAM_lI0h eEEN CO~PLETEC? NO__~__ YES OATo________________
I CERTIFY TO T~E SEST CF MY KNO.LECGE THE INFO~M~TICN CONT~I~EC
HEREIN IS CO~PLETE A~O ACCURATE. ~~
Robert G. Nesbitt, '
-----Tl~!U-O~-~~JN1!r-N~'E---------- -t lTU ~l~N~lu~~---------
******~*..***~***.**..*****..*..********.*.*****.********...******~******
'~~~I1Q~_~ BILLl~G STATEMENT Ih~OICE NO. 14294>
1. BASIC FEE $250.(0
2. A ,FEE OF !5~CC FOR E~CH ACRE CIS1UR8EC I" EXCESS OF 10 ACRES
DU~ING THE L~ST 12 ~CNTHS I
3. TCTAL (LINE 1 ! 2) 1
RES 90-1501 1/84 (S~-7)
.
.
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..
RECEIVED
DEe 12 1988
JEFFERSON COUNTY
PUBLIC WORKS OFPT
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PEItI'HT NO. ,l.O /f3()
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t' RECEIVED
STATE OF vIASHHlG'1'ON
BOARD OF NATURAL RESOURCE~
APR 14 1989
JEFFERSON COUNTY
PUBLIC WORKS DEPT
ANNUAL l.NSPEC'I'IOIJ liEI'OHT
MUlE NAME QU'tlc..e.n~.:...__.._ _~ COUNTY TAl: 110, ,
~Q~C,__..
INACCURACIES OF AND RECOf1I1ENDA'I'IONS FOR 'I'HE OPERATOR'S MIWJAL HEpr;HT:
~
3. REVISED BOND
2. CORREC'I'IVE ACTION '1'0 BE COMPLE'I'ED BY:
ACRES: TOTAL BOND REQUIRED:
$
- $ A//A-
x
4. REQUIRED CHANGE (IF ANY) IN THE AMOUN1' OF THE BOND '1'0 BE COI1PLETED BY:
/1//4
5. REASON FOR BOND INCREASE: ~~
RES 90-1501
1/84
.l>;l.4~~~1.~'~~iJ;):;zrt4~iki~1U.~~'~~~mz~~iw.:;~~MrW~~~-f"-'" ~
SM-7a
L'
INSPEc'rED BY ~ ~
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TITLE
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ANNUAL SURFACE
gfIl.QL!
PERMIT NO. 7C-C1C1E1 LOCATEO IN CCUNTY DESCRIBEO .
AS SEC 11 TkN 2~ RNG C10W ~INc NAME (IF ANY)___~2~~~~______________~
COUNTY TAX ACCOUNT NO. DNR C2 1 2
OPERATCR. Je"l ,0 ------------- ,A~EA. DISTRICT UNIT
ADCRESS:. -~-~.et~0~~~QWtl~_~~1m~Qt~~bl~~~~_____~_____~_~__
---~~~-------~---~---~~~-~---------~-~-------------~--
.-~-~~~~~-~-~-~---~---~~-~--~-------~-~-----------~-~--
PHONE NC::::::::::::::::::::::::::::::::::::::::::::::: ::::::::
SUBMIT NO LATER THAN: C1/01/198~
1. FIll OUT AND SIGN SECTIONS B ANC C.
2. SENC ALL 3 CCPIES ANC AMCUNT CF FEE AS INDICATED ON LINE C!.
3. SENC COPY OF 8 1/2 X 11 SKETC~ ~APS SHOWING ITEMS E1, !, ~, 5, 8 7.
RETURN TO: g(eJF~t ~~J~~~Lo~~~g~RCES
RT 1 BO) 1375
FORKS WA ~E3!1
IN CASE CF QUESTIONS CALL: (2C6)!74-6131
..**.*...*'**.,.,***~*.**.**....*....*.**.**.**.***..*,.*.*._...*-,.,*._*
~gf!lQ~_~ OPERATOR.S STATEMENT
1. TOlAL ACRE S F HMITTEC: _____2.?..:..:_____..:_________________________________~
2. CAlE OF ~OST RECENT MINING:__..:_~:8~_..:_____..:_____________..:_..:___________
3. T01AL ACRES CISTUReec TO DATE: ____~~________________________________~.
4. TOTAL ACRES CISTURBEC LAST 12 ~CNTHS: ___~~~2S~~_____________________
5. ACRES TO BE CISTURBEC NEn 12 MONTHS:____~_..:_________________________.-
6. HilS RECLAMATION STARlEO? NC' YES X CATe _)_-]Q_________
5;5
7. ~u~eER OF ACRES RECLAIMEC --~----------------------------~-----------
8. HAS RECLAMATIO~ EEEN CO~FLETfC? NO_!___ 1ES____ OATE________________
I CERTIFY TO T~E 8EST OF MY KNCW~ECGE lHE INFORMATICN CCNT~I~EC
HEREIN IS CO~PLElE ~NO ACCU~ATE. ~ ~.~ ~ ~ ~
-----~~~iPri*.::l'~H~H!n~"E---------- --~o~-~------- .,-
~*~*.*~.~*.*****~*.*.**.*********_.********..*.**.************~****.****.
~g~!lg~_~ BILLI~G SlATEMENT I~VCICE NO. 142S~E
1. BASIC FEE
2. A ;FEE OF $5.CC FCR EACH ACRE CISTURBEC IN EXCESS OF 10 ACRES
CURING THE LAST 12 MCNTHS
3. TOTAL (LINE 1 ~ 2)
RES 90-1501 1/E4 (S~-7)
. ~~
II ..
1)///;:;
STAlt OF USliINGTCN /1..-'"
CEFART~ENT OF ~ATURAL RESCURCE~
MINING CPERATCR'SFEPCRT ANC jlNNUiL BILLING
FRO~ JANUARY C1, 1~E9 TO JANUAFY C1, 19~O
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bf:C 12 1989
JEFFEA::>ul'l COUNTY
PUBLIC WORKS DEPT.
'-.'
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RECEIVED
STATE OF WASHINGTON
BOARD OF NATURAL RESOUHCE~
APR 14 i989
JEFFERSON COUNTY
PUBLIC WORKS DEPT
_Lf)~ZL_ MINE NAME ~{!.~fi.~__.J;[;_ COUIITY 'l'A,c 110. _,,_,_.._
f'EHW['j'rw.
ANNUAL INSPECTION HEi'OHT
1.
INACCURAC IES OF AND RECOMNENDA'J'IONS FOR 'l'HE OPERr;I'OH' oS ANNUf, L iiH'GH'l':
---~,
3. REVISED BOND - $
2. CORRECTIVE ACTION '1'0 BE COMPLE'l'ED BY:
x
ACRES: TOTAL BOND REQUIRED:
$
q. REQUIRED CHANGE (IF ANY) IN THE AMOUNT OF THE BOND TO BE COMPLETED BY:
5. REASON FOR BOND INCREASE:
RES 90-1501 I/SQ
~..--:
'.....-~ "I
L
INSPEc'rED BY h ~ g /S.lh..~
//Ik; DNR RE~.-{'l'IVE
&r7Pwl1~ a.1- h>;e..5;~,...
TITLE
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(EFART~~~~Ec~F~~~5tl~G~~~oURC.S
ANNUAL SURFACE MINI~G CPERATOR'~~EPORT AND AN~DaL BILLIhG STaTEMENT
fROM J~~UARV a" 1ge9 TO ~ANUARY 01. 1990
gf!!.QL~
PER~IT ~o. 7C-C1C1S0 LCCeTEO IN CCU~TY DESCRIBEC
AS SEC 23 TWN <7 R~G O<Ow MI~E NAME <IF ~NYl_~~~~~~~~g:_!~__________
COUNT V TAX ACCC~hT NC. _____________ DNR C2 1 2
A~EA OISTRICT U~IT
I""'; {
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OPERATCR:
AOORES~:
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.-~-~-~-~----------~--~---~---------~-------~-----~-~--
---~-~~~---~------------------------------------------
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-~-~~~-~-~-~--------~----~---------~---~-----------~--
~
PHCNE hC: -~-~---~---~----------~~-~---------~-----__~_____~____
______________________________________________________
~~BM~iL~Cob~Ti~(T~~~i ~~l~l~~~s~ AhC C.
2. SE~t ALL 3 CCPIES ANt AMCUNT CF FEE AS INDICATED Oh LINE C3.
3. SE~D COPY OF 8 1/2 X 11 SKETC~ ~APS SHOWING ITEMS 61, 3, 4, 5, 8 7.
RETURN TC: DEPT OF NAT~P.AL RESOURCES
OLYMPIC REGION OFFICE
RT 1 ECX'1375
FORKS W~ 98331
IN CASE OF Ql:ESTIDNS CALL: C20t>3i4-t131 r-
.****.~.**t****.t*~....****.**.*.t****.*****.***~***.*******~**..**.*****
~Ef!l~~_s CFE~A10R'S STATEMENT
1. T01AL aCRES FERM!TTEC:_____~S________________________________________~'
2. CA1E OF MOST RECENT MINING:_~~8E______________________________________
3. TOTAL ACRE~ ClSTURSEC TO DATE: ___2___________________________________,-, I
4. TOTAL aCRE~ CISTURBEC LAST 12 MONTHS: _~___________~___~_~___________
5. AC~ES 10 BE CISTUREec NEXT 12 ~ONTHS:__~_~~~~!~~Y2r~~~2~lt___________rj
t. HA~ RECLAMATION STARTED? NC X YES _ CATE ______________
---- 0 - ---
7. NU~BER OF aC~ES ~ECLaIMEO --~------------~---------------~-----------(1
s. H~~ RECLAMaTION SEEN CDMPLETEC? NO X VES____ OATE________________
I CERTIFY TO THE BEST CF MY KNO~LECGE THE INFORMATION CONTAINEC
HEREIN IS COMPLETE ANO ACCURATE. ~
Robert G. Nesbitt ' ~~~. ~~
-----~lPtn-O~-p~1N~tt-~~'E---------- 0 ~~CPt---------'1
.*.***.***...**.****.*****.*********************~***.*t**.*t**._.*.*.***.
~Ef!l~~_f BILLlhG STATEMENT INVCICE NC. 142~47
1. BAHC FEE
2. a 'FEE OF n.co FCR E~CH ACRE CISTURBH IN EXCESS OF 10 ACRES
CU~ING T~E LAST 12 MCNTHS
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-' D''''1910n 01 Hoalth
1112 So QUince. ET.35
OlympllJ, WA 98504
Mary T. McFadden
En\lironmtlnlal Hoalth Inspoclor
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(206) 586.441117
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TRANSIENT ACCOMMODATIONS
DATE I NUMBER OF UNITS
O{,'J ;~I ;"CI/ / ;7,
COUNTY/CITY I OAT[ ~f[D
1040 DAY YR
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CHECK APPLICABLE ITEMS
1 J8J ANNUAL INSPECTION
2 0 INITIAL INSPECTION
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1.0. NUMBER
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(X) INDICATES CONDITIONS UNSATISFACTORY & SECTIONS VIOLATED
01 DWAC 248-144-040 SUPERVISION 09 DWAC 248.144.120 FOOD & BEVERAGE SERVICE
02 DWAC 248.144-050 BUILDINGS 100WAC 248.144'130 lODGING UNIT KITCHEN
030WAC 248'144-060 DORMATORIES 11 DWAC 2048'144.140 INSECT &. RODENT CONTROL
"'04 OWAC 248.144.070 WATER SUPPLY 12 DWAC 248.144.150 PLUMBING
OS::estWAC 248.144.080 TOilET &. BATH FACILITIES
06 DWAC 248.148-Q90 VENTILATION 13 DWAC 248.144'160 SOLID WASTE
07 DWAC 248,'44,100 HEAT 14 DWAC 248.144.170 SEWAGE DISPOSAL
08 DWAC 248.144.110 LIGHTING 160WAC 248.144'180 TRAVEL TRAILERS &. MOBilE HOMES
16 DWAC 248'1404.190 SWIMMING POOLS
17 OWAC 248'10404.200 PETS
18 DWAC 248'144.210 BEDDING &. LINEN
190WAC 248'1404.220 LAUNDRY
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WAC 248'144-230 HOUSEKEEPING &.
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WAC 248-144-2040 CHEMICAL &.
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DESCRIP1;ION OF VIOLATIONS
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STATE OF WASHINGTON
COUNTY OF JEFFERSON
In the matter of
K
An Agreement for Operation K
Of the Brinnon Motel K
AGREEMENT NO.~ '..:-- ~
THIS AGREEMENT, entered into as of the date given at the conclusion
of this contract, is by and between Jefferson County, a municipal
corporation of the State of Washington, hereinafter referred to as
the "County" and the Clallam-Jefferson County Communi ty Action
Council, Inc., a private non-profit corporation formed under the
laws of the State of Washington, hereinafter referred to the
"Council ".
WIT N E SSE T H:
WHEREAS, the County and the Council are desirous of entering
into an agreement to formalize their relationship regarding the
operation of a motel on the second floor of the Brinnon Senior
Center building; and,
WHEREAS, the County has purchased the Brinnon Senior Center
building pursuant to Title I of the Housing and Community
Development Act of 1974 through a Community Development Block Grant
awarded by the Washington State Department of Community Development
under Contract No. B-85-DC-53-tOl-8502; and,
WHEREAS, in accordance with its Community Development Block
Grant application it is the County's intent to operate a motel as
a funding base for the senior center that will occupy the first
floor of the Brinnon Senior Center building; and,
WHEREAS, it would be beneficial to the County to contract with
the Council as an independent private non-profit agency to
accomplish the County's goals with said structure;
NOW, THEREFORE, in consideration of the mutual promises,
covenants, and provisions contained herein, and the mutual benefits
to be derived therefrom, the parties hereto agree as follows:
SECTION 1: SCOPE OF WORK
The Council will operate the Brinnon Motel, which shall be
known as the Bayshore Motel at Brinnon, said operation inClUding,
but not limited to management, supervision, planning, advertising
and promotion, public relations, daily maintenance and minor
repair, and grounds upkeep. Grounds upkeep shall consist of the
area of the north apartment, the sign area and sweeping the general
area by the north apartment. Further, the Council shall be
responsible for all costs associated with the operation of the
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motel, including telephone, utilities insurance daily maintenance
and minor repair, motel supplies and equipment, advertising and
promotion, but not major building repair or maintenance. Any
renovation required or desired because of the motel operation shall
be negotiated independently of this agreement.
SECTION 2: COMMENCEMENT AND TIMING OF PERFORMANCE
The undertakings described herein will be commenced
January 1, 1989 continuous through December 31, 1989.
SECTION 3: COMPENSATION AND METHOD OF PAYMENT
upon
The Council will pay eight thousand nine hundred and thirty
dollars ($8,930) for 1989 in twelve (12) monthly installments as
rent for the second floor, the office and managers' apartment at
the north end of the structure. Rent payments shall be forwarded
monthly to the Jefferson County Treasurer's Office.
When the two-bedroom apartment at the south end of the
structure is rented as transient quarters requiring the supervision
and daily cleaning and maintenance by the motel managers,
thirty-three percent (33%) of the gross rent, less any discounts,
will be retained by the Council; the remaining sixty-seven percent
will be transferred to the aforementioned Brinnon Senior Center
account.
Each year, during the month of November, the Council will
present to the County a budget for the forthcoming calendar year.
The Motel Advisory Board and the County will be encouraged to
comment to the Council on their views of the budget. Final decision
regarding the budget will rest with the Council. The County
reserves the right to approve or disapprove any proposed
maintenance as budgeted by the Council.
The County an the Motel Advisory Board agree that during the
first three years of operation, profits from the operation will be
used for capital improvements, upgrading the facility and its
furnishing, and promoting and advertising it. It will be the
Council's responsibility to develop annual plans for such
improvements and advertising. The County reserves the right to
approve or disapprove all requested capital improvements.
The Council will be reimbursed for administrative, supervisory, and
accounting services, the cost of which will be determined annually
as part of the council's "direct cost allocation formula" which is
developed for all its programs. This amount varies from year to
year, but at no time will it exceed ten percent (10%) of the annual
motel revenue. The Council will not receive any share of the
profits.
When annual actual revenues exceed the annual actual expenditures,
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the County with input from the Council and the Motel Advisory Board
will determine what proportion of the profit shall be retained for
capital improvements and other needs and what proportion shall be
transferred to the aforementioned Brinnon Senior Center account.
SECTION 4: COUNCIL STAFF ASSIGNMENT
The Council shall select necessary staff to operate and
maintain the motel, in accordance with the Scope of Work set forth
in Section 1.
All services required hereunder will be performed by the
Councilor under its supervision and all persons engaged in work
shall be fully qualified and shall be authorized or permitted under
state or local law, as may be required, to perform such services.
Assuming all other qualifications are met, ,preference shall be
given to hiring Brinnon area residents and senior citizens.
SECTION 5: COUNTY RESPONSIBILITY
The County shall provide major maintenance and repair to the
building and to its electrical and plumbing systems. (See also
Section 7: Insurance).
SECTION 6: ACCOUNTS AND RECORDS
The Council shall maintain books, records, documents, and
accounts which sufficiently and properly reflect all direct costs
expended in the performance of this Agreement.
The Council will provide the County and the Motel Advisory
Board a quarterly accounting of revenues and expenditures for the
operation of the motel.
In addition, such records will include any other information
pertaining to the Agreement such as obligations and unobligated
balances, assets and liabili ties, outlays, equal opportuni ty, labor
standards and performance, as necessary and appropriate.
The County and its duly authorized officials shall have full
access to and the r igh t to examine all such books, records,
documents, and other materials at all times during the performance
of this agreement.
SECTION 7: INSURANCE
The Council will obtain, from a recognized agent, all
liability insurance for the building and its contents. The county
will reimburse the Council for the insurance premium.
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SECTION 8: RELATIONSHIP
The relationship of the Council to the County shall be that
of an independent agency rendering profession services. The Council
shall have no authori ty to execute contracts or to make commitments
on behalf of the County and nothing contained herein shall be
deemed to create the relationship of employer and employee or
principal and agent between the County and Council.
SECTION 9: MOTEL ADVISORY BOARD
The Brinnon Senior Center Board shall be the Motel Advisory
Board and shall be consulted and shall offer advice in the
following activities and in others as may be mutually agreed upon
during the period of this agreement:
A.
The agreement between the County and the Council regarding the
operation of the motel.
The development of policies governing the motel; selection of
managers of the motel.
Selection of Managers of the motel.
Development of advertising plans and promotional activities.
Periodic review of the operation of the motel.
Review of the annual budget before its submission to the
County.
Confer with members of the senior community as the Board may
deem advisable.
B.
C.
D.
E.
F.
G.
The Motel Advisory Board will appoint one of its members to act as
speaker for the group when approaching the Councilor the County
or the motel managers, rather than all members having access.
SECTION 10: OWNERSHIP AND INVENTORY OF EQUIPMENT AND SUPPLIES
The Council will provide the County with an inventory of
equipment and supplies for the operation of the motel. The Council
will maintain said inventory, adding and subtracting as supplies
are worn out or replaced. The Council will provide the County with
an annual updated inventory of supplies and equipment at the time
it presents its annual budget for the County's review.
The County will retain ownership of all supplies and equipment
purchased with funds obtained from the operation of the motel.
SECTION 12: EQUAL EMPLOYMENT OPPORTUNITY
A. The Council will not discriminate against any employee or
applicant for employment or subcontracting services because of
race, color, religion, sex, or national origin. The Council shall
take affirmative action to ensure that applicants are employed and
that employees are treated during employment without regard to
their race, color, religion, or national origin. Such action shall
4
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include, but not be limited to, the following: employment,
upgrading, demotions, or transfers, recruitment or recruitment
advertising; layoffs or terminations; rates of payor other forms
of compensation; selection; for training including apprenticeship;
and participation in recreational and educational activities. The
Council will in all solicitations or advertisements for employees,
placed by or on behalf of the Council, state that all qualified
applicants will rec~ive consideration of employment without regard
to race, color, religion, sex, or national origin. The Council will
cause the foregoing provisions to be inserted in all subcontracts
for any work covered by this contract so that such provisions will
be binding upon each subcontractor provided that the foregoing
provisions shall not apply to subcontracts for standard commercial
supplies or raw materials.
B. The Council shall keep such records and submit such reports
concerning the racial and ethnic origin of, applicants for
employment and employees as is required.
C. The Council agrees to comply with such rules, regulations, and
guidelines necessary to implement these requirements.
SECTION 13: TITLE VI OF THE CIVIL RIGHTS ACT OF 1964
During the performance of this Agreement the Council agrees
to Comply with Title VI of the Civil Rights Act of 1964 which
provides that no person shall, on the grounds of race, color, or
national origin, be excluded from participation in, be denied the
benefits or, be subjected to discrimination under any program or
activity receiving federal financial assistance.
SECTION 14: SECTION 3 COMPLIANCE
A. The work to be performed under this Agreement is in the
Brinnon Senior Center building which was purchased and renovated
with direct federal financial assistance from the Department of
Housing and Urban Development and is subject to the requirements
of Section 3 of the Housing Urban Development Act of 1968, as
amended, 12, U.S.C. 1701. Section 3 requires that to the greatest
extent feasible, opportunities for training and employment be given
lower-income residents of the project area and subcontracts for
work in connection with the project be awarded to business concerns
which are located in or owned in substantial part by persons
residing in the area of the building.
B. The parties to this Agreement will comply with the provision
of said Section 3 and the regUlations issued pursuant thereto by
the Secretary of Housing and Urban Development issued thereunder
prior to the execution of this Agreement. The parties to this
agreement certify and agree that they are under no contractual or
other disability which would prevent them from complying with these
provisions.
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C. The Council will include this Section 3 clause in every
subcontract for work in connection with the project and will take
appropriate action pursuant to the subcontract upon a finding that
the subcontractor is in violation of regulations issued by the
Secretary of Housing and Urban Development, 24 CFR Part 135. The
Council will not subcontract with any subcontractor where it has
notice or knowledge that the subcontractor has been found in
violation of regulations under 2~ CFR Part 135 and will not let any
subcontractor, unless the subcontractor has first provided it with
a preliminary statement of ability to comply with the requirements
of these regulations.
SECTION 15: AUDITS
The Council shall include the motel accounting in its annual
financial report and audit, and will submit a copy of said audit
to the County when it has been submitted in final form.
SECTION 16: HOLD HARMLESS
The Council agrees to indemnify and hold harmless the County,
its appointed and elected officers and employees, from and against
all loss and expense, including reasonable attorney's fees and
costs by reason of any and all claims and demands upon the County,
its elected and appointed officers, and employees from damages
sustained by any person or persons, arising out of or in
consequence of the Council and its agents' negligent performance
of work associated with this Agreement. The Council shall not be
liable for property and bodily injury that may result from the
negligence of any County officer, employee, or its agents with
regard to the maintenance and repair of the structure.
SECTION 17: MODIFICATION
This Agreement constitutes the entire agreement between the
parties. The County or the Council may suggest changes or
modifications in the Scope of Work to be performed hereunder and
in other sections of this agreement. No alteration or modifications
of this Agreement shall be effective unless such modification shall
be,in writing and signed by the parties hereto.
SECTION 18: SEVERABILITY
If any provision of this Agreement is found to be in conflict
with any rule or statutory provision of the State of WaShington,
then such provision which may be in conflict shall be deemed
inoperative and null and void, but shall not be deemed to effect
the validity of the (remaining proviSions of this Agreement.
6
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SECTION 19: ASSIGNMENT
Neither party shall assign, transfer, or contract to assign
its respective rights or duties in this Agreement without the
express,prior consent in writing of the other party.
SECTION 20: EXTENSION
This Agreement may be extended beyond December 31, 1989 for
annual periods based on the calendar year. Extensions will require
a written amendment to this agreement outlining the scope of work
as it may differ from the scope of work attached to this document,
expected,termination, and fees as may be appropriate.
SECTION 21: BREACH OF AGREEMENT
A. If at any time, in the opinion of the County, the Council has
failed to render services of proper quality or has failed to comply
wi th the terms and conditions of this Agreements, the County,
without prejudice to any other right or remedy, may give the
Council written notice to correct such conditions or cure such
default and if any such condition or default shall continue for
thirty (30) days after such written notice, then and in that event
the Agreement shall cease and expire. Thereupon, the County of its
duly authorized representative may employ other parties to carry
the contract to completion in such manner as the County may deem
proper. Any excess costs arising therefrom will be charged against
the Council.
B. In the event that the County fails to fulfill its
responsibilities with regard to this agreement within thirty (30)
days notice of such failure, the County agrees that the Council
shall have the right to consider said default a breach of this
Agreement and the duties of the Council under this Agreement
terminated.
SECTION 22: TERMINATION
This Agreement may be terminated in whole or in part upon a
forty-five (45) day written notice, by either party. All costs
incurred under the provisions of this Agreement shall be paid in
full for services actually rendered to the date of termination even
in the event of early termination.
SECTION 23: PERIOD OF AGREEMENT
1,
or
This Agreement shall be retroactive to and including January
1989, and continue through December 31, 1989, unless extended
terminated at an earlier date.
IN WITNESS WHEREOF, the parties hereto have executed, in duplicate
this agreement on this day of 1989.
7
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JEFFERSON COUNTY
BOARD OF COMMISSIONERS
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APPROVED AS TO FORM:
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Clerk of the Board
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Agreement for Operation of Brinnon Motel
CLALLAM-JEFFERSON COUNTY
MUN:.t' ~C\ION COUNCIL
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Peter SimpsQn-Tdate) I ~
Executive Dir~ctor
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JEFFERSON COUNTY
STATE OF WASHINGTON
In the Matter of:
x
AGREEMENT NO. 8'7..';;; '''6'/
An Agreement With x
Clallam-Jefferson County x
Community Action Council x
Concerning the Rental of the x
Brinnon Senior Center for x
The Operation of the x
Senior Nutrition Program x
THIS AGREEMENT, entered into as of the date given at the
conclusion of this contract, is by and between Jefferson County,
a municipal corporation of the State of Washington, hereinafter
referred to as the "COUNTY", and the Clallam-Jefferson County
Community Action Council, Inc., a private non-profit corporation
formed under the laws of the State of Washington, hereinafter
referred to as the "COUNCIL", and is hereby adjusted as follows:
WIT N E SSE T H:
WHEREAS, the COUNTY will be contracting effective June 1, 1988
with the Brinnon Senior Organization to operate the Brinnon Senior
Center; and,
WHEREAS, the COUNCIL will continue to use the kitchen and
dining facilities of the Brinnon Senior Center five (5) days a week
to operate the senior nutrition program;
NOW THEREFORE, in consideration of the mutual promises,
covenants, and provisions contained herein, and the mutual benefits
to be derived therefrom, the parties hereto agree as follows:
SECTION 1: SCOPE OF WORK
The COUNCIL will rent the kitchen and dining facilities of the
Brinnon Senior Center for five days a week for the purpose of
operating the senior nutrition program which provides both
congregate and home-delivered meals to persons over the age
of 60 in the Brinnon area. The COUNCIL shall have the
principal use of said facilities for a period of six hours,
four hours prior to and two hours after the serving time,
Monday through Friday.
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SECTION 2: COMMENCEMENT AND TIMING OF PERFORMANCE
The undertakings described herein will be commenced upon Jan.
1, 1969 continuous through December 31, 1969.
SECTION 3: COMPENSATION AND METH~ P.AYMENT
c-'lAJS,.s;;..!'l..g'1 ./((t, f~:, ~
The COUNCIL ~il pay two.thousan~ four~~red dollars and no
cents ($2,400~.OO) for the period of the agreement in twelve
(12) monthly installments as rent for the kitchen and dining
room and equipment therein. Rent payments shall be delivered
monthly to the Jefferson County Treasurer no later than the
seventh (7th) working day of the month.
SECTION 4: COUNCIL STAFF
The COUNCIL shall select the necessary staff to operate and
maintain the senior nutrition program in the Brinnon Senior
Center. All services required hereunder will be performed by
the COUNCIL or under its supervision and all persons engaged
in work shall be fully qualified and shall be authorized or
permitted under state or local law, as may be required, to
perform such services. Assuming all other qualifications are
met, preference shall be given to hiring Brinnon area
residents and senior citizens. (See also Section 6 below.)
SECTION 5: REPAIR AND MAINTENANCE
The COUNTY shall provide general maintenance and repair to the
ki tchen and the dining room. The COUNCIL shall clean the
kitchen and dining room and clean and repair attendant COUNTY-
owned equipment based on Use by the senior nutrition program.
The COUNTY or its agents shall be responsible for cleaning and
repair of the kitchen and dining room and attendant COUNTY-
owned equipment required as the result of other uses. The
COUNCIL may provide additional equipment for the purposes of
operating the senior nutrition program, and shall clean,
maintain and repair said equipment, retain responsibility,
primary use, and ownership of said equipment and may remove
it at the COUNCIL's convenience.
SECTION 6: RELATIONSHIP
The relationship of the COUNCIL to the COUNTY shall be that
of an independent agency leasing a building facility and
rendering professional services. The COUNCIL shall have no
authori ty to execute contracts or to make commi tments on
behalf of the COUNTY and nothing contained herein shall be
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deemed to create the relationship of employer and employee or
principal and agent between the COUNTY and the COUNCIL.
SECTION 7: CIVIL RIGHTS AND OTHER COMPLIANCES
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A. During the performance of the Agreement the COUNCIL agrees
to comply with Title VI of the Civil Rights Act of 1964, and
all sUbsequent legislation relating to civil rights, which
provides that, no person shall, on the grounds of race, color,
or national origin, be excluded from participation in, be
denied the benefits of, or be subjected to discrimination
under any program or activity.
B. The work to be performed under this rental agreement is
in the Brinnon Senior Center building which was purchased and
renovated with direct federal financial assistance from the
Departmen~ of Housing and Urba~ Development and is subject to
the requirements of Section 3 of the Housing and Urban
Development Act of 1968, as amended, 12, U.S.C. 1701. Section
3 requires that to the greatest extent feasible, opportunities
for training and employment be given to lower-income residents
of the project area and contract for work in connection with
the project be awarded to business concerns which are located
in or owned in substantial part by persons residing in the
area of the bUilding. (See also Section 4 above.)
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SECTION 8: HOLD HARMLESS
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The COUNCIL agrees to indemnify and hold harmless the COUNTY,
its appointed and elected officers and employees, from and
against all loss and expense, including reasonable attorney's
fees and costs by reason of any and all claims and demands
upon the COUNTY, its elected and appointed officers, and
employees from damages sustained by any person or persons,
arising out of or in consequence of the COUNCIL and its
agents' negligent performance of work associated with the
Agreement. The COUNCIL shall not be liable from property and
bodily injury that may resul t from the negligence of any
COUNTY officer, employee, or its agents with regard to the
maintenance and repair of the structure.
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This Agreement constitutes the entire agreement between the
parties. The COUNTY or the COUNCIL may suggest changes or
modifications in the Scope of Work to be performed hereunder
and in other sections of the agreement: however, not
alteration or modifications of the Agreement shall be
effective unless such modification shall be in writing and
SECTION 9: MODIFICATION
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~ECTION 10: SEVERABILITY
If any provision of this Agreement is found to be in conflict
with any rule or statutory provision of the state of
Washington, then such provision which may be in conflict shall
be deemed inoperative and null and void, but shall not be
deemed to effect the validity of the remaining proVisions of
the Agreement.
SECTION 11: ASSIGNMENT
Neither party shall assign, transfer, or contract to assign
its respective rights or duties in the Agreement without the
express prior consent in writing of the other party.
SECTION 12: EXTENSION
This agreement may be extended beyond December 31, 1989, for
annual periods based on the calendar year. Extensions will
require a written amendment to this agreement outlining the
scope of Work as it may differ from the SCope of work attached
to this document, expected termination, and fees as may be
appropriate.
SECTION 13: BREACH OF AGREEMENT
If at any time, in the opinion of the COUNTY, the COUNCIL has
failed to comply with the terms and conditions of the
Agreement, the COUNTY, without prejudice to any other right
or remedy, may give the COUNCIL written notice to correct such
conditions or cure such default and if any such condition or
default shall continue for thirty (30) days after Such written
notice, then and in that event the Agreement shall cease and
expire. Thereupon, the COUNTY or its duly authorized
representative may employ other parties to carry the contract
to completion in Such manner as the COUNTY may deem proper.
Any excess costs arising therefrom will be charged against the
COUNCIL.
SECTION 14: TERMINATION
This Agreement may be terminated in whole or in part upon a
fortY-five (45) day written notice, by either party. All
costs incurred under the proviSions of this Agreement shall
be paid in full of services actually rendered to the date of
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Agre~nent re: Rental of Brinnon Senior Center for
Operation of Senior Nutritinn Progr&n
termination even in the even of early termination.
SECTION 15: PERIOD OF AGREEMENT
This Agreement shall become effective on January 1, 1989, and
continue through December 31, 1989.
IN WITNESS WHEREOF, the parties hereto have executed. in
duplicate, this agreement on the day and year below written.
JEFFERSON COUNTY
BOARD OF COMMISSIONERS
CLALLAM-JEFFERSON COUNTY
~r\:d::U"::/11 tJtj
feter Simp~~ (date)
Executive Director
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Ge rge cCfBrown, Chairman
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JOhfi ~ymond / ./
Pro~cuting Attorney
APPROVED AS TO FORM:
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Lorna Delaney
Clerk of the Board
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STATE OF WASHINGTON
COUNTY OF JEFFERSON
In the matter of
x
MANAGEMENT AGREEMENT
An Agreement for Services x
At the Quilcene and Tri- x
Area Community Centers x
Between Jefferson County, Washington and Clallam-Jefferson County
Community Action Council, Inc. for the
OPERATION OF THE QUILCENE AND TRI-AREA COMMUNITY CENTERS
THIS AGREEMENT, entered into on the date given at the conclusion
of this contract, by and between Jefferson County, a municipal
corporation of the State of Washington, hereafter referred to as
the "County," and the Clallam-Jefferson County Communi ty Act ion
Council, Inc., a private non-profit corporation formed under the
laws of the State of Washington (hereafter referred to as "the
Council"),
WIT N E SSE T H:
WHEREAS, the County is desirous of providing programs and
services to its citizens in the Quilcene area and the Tri-Area
communities of Chimacum, Hadlock, and Irondale; and
WHEREAS, the County does not have an appropriate department
in which to house the operation of said centers;and
WHEREAS, the Council has organizational experience and skill
in providing such services;
NOW, THEREFORE, in consideration of the mutual promises,
covenants, and provisions contained herein, and the mutual benefits
to be derived therefrom, the parties hereto agree as tollows:
SECTION 1: SERVICES TO BE PERFORMED
The County gives authority to the Council to operate said
centers, providing programs and services to all Jefferson County
residents with particular emphasis on low-income people and senior
citizens.
SECTION 2: RESPONSIBILITIES OF THE COUNCIL
With funds provided by the County (see Section 3), the
Council, using sound management practices, will provide daily
operation and staffing of the centers, provide program planning,
schedule events and groups, and janitorial services.
Submi t an annual budget request in accordance with the County's
annual budget schedule.
Provide the County with a copy of the Council's annual financial
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audit, and an annual statistical report on the use, services, and
programs at each center.
SECTION 3: RESPONSIBILITIES OF THE COUNTY
The County will provide an annual budget for the operation of
the Center based on revenues available to the County and paid to
the Council on a quarterly basis. The County will provide building
and grounds maintenance.
SECTION 4: RESPONSIBILITIES OF THE BUILDING BOARD
Through the Board of County Commissioners, the County will
appoint members to a "bUilding board" for each center that will
have the responsibility to set user fees for the building, to
represent the County to the ci tizens using the centers, and to
represent local citizens to the County. The Council and its staff
will work cooperatively wi th the "building board," meeting wi th
them from time to time as necessary.
SECTION 5: RELATIONSHIPS
The relationship of the Council to the County shall be that
of an independent agency rendering professional services. The
Council shall have no authority to execute contracts or to make
commitments on behalf of the County and nothing contained herein
shall be deemed to create the relationship of employer and employee
or prinCipal and agent between the County and the Council.
SECTION 6: HOLD HARMLESS
The County shall hold harmless the Council with respect to
any damages arising from any of the work performed in respect to
this agreement.
SECTION 7: NO SMOKING
By a resolution adopted by its board of directors on December
14, 1988 the Council declared itself to be "a non-smoking agency
and shall provide smoke-free environments at all of its locations."
The Resolution further stated that the Council shall "follow the
posting requirements of the Washington Clean Indoor Air Act." The
Council will therefore post both the centers wi th appropriate
signage indicating that smoking is not allowed inside the
facilities.
SECTION 8: MODIFICATION
This Agreement constitutes the entire agreement between the
parties. The Council may, from time to time, require or the
Council may suggest changes or modification in this agreement. No
alteration or modification of this Agreement shall be effective
unless such modification shall be in writing and signed by the
parties hereto.
SECTION 9: ASSIGNMENT
Neither party shall assign, transfer, or contract to assign
its respective rights or duties in this Agreement without the
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express, prior consent in writing of the other party.
SECTION 10: EXTENSION
This Agreement shall continue through December 31, 1988.
Extensions may be made by the simple submission by the Council of
the annual budget request to the County, unless modifications are
required which must be approved in writing by both parties (see
Section 7).
SECTION 11: TERMINATION
This Agreement may be terminated in whole or in part upon a
thirty (30) day written notice, by either party. All costs
incurred under the provisions of this Agreement shall be paid in
full for services actually rendered to the date of termination even
in the event of early termination.
SECTION 12: PERIOD OF AGREEMENT
This Agreement shall be retroactive to include those years in
which the Council has been operating the said Centers for the
County, and will continue through December 31, 1989, unless
extended (see Section 9) or terminated (see Section 10) at an
earlier date.
IN WITNESS WHEREOF, the parties hereto have executed, in duplicate,
this agreement on the day and year below written.
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JEFFERSON COUNTY
BOARD OF COMMISSIONERS
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George C. rown, Chairman
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~nnison, Member
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Pr6secuting At~ney
APPROVED AS TO FORM:
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Lorna Delaney
Clerk of the Board
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CLALLAM-JEFFERSON COUNTY
t'=I~~;;:Ou;r ~ 81
Peter SimpS?~ (date) I !
Executive Director
4
1989 Management Agreement, Quilcene and
Tri-Area Community Centers
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COUNTY OF JEFFERSON
STATE OF WASHINGTON
In the Matter of:
x
MANAGEMENT CONTRACT
Operation of the
Brinnon Senior Center
By the Brinnon
Senior organization
x
x
x
x
THIS AGREEMENT, entered into on the date given at the conclusion
of this contract, by and between Jefferson County, a municipal corporation
of the State of Washington, hereafter referred to as the "County", and the
Brinnon Senior organization, a private non-profit corporation formed under
the laws of the State of Washington (hereafter referred to as "Brinnon
Seniors") I
WITNESSETH:
WffEREAS, the County is desirous of providing programs and services
to its senior citizens in the Brinnon area, commencing from Mt. Walker, south
to the Jefferson County line; and
WHEREAS, the County does not have an appropriate department in
which to house the operation of said center;
WffEREAS, the Brinnon Seniors have expressed a desire to and are
developing organizational systems necessary to provide such services;
NOW, THEREFORE, in consideration of the mutual promises, covenants,
and provisions contained herein, and the mutual benefits to be derived
therefrom, the parties hereto agree as follows:
SECTION 1: SERVICES TO BE PERFORMED
The County gives authority to the Brinnon Seniors to operate said
Center, providing programs and services to all ,Tefferson County residents
over the age of 60 who reside in the area described above, providing emphasis
to low-income people.
SECTION 2: RESPONSIBILITIES OF THE BRINNON SENIORS
1. Wi th funds provided by the County, the Brinnon Seniors, using sound
management practices, will provide daily operation and staffing of the
Center, provide program planning, schedule events and groups, and
janitorial services in a safe and efficient manner.
2. The Board of County Commissioners agrees that the Brinnon Seniors Board
of Directors will be responsible for the operation of the Center, for
setting user fees for occasional use of the building, for representing
the County to all Brinnon citizens using the Center, and representing
local senior citizens to the County. All user fees will be submitted
monthly to the County Treasurer by the last working day of the month the
fees were collected.
3. Submit an annual budget in accordance with the County's annual budget
schedule. Funds will be disbursed by the .Tefferson County Auditor's
Office on a quarterly basis as per the annual budget.
Management Contract:
Operation of the Brinnon Senior Center
SECTION 2:
RESPONSIBILITIES OF THE BRINNON SENIORS - Continued
4.
Provide the County with a copy of a monthly financial statement and an
annual financial report. The reporting format shall be provided by the
County.
5.
Provide to the County a quarterly statistical report of the use,
services, and programs at the Center. The reporting format shall be
provided by the County.
6.
Provide the following assurances:
a. It possesses the necessary legal authority to operate the Center;
that a resolution, motion, or similar action has been duly adopted
or passed as an official act of the Brinnon Senior's governing
body, authorizing the signing of the contract, including all
understandings and assurances contained herein, and directing and
authorizing the person identified as the official representative
of the Brinnon Seniors to act in connection with the contract and
to provide additional information as may be required.
b. It possesses the necessary organizational systems, including, but
not limited to, a BARS financial system, personnel policies,
written by-laws, minutes of proceedings, bonding of persons
responsible for handling the Brinnon Senior Center funds, and
appropriate liability insurance. Provide to the County in writing
within 30 days for any changes in by-laws, and personnel policies,
and minutes of proceedings.
c. It will comply with Title VI of the Civil Rights Act of 1964 (P.O.
66-352) and in accordance with Title VI of that Act, no person in
the United States shall, on the ground of race, color, or national
origin, be excluded from participation in, be denied the benefits
of, or be otherwise subjected to discrimination under any program
or activity and will immediately take any measures necessary to
effectuate this agreement.
d. It will comply with Title VI of the Civil Rights Act of 1964 (42
US CD 2000d) prohibiting employment discrimination where (1) the
primary purpose of a grant is to provide employment or (2)
discriminatory employment practices will result in unequal
treatment of persons who are or should be benefitting from the
activity.
e. It will comply with the minimum wage and maximum hours provisions
of the Federal Fair Labor Standards Act (29 U.S.C. 201) as they
apply to employees of nonprofit organizations. Assume full
responsibility for the payment of all payroll taxes, and other
forms of taxes or other payment required by any County, Ci ty,
Federal, or State legislation which are now or may during the term
of the contract be enacted as to all persons employed in perfor-
mance of the work under this contract and shall assume exclusive
liability therefore, and meet all requirements thereunder pursuant
to any rules or regulations that may apply.
f. That officers, board members, and employees will not use their
positions for a purpose that is or gives the appearance of being
motivated by a desire for private gain for themselves or others,
particularly those with whom they have family business, or other
ties.
2
,'~~
Management Contract: Operation of the Brinnon Senior Center
SECTION 2: RESPONSIBILITIES OF THE BRINNON SENIORS - Continued
g. It will give the County and the State Auditor's Office, through any
authorized representative, the access to and the right to examine
all records, Management Contract/Brinnon Senior Center books,
papers, or documents related to the operation of the Center,
including the records of any contractors or subcontractors
performing under the contract.
h. The work to be performed under this agreement is in the Brinnon
Senior Center building which was purchased and renovated wi th
direct federal financial assistance form the Department of Housing
and Urban Development and is subject to the requirements of Section
3 of the Housing Urban Development Act of 1968, as amended, 12,
U.S.C. 1701. Section 3 requires that to the greatest extent
feasible, opportunities for training and employment be given lower
income residents of the project area and contracts for work in
connection with the project be awarded to business concerns which
are located in or owned in substantial part by persons residing in
the area of the building.
i. That the Brinnon Senior Organization shall indemnify and hold
harmless the County from and against all claims for any damage,
including, but not limited to, claims for damage to property or
claims of misrepresentation in negotiations, due to negligence of
the Brinnon Senior Organization or their employees including court
costs and attorneys' fees, if any.
7. Provide landscaping and grounds maintenance.
SECTION 3: RESPONSIBILITIES OF THE COUNTY
1. Provide general building repair.
2. Provide general liability.
3. The Board of County Commissioners shall furnish final
decisions, in writing, on questions not covered by the above.
SECTION 4: RELATIONSHIPS
The relationship of the Brinnon Seniors to the County shall be that
of an independent agency rendering professional services. The Brinnon
Seniors shall have no authority to execute contracts or to make commitments
on behalf of the County and nothing contained herein shall be deemed to
create the relationship of employer and employee or principal and agent
between the County and the Brinnon Seniors.
SECTION 5: MODIFICATION
This Agreement constitutes the completed and integrated understAnd-
ing, Agreement, or negotiation between the parties. Any oral or writtl!m
representation not set forth herein Is excluded. Amendments hereto shall be
set forth In writIng and executed by both partIes. No change by the BrInnon
Senior Organization shall be recognized wi thout wrI tten approval of the Board
of County CommIssioners. Nothing in this section shall excuse the Brinnon
Senior Organization from proceedIng wIth performance of the contract.
3
Management Contract: Operation of the Brinnon Senior Center
SECTION 6: ASSIGNMENT
Neither party shall assign, or transfer, its respective rights or
duties in this Agreement without the express prior consent in writing of the
other party.
SECTION 7:
EXTENSION
This Agreement shall continue through
Extensions may be made by the simple submission by the
annual budget to the County, unless modifications are
approved in writing by both parties (see Section 5).
December 31, 1969.
Brinnon Seniors of the
required which must be
SECTION 6: BREACH OF AGREEMENT
If at any time, in the opinion of the County, the Brinnon Seniors
have failed to comply with the terms and conditions of the Agreement, the
County, without prejudice to any other right of remedy, may give the Brinnon
Seniors written notice to correct such conditions or cure such default, and
if any such condition or default shall continue for thirty (30) days after
such written notice, then and in that event the Agreement shall cease and
Management Contract/Brinnon Senior Center expire. Thereupon, the County or
its duly authorized representative may employ other parties to carry the
contract to completion in such manner as the County may deem proper. Any
excess costs arising therefrom will be charged against the Brinnon Seniors.
SECTION 9: TERMINATION
This Agreement may be terminated in whole or in part upon a thirty
(30) day written notice, by either party. All costs incurred under the
provisions of this Agreement shall be paid in full for services actually
rendered to the date of termination even in the event of early termination.
Upon payment of such sums, the County shall be discharged from all
liability to the Brinnon Senior Organization hereunder. Upon termination of
the contract all documents, records, and file material shall be turned over
to the County by the Brinnon Senior Organization.
SECTION 10: PERIOD OF AGREEMENT
This Agreement shall be effective January
cont inue through December 31, 1969, unless extended
terminated (see Section 9) at an earlier date.
I, 1989, and will
(see Section 6) or
4
Management Contract: Operation of the Brinnon Senior Center
SECTION 11: AUTHORIZED REPRESENTATIVES
In performing the services defined herein, the Brinnon Seniors
shall report to:
Board of County Commissioners
P.O. Box 1220
Port Townsend, WA 96366
Phone: (206) 365-9100
Brinnon Senior Organization's authorized representative is:
Isabel ~rrnstrong
President
Title
Phone: 79~-432;l
SECTION 12: NOTICES
Any notice given by either party to the hereunder shall be served,
if delivered in person, to the office of the representative authorized and
designated in writing to act for the respective party, or, if deposited in
the mail. properly stamped with the required postage and addressed to the
office of such representative as indicated in Section 11. Either party
hereto shall have the right to change any representative or address it may
have given to the other party by giving such other party due notice in
writing of such change.
DATE:
50./>\0. 5. 1915'1
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JEFFERSON COUNTY
BOARD OF COMMISSIONERS
ATTE~ {kA
(Y),t1 0... ~L
Lorna Delaney, if
Clerk of the Board
-~~~
George C' Brown, Chairman
~~/
B. G. Brown, Member
Member
BRINNON SENIORS ORGANIZATION, INC.
DATE:
::\i 1.M!:> 5, /crx9
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jellerson Street
P,O, Box 1220
Port Townsend, WA 98368
(206) 3B5.9160
Gary A. Rowe, P.E., Director
Rober' G. Nesbitt. P,E., County Engineer
June 9, 1989
Mr. Vie Dirksen, Chief Administrator
Jefferson General Hospital
834 Sheridan st.
Port Townsend, WA 98368
Dear Vie,
My apologies for having not corresponded with you for quite
some time regarding the possibility of the hospital purchasing the
mUlti-service building. At our last meeting, we discussed the
current needs study that the county is conducting in order to
better determine our space and location requirements. We have done
some major reorganization within public works, and I am just now
able to return to the needs assessment. I will continue to work
on the hospital-county assessment, and will be contacting you this
summer for input.
I spoke today with Bret Kinney, regarding the laundry area,
which he has requested that the county return to the hospital. I
will do some research regarding that possibility, and hope to have
some information next week.
Thank you for your patience.
sincerely,
~
M.Carter Breskin
Planning and Programs Manager
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AGREEMENT NUMBER 90- I NT-O I 0
INTER LOCAL COOPERATIVE LEASE AND PURCHASE AGREEMENT
Pursuant to Chapter 39,34 RCW and to other provisions of law, the State of Washington. Department of
Information Services, and the following named municipal corporation, political subdivision, or other
public agency of the State of Washington. Jefferson Countv
I hereinafter called the .Political Subdivision,. hereby agree to
cooperative governmental leasing and purchasing upon the following lerms and conditions,
, . The Department of Information Services. in contracting for the lease and purchase of data
processing goods and services for the State of Washington. agrees to contract also on behalt of
the political subdivision, to the extent permitted by law and agreed upon by the parties,
2. The Department of Information Services will contract for the lease and purchase of data
processing goods and servjces according to the laws and regulations governing leases and
purchases by and on behalf of the Department of Information Services. Chapter 43,1 OS RCW.
The po!itic:al su!::d:viel::ii c.cccpts raspvl',~;~:!ai' :c;r ~cliipljallc.;e with ani addiiional or varying
laws and regulations governing leases and purchases by or on behalt of the political subdivision
in question.
3. Whenever the Department of Information Services has contracted to lease or purchase data
processing goods or services on behalf of (a) political subdivisions in general, or (b) a class of
political subdivisions which includes the undersigned political subdivision. or (c) the specific
political subdivision undersigned, the political subdivision may lease or purchase goods and
services covered by the contract on the same terms and conditions as the State of Washington,
Such a lease or purchase by the political subdivision may be effected by a purchase order
directed by the political subdivision to the vendor or other party contracting to furnish data
processing goods or services to the state, The Department of Information Services accepts no
responsibility for the performance of any lease or purchasing contracts by the vendor and the
Departm,mt of Information Services accepts no responsibility for the payment of the lease or
purchase price by the political subdivision.
4, The politlcai subdivision reserves the right to contract independently for the lease or purchase
of any particular class of data processing goods or services, with or without notice to the
Department of Information Services.
5. Any administrative fee cited in state master contracts will be charged to the political
subdivision utilizing that contract.
6, The Department of ,Information Services reserves the right to exclude the undersigned political
liiuLJdivision, ur any ciass contaIning the undersigned political subdivision, or political
subdivisions in general, from any particular data processing lease or purchasing contract, with
or without notice to the political subdivision.
7. This Agreement shall continue in force until cancelled by either party, which cancellation may
be effected with or without notice to the other party,
8. This Agreement is for state contracts entered Into by. or under the authority of, the
Department of Information Services.
g. CONTACTS:
Jefferson County
Political Subdivision
P.O. Box 1220
Mdress
Port Townsend, WA
City
Phone
State of Washington
Department of Information Services
Management Support Division
Contracts Office MS: PC.'1
1110 S.E. Jefferson Street
Olympia, Washington 98504.81 l'
Phone (206) 586-4917 or 586.1799
98368
Zip Code
ZCEPTED:
't!-".. ({--~,.~
. SIGNATUR . POLITICAL SUBDIVISION
"b!4.Orr
George C. Brown,
TYPE OR PRINT NAME
l~~n~~t~ ~~\I~rlgp-Arp
DIS CONTRACT ADMINISTRATOR
D~.A'A iJ( .1Jb!:L d' _L2Jt~__
-J.W.\'-t.B.,...J.s1l.9-_________
DATE
]]]0 SE 1efferson SUeel Mail SlOp pc.] 1
ConUtlClS Office
Olympia, WA 98504.81]] Telephone (206) 586-1799 or 586-4917
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IBM Corporation
6155 9th Street
Tacoma, WA 98405
Attn: Claude Lindsey
Dear Mr. Lindsey,
JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
1820 Jefferson Street
p,O, Box 1220
Port Townsend, WA 98368
(206) 385,9160
Gary A. Rowe, P.E., D/rector
Robert G. Nesbitt, P.E., County Engineer
July 26,1989
Thank you.
Please issue a refund check in the amount of $1,963.86, reference
invoice E733709, to this department.
S~1:erelY, .
rP~v'k.j"" ,
Eleanor J. S::;k~
Bookkeeper
xc: E09.50'
A02
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********111**********************..*********,**************"'***************. ) ;,/. ,:::",..' '"
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~E~!IQ~-f BILLING STATEMENT INVOICE NO. 152667 . "
$250.00 ) I ' . ,,' ,.'
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STATE OF ~ASHINGTON
CEPARTMENT OF NATURAL RESOURCES
ANNUAL SURFACE MINING OPERATOR'S ~EPORT ANO ANNUAL BILLING STATEMENT
FROM AUGUST 01, 19H9 TO AUGUST 01, 1990
PERMIT NO. 70-011039 LOCATED IN JEFFERSON
AS SEC C7 TWN 3C RNG 010~ ~INE NAME
COUNTY TAX ACCOUNT NO. _____________ DNR
OPERATCR:
COUNTY OESCRI6ED
(IF ~N')_~~Ee~crw_!l__________
02 1 2
AREA DISTRICT UNIT
--~~tF~r~~~~Q~~~_Q~~~_gfY~21i~~2r~~____________________
__E~~_~2~11gQ_________________________________________
__E~~12~~~Dgk~~__~~3J~________________________________
ADDRESS:
------------------------------------------------------
PHONE ~D: __~~~-21~~_____________________________________________
SUBMIT NO LATER TH~N: 08/01/19B9
1. FltL OUT AND SIGN SECTIONS d AND C.
2. SENO ALL 3 COPIES ~ND AMOUNT OF FEE AS INDICATED ON LINE C~.
3. SE~O COpy OF 8 1/2 X 11 SKETCH MAPS SHOWING ITEMS Bl, 3, 4, 5, & 7.
RETURN TO: DEPT OF NATURAL RESOURCES
OLYMPIC REGION OFFICE
RT 1 BOX 1375
FORKS WA 98331
IN CASE OF QUESTIONS CALL: (206)374-6131
********************************************************.****************
~E~!IQ~_~ OPERATOR'S STATEMENT
1. TOTAL ACRES PERMITTEO:________1Q!____________________________________
2. DATE OF MOST RECENT MINING:___~ErD~_12~~_~_______________~___________ 1
3. TOTAL ACRES CIST~R8EC TO DATE: ~Qer2~_~________________~_____________
4. TOTAL ACRES CISTURBED LAST 12 MONTHS: JJj~_~jJ_~~Q~QC~~wj_____________
5. ACRES TO BE CISTURBEO NEXT 12 MONTHS:__~__~~teIl~lJIQ~_~t2~~~U~_Q~~____
6. HAS RECLAMATION STARTED? NO _~__ YES _____ OATE ______________
7. NU~eER OF ACRES RECLAIMEO -------------______________________________
8. HAS RECLAMATION SEEN COMPLETED? NO__~__ YES____ OATE__~_____________ ~
I CERTIfY TO THE BEST OF MY KNOWLEDGE THE INFORMATION CONTAINED
HEREIN IS CO~PLETE AND ACCURATE.
Jefferson Countv ~~~~ ~ ~
-----T'~~n-nR-~Rl~T~~-N~~---------- ~~~R~---------
1.
2.
3.
RES
BASIC FEE
A FEE OF ~5.CC FOR EACH ACRE
DURING THE LAST 12 MCNTHS
TOTAL (LINE 1 & 2)
90-1501 1/84 (SM-7l
CISTUPBED IN EXCESS OF 10 ACRES
,f~~C~~VED
JUL 171989
JEFFEHSOi\J (;OUNTY
PUBLIC '/'JORKS DEPT,
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STATE OF "~SHINGTON
CEPA~T~ENT OF N~TURAL ReSOURCES
~NNUAL SURFAce MINING CPERATOH'S REPCRT AND ANNUAL ~ILLING STATEMENT
FROM AUGUST 01, 198Y TO AUGUST 01, 19YO
g!;!!QtL~
OPE~ATCR:
AOORESS:
COUNTY OESCRlaED
(IF ~NY)_~~~u~~j1____________
02 1 2
AREA DISTRICT UNIT
_d~~~e!~~~S2~~ty________________________________________
_~~~~~~~JllQ~_~r~]3~~~~~~-~~-2~~~~-------------------
PERMIT NO. 70-012452 LOC~TED IN JEFFE~SON
AS sec 11 TWN 29 RNG 010W ~lNE NAME
COUNTY TAX ACCOUNT NO. _____________ DNR
. . ..
----------------------------------~-------------------
------------------------------------------------------
PHONE ~O: _EQ~~~2=~~~___________________________________________
SUBMIT NO LATER THAN: (8/01/1989
1. FILL OUT AND SIGN SECTIONS BAND C.
2. SEND ALL 3 COPIES AND AMOUNT OF FeE AS INDICATED ON LINE C3.
3. SE~D COPY OF 8 1/2 X 11 SKETCH MAPS SHOWING ITEMS 61, 3, 4, 5, & 7.
RETURN TO: OEPT CF NATURAL RESOURces
OLYMPIC REGION OFFICE
RT 1 BOX 1375
FORKS WA 98331
IN CASE OF QUESTIONS CALL: (206)374-6131
*************************************************************************
I ~gI!Q!L!! OPERATOR'S STATEMENT
1. TOTAL ~CRES PERMITTED:____~~______________________________________---
2. DATE OF MOST RECENT MINING:_l~BJ~_____________________________________ )
3. TOT~L ACRES DISTURBED TO DATE: _~~_______, ________________________
4. TOTAL ~CRES DISTURBED LAST 12 MONTHS: _V~_~~~~lQitI~n_~oIrQ~L_~______
5. ACRES TO ~E DISTUR~EC NEXT 12 MONTHS:___~~__~t9~lQiLe_2UUL_~___________
6. HAS ~ECLAMATION ST~RTED? NO _~__ YES _____ DATE ______________ )
7. NU~8ER OF ACRES RECL~IMED -------------------------------------------
8. HAS ~ECL~MATION BEEN COMPLETED? NO__~__ rES____ DATE________________ )
I CERTIFY TO THE BEST OF MY KNOWLEDGE THE INFORM~TION CONTAINED
HEREIN IS CO~PLETe AND ~CCURATE.
-----Tl~~~~~a~~f~~~~AM~---------- ~~------~-)
*************************************************************************
~~fI!Qli~ ~ILLING STATE~ENT
INVOICE NO. 152699
1.
2.
3.
RES
$250.00
$
$
BASIC FEE
A FEE OF i5.CO FOR EACH ACRE
DURING THE LAST 12 MONTHS
TOTAL (LINE 1 & 2)
90-1501 1/04 (SM-7)
CISTURBEO IN EXCESS OF 10 ~CRES
,- ll~ N"" ;~ ~ V ~ D
~.;~ U: \\,,:1 ~,U 'j/ !!:.
JUL 171989
JEFFER~Ol'J COUNTY
PUBLIC WORKS DEPT.
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NON DEPA,,'TMi:NTAL,
TO,. DAVID ,.IOHNSTor~
299 OLD BLYN HIGHWAY
Sr,:QUIM WA 98382
WARRANT ~'
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tlATE JNVClICC NO. tlESCrnF'TION AMOUNl
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J. l'HF UNDEr.:SH1NFD nn HEm::J<Y C!::r<TIFY UNDEf,' "
F'r:tJAI.l'Y OF F'ER,JlmY. THt-.T THE MATCFnALS HAVE ,x'
HCF.N FlmNlSHCfr. THE SEwnCES F,ENr":::Hr::.I1 (l[~ .-
THE LAnor, PERrOF,Mr:,rr AS rrESCRH'I~D Hr:r-'EIN. 0(,
AI.ln TH"'l' THF CLAIM IS .JlIST. nul" AtUi t1NPAln "
OE<I.JGATJON I',GAHlST JEFrEF:SOl~ COWlTY. AND THAT",
r AM AUl'Hor,l:ZEII Tn AIITHENTICATE ANn r:ErnIFY "
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250.25
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.JEFFEr~SON COUNTY COMHISSIONER~;
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DAVID A. JOHNSTON A.I.A.
299 OLD BLYN HIGHWAY
SEDUIM. WASHINGTON 98382
(206) 683-5584
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MAR Z 9 1989 fDJ
JEFFERSO
BOARD OF co/,f COUtny
MISSIONERS
Reference: Litigation Jefferson County vs Fidelity &. Deposit Co. of Maryland,
PaJmer Constructors on the Jefferson County Jail project
March 28, 1989
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Jefferson County Courthouse
Port Townsend, W A 98368
Gentlemen,
Yesterday, March 27.1989, 1 attended a meeting at Ross Boundy's office, the
purpose of which, was to discuss the report by the engineers (R.W. Beck &.
Associates.) on settlement and defects which may be claimed in the coming
litigation,
As the matters discussed in that meeting were confidential and will be
explained privately by Ross to you, I can only say that I provided lnfonnatlon
on behalf of the County and to the County's benefit.
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DAVID A. JOHNSTON A.LA.
299 OLD BLYN HIGHWAY
SEQUIM. WASHINGTON 98382
(206) 683-5584
March 28, 1989
Jefferson County Board or Commissioners
Jefferson County Courthouse
Port Townsend, W A 98368
Rererence: Litigation Jerrerson County vs Fidelity & Deposit Co. or Maryland
Billing ror services rendered in consultation with Ross Boundy, Joe Adams
and Engineers.
ST A TEMHNT
, Professional Services
4.0 Hours t> S 55.001 hour - S 220.00
Travel to Seattle office or Shidler McBroom Gates & Lucas
EIpenses:
Travel
Parking
Ferry
S 24.50
3.00
1.65
Total
S 29.15 J: 1.1 -
S 30.25
Amount Due
$250.25
r:m.JOHNSTONrASSOCIATES rARCHITECT.
J E F FER SON C 0 U N T Y
NON DEPARTMENTAL
TO- DAVID JOHNSTON
299 OLD BLYN HIGHWAY
SEQUIM WA 98382
WAf<RANT ~
VOUCHER ~
VEt~nOR ~ JOH300
DATE INVOICE NO. DESCRIPTION AMOUNT
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11/14/88 .. .. 02770 41 0030 ..
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AUDITEtI BY --------------- IIATE --------- ..
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I. TH"; UNDERSIGNED 110 HEREBY CEfaIFY UNIIER ..
~~~~L~8R~is~~~JU~~E ~~~0It~g ~~~f.~~~r.SO~AVE :
THE LABOR F'ERFORMED AS rlESCRIBED HEREIN, ..
~~eI~~~IO~H~G~y~~~ 3EF~~~~6ND~5u~~~.U~~~I~HAT:
I AM AUTHORIZED TO AUTHENTICATE AND CERTIFY ..
TO SAID CLAIM. ..
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3,150.51
3,150.5:;'
IIEF'ARTMENT HEAD
JEFFERSON COUNTY COMMISSIONERS
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Jefferson County Board of Commissioners
Jefferson County COUrthouse
Port Townsend, W A 98368
Reference: FEMA portion Jefferson County Jail
DAVID A, JOHNSTON A.I,A.
299 OLD BLYN HIGHWAY
SEDUIM. WASHINGTON 98382
12061 683.5584
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Billing for services rendered in preparing argument to counter FEMA audit.
ST A TliMENT
Professional Services ( Per attached summary)
53.0 Hours E' S 55.00/ hour - S 2,915,00
EJ:penses:
Travel S 30.75
Total
S 30.75 I 1.1 =
Total FEMA work
LITIGATION
Review and organize shop drawings for transport to
Shidler McBroom Gates & Lucas (Joe Adams)
10/17/88 2 Hours p S 55.00/hour = S 110,00
10/28/88 I Hour p S 55.00/hour = 55,00
Expense:
Telephone
Bus bills
19.65
13,70
Total
S 33.35 I 1.1 =
Total Amount Due
,
S 2.915,00
s
33.83
S 2,948.83
S 165.00
S
36,68
S 3,150.51
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October 31,1988
Jefferson County Board of Commissioners
Jefferson County Courthouse
Port Townsend, W A 98368
Reference: FEMA portion Jefferson County Jail
Date
Descriotion
Hours
10/5/88
H,G. authorizes evaluation of FEMA audit. Discuss w/
Hubbs, Anne Sears N,C,
Office search files for EOC info 2,0
Review plans EOC, correspondence, Palmer estimate
study actual needs 2,5
Review materials sent by Anne Sears 1.0
Begin estimating EOC costs 5.0
Continue estimate 3,0
Complete & total estimate 1.0
Evaluate costs provided by FEMA, project own est.
organize action plan, meet with County Commissioners <l.0
Organize & prepare argument for FEMA 1.5
. Organize & prepare argument for FEMA <l.0
Organize & prepare argument for FEMA 3,5
Re-align costs for FEMA participation 2.0
reorganize presentatiQn, recompute' of participation
and total 6,0
Continue checking for accuracy 5,0
Organize presentation(2hr), Meet with FEMA auditors
at Sheriff's office ( <l,5hr), review FEMA mat'l.@>office( 1.5) 8.0
Meet w/ FEMA,State,County fll courthouse(jncLtraveI) <l,5
10/6/88
10/10/88
10/11188
10/12/&&
10/13/&8
10/14/88
10/17188
10/1&/&&
10/19/88
10120/&&
10/24/88
10125/88
10/26/&&
10/27/88
Total Time
53.0 hr.
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PURCHASED flY
OHICE OF COUNTY
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\tOUCHER
COUNTY OF JEFFERSON
PORT TOWNSEND, WASHINGTON liUGS
NaJ-DEPAR:IME:m'AL
AMOUNT AU1HORI1[O
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CCT 28, 1988
David A. Jolmston
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COUNTVOrflClUSE ONLY
CERTIFICATION
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NOTICE-TO SECURE PAYMENT THIS fORM MUST BI: MADE OUT IN
TRIPLICATE AND ITEMIZED, AND MAILED TO COUNTY AUDITOR,
COURT HOUSE. ey
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DESCRIPTION
Billing regarding rraintenance oroblens
COnsulting services ..,;,_ 1ail liti=ticrl
VENDOR lOR SELLERSI SIGNATURE NOT REQUIRED
BOARDO' COUNTYCO~"," OAlE
COMMISSIONtR OIS~ - ,/:::1.3-Y-.-_ -r.....O<"-
COMM.SS'ONER 0.51, .. ;;;At.L1"'-";/V
CHAIRMAN Of BOARD U .
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October 17. 19S5
DAVID A. JOHNSTON A.I.A.
.1111 OLD lLYN HIGHWAY
.[QUIM, WASHINGTON 11312
12061 U3.UB4
Jefferson County Board of Commissioners
Jefferson CounlY Courthouse
Port Townsend. W A 9S36S
Reference' Jellerson County Jail
Billing over past i month!! for consulting services in ~espon!le to Sheriff Met
Mefford and Cerler Breskin. Jefferson County for Mlllntenance problems.
ST A TEMIiNT
Professional Services (Per attached summary)
14,50 Hours .. S 55,001 bour. S 797.50
S 797,50
EJpenses:
Travel elpense
Telephone
Total
S 10,00
11.05
S 21.0.5 I U .
23,1.5
Total Due
S 820,65
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Jereerson COunty
Summary of activities of services related to requests of Sheriff Mefford and
Carter Brcsl:.in from June 88 thru September 88. Service, performed by
David A. Johnston AlA,
Date
7/18/88
7/18/88
7/19/88
7121188
7122188
7125/88
812~/88
9120/88
9127/88
,
Descrintion
Visit jail site; review complaints
by Sheriff ( Ltr to COm missioners 7121/88)
Review.. office; Telecons; Robinson, VF!
Job corrections information (Ltr 7121/88)
Begin teller to Commissioners
Telecons, VFT; R,Boundy: Sheriff
Prep Ltr, to Palmer (not sentl
COmplete Ltr. 10 COmmissioners
Transmittals to Commissioners, Carter
Breskin; COpies of field reporu
Meeting at architects office with Dave
Funsch FEMA represenative for COunty
Meetinl! at architects office with Tony
Sison R.W.Beck, engineers re: shop
drs'\ving review for structure
Deliver tracings Jerrco jail 10 Caner B.
Hours
2,0 hrs,
2,Ohr',
1.0 hr',
0.5 hr',
0,5 brs,
0,5 hrs,
3,0 hrs,
2,0 brs,
2,0 hrs,
1.0 hr,
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DAVID A. JOHNSTON A.I.A.
r~!1 OLD lLYN HIGHWAY
at:OUIM, WASHINGTON ..312
11051 &13-"84
Oclober 17. 1988
Jefferson County Board of Commissioners
jellerson County Courthouse
Pori TO""Jlsend, W A 98368
Relerence' jelCersoo CounlY jail
Billing over past'" months for consulting services in ~~spo.n5e l.<<? R055 B~undy
and Joe Adams, Shidler McBroom Gates & Lucas for litlgBtlon WJth Bonding
Company,
ST ATfiMENT
Prolessional Services ( Per a\lathed summary)
13.50 Hours <p S 55.00/ hour. S 7~2,50
S 7~2,50
Expenses:
Telephone
Bus bill
28.19
9,75
S 37.9~ J J.1 .
S ~L73
TOlal
Total Due
S 78~,23
Approvu.i t., t." .
J.at1c'Ison Co..m~l~" COl;~;;;:~'~I~:C:/S
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OClober 17.19BB
Jefferson CounlY
Summary of activities of services related to requests of Ross Boundy Bnd Joe
Adams. Shidler McBroom Gales & Lucas [Does not include deposition) (rom
June BB Ihru September B8, Service, performed by David A, JOhn'ton AlA,
6120/BB Select data for depo,ilion reQue'ted by R, Boundy 1.0 hr,
6/21/BB A,semble data fnr deposilion 3,0 hr,
Instruction lelecon R, Boundy (sUagesllelecon
to Wll Blain) O,nhr,
Telecon 10 Wll Blain 0.5 hr,
7/25/BB Review depo,ilion taken 6/22/B8 & 6/23/BB
rush return 10 RBoundy via Greyhound 3,0 hr,
8/21B8 Telecon R, Boundy 0,25 hr,
Review dala for upcoming trial 0,75 hr,
8/11/8B Information requested by Joe Adam,; ,earch file,
copy and mail 3,0 hrs,
9/2B/8B Counl and compule area of ahop drawings;
Telecon Superior Reprographics for copy price
rei urn info 10 Joe Adam' 1.25 hr',
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VOUCHER
COUNTY OF JEFFERSON
PORT TOWNSEND, WASHINGTON 98368
Nrn. DEPARlMENTI\L
I AMOUNT AUTHORIZED
MAY 88
2740
41.10
ADDRESS
Johnston & Associates
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46890
WARRANT NO
STATE
COUNTY OFFICE USE ONL Y
CERTIFICATION
I, 1he undenigned do hereby cell,lv undel penalty of perjury. Ihal the
matI'IICl'~ h<lvC been furni1hed lhe servieu rendered 01 lhe labor per
tormed lt~ de)ctibed herem, B~d lhal the cl...m l~ a juS!, due lInd unpaid
obligatlon against Jellefson CounlV. and thai I am authOFlled 10 i1u,hl.'nti.
cale end cenlly said claim,
Signed
NOTICE-TO SECURE PAYMENT THIS FORM MUST BE MADE OUT IN
TRIPLICATE AND ITEMIZED, AND MAILED TO COUNTY AUDITOR,
COURT HOUSE,
DESCRIPTION
DATE
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QUANTITY
Professional Services for ~ upcaning
litigation with Bonding Co, Jeff Co Jail
VENDOR (OR SELLERS) SIGNATURE NOT REOUIRED
ALLOWED
BOARD OF COUNTY COMA....NERS DA TE
COMMISSIONER DIST 4' ,/1T ~
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CHAIRMAN OF BOARD L~ ~ ~/
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UNIT
PRICE
AMOUNT
350.25
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DAVID A. JOHNSTON A.I.A.
299 OLD BLVN HIGHWAY
SEQUIM, WASHINGTON 98382
(206) 693-5584
llay 2, 1988
ICFFERSOi'! Coutm
BOP.RD OF COMMISSIO!iEn;;
Jefferson County Board of Commissioners
Jefferson County Courthouse
Port Townsend. Washington
Reference: Jefferson County Jail
Billing for Consulting Services in response to F. Ross Boundy b Sheriff
Mel Mefford. For upcoming Litigation with Bonding Co.
STATEMENT
Professional Services ( per attache~ breakdown)
6.0 Hours @ $55.00/Hour ~
$330.00
$330.00
Current Expenses
Travel Expense
$20.25
20.25
Total Due
$350.25
f-.p~ I; c.::':! ! -:.r t:~.~~ Pr-!~.;c:: ~~. ,..
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Jefferson County
Nay 2,1988
Additional Services
~.
DescriPtion
Hours
4/6/88
Review lawsuit for additional warranty
claims and information for Ross Boundy
2.0 hrs.
4/7 /88
Heet with County Commissioners, R.Boundy,
Sheriff, and Steve Olson
Site visit to County jail to look at ceilings
2.0 hrs.
1.0 hr.
1.0 hr.
6.0 hrs.
4/22/88
5/1/88
Prepare letter to commissioners
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PURCHASED BY
OFF ICE OF COUNTY
TO
ADDRESS
CITY
TERMS
muonn t""'^,,~~ "OM<"'
DATE
CONST & RENOV
SEPT 87
VOUCHER
COUNTY OF JEFFERSON
PORT TOWNSEND. WASHINGTON 98368
~2S13
WARRANT NO.
STA TE
AMOUNT AUTHORIZED
13900
62 20
IoCCOI./N"r 10 ilL Cl-1AF;CLD
Johnson-Hunt & Assoc ~tects
OR,
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COUNTY OFFICE USE ONL Y
CERTIFICATION
I, the unde"igned do hereby certify under penallV 01 perjury. thai the
materials hilve been lurnlshed. the services rendered or 1hl' labor per.
fOrmed as desCrlberl herein, and lhal the claIm is a IUS!, dut' .Bnd unpaid
obligation 8gamSl Jelleaon County. and Ihal 1 am Buthonled to authentl'
cate and ce:"tv laid claim.,/l, V
SIgned ..-t<-/~ a 7\~ ltitlel
NOTICE-TO SECURE PAVMENT THIS FORM MUST BE MADE OUT IN
TRIPLICATE AND ITEMIZED, AND MAILED TO COUNT V AUDITOR,
COURT HOUSE.
UNll
PRICE
AMOUNT
Re1ur" All Copiel
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DATE
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QUANTITY
BV
DESCRIPTION
Consulting reo litigation with Bonding company
2849.43
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ALLOWED
VENDOR (OR SELLERSl SIGNATURE NOT REOUIRED
DATE
BOARD OF COUNTY COMMISSIONERS
COMMISSIONER OISl'.
COMMISSIONER OIST,
CHAIRMAN OF BOARD
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JOHNSTON-HUNT & ASSOCIATES ARCHITECTS
A PROFESSIONAL SERVICE CORPORATION
'112 EAST FRONT STREET PORT ANGELES, WASHINGTON 98362
TELEPHONE 206,452-688'
August 31, 1987
[R<~~lE~WlE[D)
SiiJ -11987
JEFFERSON COUN1Y
BOARD OF COMMISSIONERS
Jefferson County Board of Commissioners
Jefferson County Courthouse
Port Townsend, Washington 98368
Reference: Jefferson County Jail
Billing for Consulting Services in Answering Interrogatories for
Upcoming Litigation with Bonding Company
Professional Services (per attached breakdown):
47.0 Hours @ $55.00/Hour ~
41.5 Hours @ $27.00/Hour ~
$ 2,585.00
1,120.50
3,705.50
$ 3,705.50
Current Expenses:
Xerox Copy Expense
Postage Expense
$
62.00
1.92
63.92 x 1.1 ~
70.31
Sub-total this Statement
$ 3,775.81
926.38
Less Fee Reduction ($3,705.50 x 25%)
(See Note Below)
Total Due ~
2,849.43
IlOTE: Ross Boundy was not available for help in
answering our questions on bow to proceed
and the degree of detail needed. Thus,
some of our time was spent second-guessing
what was required, which we feel was not as
productive as it should have been. We have
decided to reduce our time on this portion
of the work accordingly.
Jefferson County
August 31, 1987
Summary of Services answering Interrogatories
Time for Pavid Johnston
Dat.e
8/18/87
8/19/87
8/20/87
8/21/87
8/24/87
8/25/87
8/26/87
DescriPt ion
Hour.!.
Read interrogatories & evaluation; telecon
attorney for direction (not available); work
on questions U 1-10; telecon Locker - activity
OK so far, refer to Sue Thorud; Sue says to not
answer 0 1-10 hut ~ork on warranty; work on 026
and how to prepare answer
8.0 Hrs.
Review documents & continue 026; assist Nancy
t.o org~ fee questions so she can work 038 6 39,
continue 026-29; problem w/ VFT billing; te1econ
Piermattei (VFT). review all questions wI Nancy
re how to approach & answer
6.5 Hrs.
Review detail of warranty corrections; review
wI Uancy re actual vs. liquidated damages;
telecon VFT re billing; try to contact attorney
for clarification (not available); work on 014;
telecon atty. (Sue)- she cannot answer, Boundy
not available til mid-Sept., Locker will have to
clarify; review questions wI Nancy & begin to
short-cut answers; detailing question 027 re
future warranty items
6.25 Hrs.
Work on U44; 2 telecons to tmrk Johnson (PC&P)
re sub-contractors returns; 2 telecons to ~.W.
Poor re sub payments (0 44); questions 0 45 & 46;
telecon VFr re reductions in their billings
8.0 Hrs.
Review all questions wI Nancy; begin final
answers; form list of questions for attorney;
telecon Locker re questions; work on questions
16-18 and review of telecons wI atty., VFT,
Angeles Elec. & Mahlum & Nordfors
7.25 Hrs.
Review cost items in claim 0 question U 46,
telecon Sue Thorud, work on questions n 18 & 19,
telecons Carla (2), Bubbs (1), Ann (2), Bud Grey
(Power Systems) (2), Work on 033 PC&P C.O.s
6.0 Hrs.
Finalize questions 0 45-47, complete question
#28, review copies of complete package to go
to attornies
5.0 Hrs.
47.0 Hrs.
Jefferson County
August 31, 1987
Summary of Services answering Interrogatories
Time for Nancy Deaver
~
8/18/87
8/19/87
8/20/87
8/21/87
8/24/87
8/26/87
8/31/87
DescriPtion Hours
Jeffco interrogatory; read through instructions
and questions for familiarization; wrote answers
to questions # 11-15; went through interrog. wI
Dave discussing directions; file search b copies 8.0 Hrs.
Discuss tasks; work on files & copies; questions
U 38 b 39 re warranty claim & fees; sort 6 copy
JH & VFT bills; go through interrog. & production
reqmts. wI Dave re how to proceed, what is back-up
& what to pull from files for answers 8.0 Hrs.
Go through interrog. wI Dave re back-up needed,
telecon to VFT; copies from files; file search
& copies re notice of warranty items; compare
notes wI Dave; discuss direction & duties of each 7.0 Hrs.
Prepare charts on warranty claims - questions n
26-30, discuss wI Dave re his questions on sub-
contractors claims, VFT 4.0 Hrs.
Run new copy of interrog_ pulling together
answers and trying to WTap up project; finish
two charts; compile and transfer answers onto
clean finished copy and review w/ Dave 8.0 Hrs.
~rap up and try to finish for mailing; gather
final answers and check through for all answers
and completeness; copy (3X) for mailing; clean
up and organize masters and records for office;
go through production work compiling copy list 4.5 Hrs.
Finish organizing production requirements and
run copies for attorney's office; organize office
records; transmit copies to attorney & Jeffco. 2.0 Hrs.
41.5 Hrs.
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PURCHASED BY
OFFICE OF COUNTY
DATE
4301Ll
VOUCHER
COUNTY OF JEFFERSON
PORT TOWNSEND. WASHINGTON 98368
CONSTRUCTION & RENOVATION
OCTOBER 87
Johnston-Hunt & Assoc.
TO
ADDRESS
CITY
TERMS
S1 A TE
NOTICE-TO SECURE PAVMENT THIS FORM MUST BE MADE OUT IN
TRIPLICATE AND ITEMIZED, AND MAILED TO COUNTY AUDITOR,
COURT HOUSE.
OEseRIPTION
Consulting services in answerin.o: interrogatori s
--Q
--J
DATE
OUANTITY
\
t
Ii.
Relurn.AlI Copills 1'""( J
to Auditor, lY\
L
IL
c.
, .
WARRANT NO
AMOUNT AUTHORIZED
13900 41. 30
""ccout.:"l TO 1:1[, CI>1",,,,c;Ll,l
DR.
ST.
COUNTY OFFICE USE ONL V
CERTIFICATION
I, lhe under~19ned do hIHeb~' ct'nily undel pt'nally of perjury. Ihal the
maler,als have t>een furnished, the 'en/ices rendeled 01 Ihe labol pe'.
larmed 81. dt'~cribed herein, end that the cloim IS a JUSl, due and unpaid
oLI.""on "atn" ","",on coun'~h" I,m ,"lho"..d'o ,u"".nll'
cale and cellltv said claim. a n
Signed ~ ~ lllllel
Bv
UNIT
PRICE
AMOUNT
'., _.
co, o~
ALLOWED
VENDOR (OR SELLERSl SIGNATURE NOT REDUIRED
DATE
BOARD OF CaUNTV COMMISSIONERS
COMMISSIONER DIS1.
COMMISSIONER OISl.
CHAIRMAN OF BOARD
'~1Ill 1Il~_.lI" IJf_WlllllllOlIl1
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JOHNSTON-HUNT & ASSOCIATES ARCHITECTS
A PROFESSIONAL SERVICE CORPORATION
"12 EAST FRONT STREET PORT ANGELES. WASHINGTON 98362
TELEPHONE 208-452-6881
September 30, 1987
~[E@[F;~\V/fEIW
ocr - G ',:'1:1 .
Jefferson County Board of Commissioners
Jefferson County Courthouse
Port Townsend, Washington 98368
JEffER~:(Jt! COUNTY
BOARD OF COMMISSIONERS
Reference: Jefferson County Jail
Billing for Consultins Services in Answering Interrogatories
for Upcoming Litigation with Bonding Company
Professional Services (per attached breakdown):
11.0 Hours @ $55.00/Hour ~
4.5 Hours @ $27.00/Hour ~
$ 605.00
121. 50
$ 726.50
$ 726.50
Current Expenses:
Telephone Long Distance
Xerox Copy Expense
Postage/Freight
$ 51.65
77 .50
12.09
$ 141.24 x 1.1
155.36
Total Pue ~
$ 881.86
DAVID A, JOHNSTON AlA
MILTON D. HUNT AlA
Jefferson County
September 30, 1987
Summary of Services answering Interrogatories
Time of David Johnston
~.
DescriPtion Hours
9/4/87
Copy Interrogatories 0 1-10 after a new request
from L. Locker; review Palmer Correspondence
Files D 1-5 for correspondence related to questions;
review field notes; response to questions 0 1-7 5.5 Hrs.
9/5/87
Continue work on Interrog. questions 8-10; finish
draft for mailing to L. Locker 3.0 Hrs.
9/9/87
Telecon L. Locker re interrogatories; telecon
Sue Thorud 0.5 Hrs.
9/22/87
Telecon wI L. Locker to review answers to
interrogatories 0.5 Hrs.
9/28/87
Select materials for copying; copying of all
files from 7/8/85 to present per request of
Sue Thorud; take to Greyhound for shipping 1.5 Hrs.
Time of Nancy Deaver
9/28/87
Sorting and xerox copying of all files for
attorney, from time of arbitration to present
4.5 Hrs.
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FILED FOR RECORD AT REQUEST OF
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WHEN RECORDED RETURN TO
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Statutory Warl..lnty Deed
THE GRANTOR
Carl A. Wiflrich and Mavis Y. Willrich,
husband and wife.
for and inconaideraUonof Ten Dollars and other valuable
considerations
iohandpaid,convey.andwarrantato Co u,n t y of J ef fer s on
the foUowin, dMCribed real _tate, aituated in the County of J e f fer son
, Stale 01 Wuhin(ton:
The Southwest quarter of the Northwest quarter of Section 23, Township 27
North, Range 2 West, W.M. EXCEPT 30' wide strip along the Ea~t side
of a portion thereof conveyed to Jefferson County by deed dated
February 3, 1930 and recorded in volume 98 of Peeds on page 171, and
EXCEPT portion conveyed to the State of Washington for State Highway
by deed dated April 24, 1935 and recorded under Auditior's File No.
74051, and EXCEPT 60' wide strip of land conveyed to Jefferson County
for county road (old state highway) by instrument recorded May 10,
1909 in Volume 1 of Road Waivers on page 4a records of Jefferson County.
EXCEPTING there from that portion of premise lying southeasterly
margin of State Road No.9
,m'JlSON COUNT{ ~ W
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On thl. day penonally appeared before me befo~n~~.the.und;njj.~:x. ~ No.ia;:;:..~.biic..i~...~..'io~..th;..S.ia~ ~~"W;uh:
..Ca.f.\.L..Q..,..:.{...Cbe:r...v.~:s...~L...W..J.l.J..c.i.~.. IlllIton, duly commlaioned and lworn, poroonally .ppeared................................
to m. known to bo th. IndiYid;.;.\ deoc:ribod In .nd ..........................................................................................................................................
who executed the wit.hin~d lore,oin, inltnunent, .n.d.....................................................................................................................................
and ac:knowteda:ed that .J.nb~... ",ned the urne' to me known to be the ............................Pr.ident and".......................,Sec:retary,
.. :::t.1~.I.(...... Iree and voluntAry act and deed. relpectively. 01.....,...............,........."..................",....,...,......................................"..........
lor the ute. and purpo.~\h.rein ~.e'nti~ned. ~~: ~~r~:;~~e~:ke:c~t:1r~e.~dr:~J~~f.~~~~dt~~d 01c:.k.idwd:~pgo~
. ~~:~:;~~;.~~~~ .~: .."',. .~,._. .Uon. lor the UBeI and purpo.ee theroin ment.ioned. and on oat.h .tated t.hat.
~ a,!YEN undp:. '~~."II\~~~~~. ..al thiI aiiiled..ii..ih~.corpo~~t~h~:~ie:, :i~X:~r~uo,:id inltrument and that t.he 10a1
~...~ ay Olt'l..t:'.~~r..~ .....,..,...', 18.$~, Wltn... my h.nd .nd olIlcl.1 ...1 h.r.to aftIxed tho clay and y..r lint
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n,ton, r"idin, .L.QJ.:.~~':h.f...It.~................. r..ldlDl .L.................................................................
. " MY COMMISGION Exr/~t9 ~~;14 :..r 4.0
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TO OBTAIN Morl[, n~EE PAt)S CAl.L OLYMPIC PRINTERS
452.1381 TOLL FREE 1.800.535.9204
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COUNTY ('1 MUNICIPALITY
RECOMMENDATIONS
l~):
STATE OF WASHINGTON
80ARD
of
NATURAL RESOURCES
Olympio, Wo,98504
: 1529
SURFACE MINING
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TO BE COMPLETED BY APPLICANT
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DESCRIPTION OF SITE
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ADDRESS ,;;::-"70. b"'~..t:: 6"77
C).,::y/-,-,P/r!, /~~5H.
SEe IT I RGE 0 E ! COUNTY
,Z3 27NI 2 Gw If
DISTANCE I DIRECTION FRC:M ! r-JEAREST COMMUNITY
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TELEPHONEr-IO.: ',?~3-;;:'2::30 ~~y 7.1.N/Ctt!'";"I"I-
!NDICATE PROPOSED SUBSEQUENT USE OF SITE UPON COMPLETION OF RECLA"..\ATIOt';
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SIGNATC:::RE (AP ICANT'S) _, I TITLE
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I DATE .
'. j ///3/71-
MUNICIPALITY
TO BE COMPLETED BY APPROPRIATE COUNTY OR
TO: BOARD OF NATURAL RESOURCES
SUBJECT: RECOMMENDATIONS ON SURFACE MINING PER/IIlT APPLICATION FOR A NEW OPERATOR CON\MENCING OPERATIONS
Yes No
1. Is the proposed subsequent use legal und.er currentlacaf zoning regulations?
2. Does the applicant hove an appropriate permit to conduct surface mining if required by local
regulations? (Plec:ae ottach 0 copy af the permit, written order or ordinance)
3. Recommendotions and comments:
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ADDRESS SIGNATURE {PLANNING DIRECTOR OR ADMINISTRATIVE OFFICIAL)
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TElEPHONE NO., '<"'K c:-. .:: I r/J I DATE,'.', i i J 0 I '1~
NOTE: Chapter 64, laws of 1970, 1st (x.- Sell., requires evidence that the proposed sublequent uu: would hOt be illegal under
local ~o"ing regulotions.
jPERMIT NO,'
1089.13
SM-6
Revised 5-9-72
COPY Dhtrlbutlon: White - Olympia, Yellow - Di\trlct, PInk - Operator, Blue - County or Municipality
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TW~J 27 RN.; 020W nNE I'AME (IF ONYl_________________ II ',,".,",:, ,,',""" , :;", ',',',""" ,
~CCCu~T NO. _____________ QNP A~~A OISlkICT u~IT.:'" "
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FhC~; ~Q: =~:~C=;~?:?:=~~=_:~=============================== ; " ' ·
SL:MIT NC L~TE~ THAN: 11/01/1908 l':" "'.:' ';'.' J
1. FILL OUT .,.,C SIG" SECT!ONS B ~"C C. \:',
2. SE~C ~LL J COPIES ANC AMOUNT CF FEe AS INDICATeD ON LiNE C' \ ' .,,'," , , ,
3. seNC CCPY OF B 1/2 X 11 S~ETC~ MAPS ShOrtING ITFMS ,1, ~, 4, 5, & 7. ;- .'. '
RET UR N TO: D EPT' CF' NA TURA L 'RE SCURC E S ' ,~,..' ,',
2~Y~PggxRi~H" OFFICE) f,' ,/,i I' ,
" FORKS ~A 90331 ' ','
I ~ CAS E OF' QUE S TI 0 ~ 5 C H L: (j! 0 en 7 4 - e 131 ", .. ," t, .'
**.~*:.. * *:,:t~***... *.... ***.** **~~..~*.,. ......",*.. ** ....... **.. ft'**~~'*"""""".'" ~". " ;.:::.,~,.~'._,::;;i:::'
. gl;HQ~';~~;,;~~: OPERATCR~,~ ST~TEME,HT, " .; t.. ·
1. TOT~L ACRES FE~MITTED:______E_3.::?._n__'_______'_______________~_.:~.:..__;... [' .'.
"," .._.,... , "l:9P ", 'i....',..
2. qA1E O~ MOST RECENT ~INI~G:__-~~~J~___~~~_~__~_______________________. /;0'.f~:0/<
3. TOTAL ACRES CISTURBEC, TO DATE: /,-:') ,".' '''-, "" '
I,. TOtAL ACRES CISTLReeC LAST 12 ~~~~~~:-==L=====~~.============:===:=:=:l '"
5. ACHS H BE CISTURBEC NEXT 12 ~ONTHS:__~~1"!~qe~______________~:..___, . ,~
..6. HAS"RECuAMATION STARTED? ,,~O _L YES '-!;.:_';;;~:- CATE ___"'""___.:.'~':_~~:.','" 1,'~~
7. NU~BER OF AC~ES RECLAIMED ----------------------~--------------------~. I':::' '."
B. HAS RECLAMATIO~ 9EEN CO~PLETEG? NO_~_ YES____lCAT~---~----~----~--~) I, ':,
ICE R T IF Y TOT h E dES T 0 F 'M Y K N C ~ L E C GET ME' IN FOR H ~ TI 0 N CON H I ~ C ", ,,'" "-. '" i . .",' :"
HEREIN IS CO~PL ETE A~O ACCURATE. ~ /,.~:' . '; I '"
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AN~UAL S'JRF~CE
STATE OF ~AS"lNGTCN
CEPAR~TeNT CF ~OTUKAL R~SCURCcS
"IN1NG OPERATCR'S ~EPCRT ANe AN~UAL
FRC" MCVEMeER C1, 19!~ TO NOV~~8ER
BILL!NG ST~TE~ENT
01, 19"
5 E C TI ON A" "',:'
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PERM!T "N'C.
AS SEC 23
COUNTY TAX
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,HfIlQ!Lf .l'!LLING STAHMENT
1. BAS'Ie FEE
2. APEE OF ~5.C(j FOR
DURING THE L~ST 12
3. TOTAL (LINE 1~ 2)
INVCICE NO. 13973:
EACH ACRE CISTURBEO IN EXCESS OF 1C ACRESS250.:00
MONTHS $
$
RES 90-1501
1/84 (S~-7)
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.~ WASHINGTON STATE DEPARTMENT OF
~aIlJf Natural Resources
BHIAN BOYLE
COllHnl~SIOnf:r 01 PubliC Lands
July ll, 1989
Carl A. Wilrich
l824 Lakehurst Drive
Olympia, WA 9850l
OlympIC R~glon QUiet:
Hoult: 1. 80). 1375
Forks, WA 98331
Subject: Surface Mining Permit #70-010898
In order to transfer your surface mining permit, we will need the following:
l) Signatures, on this form, from both parties acknowledging the transfer
of the permit.
2) A statement from the proposed permittee accepting the current plan of
operations and reclamation plan on file. (If changes are desired, new
plans will need to be submitted and are subject to review and approval
prior to the transfer of the permit.
3) Completion of the enclosed SM8a.
Until these requirements are satisfied, the permit is still in ownership of
the existing permittee and therefore the permittee's liability.
~C? GY~
, CURRENT PERMIT HOLDER
? ?4-/6' f
DATE
~~'
~ NEW P T HOLDER
8" ~t7 /3 ~
/ / DATE
Sincerely,
9..0 d":' ~JiuJo~
Jodi Luedecker
Clerk Typist 3
For: John M. Calhoun
Regional Manager
Olympic Region
Enclosure
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Equal Opportunity! Aff"malive Action Employer
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Permit!
Permit Application
No.
FORM SM-8A
Standard Reclamation and Operating Plan
The Surface-Mined Lands Reclamation ActlRCW 78.441. as amended
during 1987, requires lhat all mines exceeding lhe following lhresholds
shall have an approved reclamation and operating plan on file with the
Department of Natural Resources:
(!) mine in which three acres of land (including highwalls, pit
floors, stockpiled areas, sidecast areas, and processing-plant sites)
have been disturbed by mining or related activities and/or,
(2) mines having working faces which are both higher than 30 feet
and steeper than I horizontal to I vertical (45').
Lands which have been reclaimed to the standards given in RCW 78.44
should not be included when calculating the disturbed-area or face-height
thresholds.
The Department encourages operators of smaller mines to submit a
reclamation/operating plan in order to protect against excessive reclamation
costs should operations expand in the future. The following form is
intended as guide to assist the operator in preparation of a
reclamation/operating plan which meets all requirements of the Act.
GENERAL INFORMATION
(l) Operator J(Z..r./Jz.4~t:J, (l/Z...V,..z. ~
(2) Operator's Address ,Rtf}, /.3p')L /..2.:<t? . Arr- "T:;&/.-?s",,,, ""'/ u/,.,_
'9 i?':t t: q----
(3) Operator's Phone ~Qs. ~06 - J g-.s~ - 9/& t)
(4) Landowner :..:J~,.,.;",-- /!..au.......-<I--t -
(5) Landowner's Address !:(Y, /'3~ /~..2~ ~,.T 7;"IPHS~"1,Cj/ '11/", 98':56ff
(6) Landowner's Phone (~) ~ 'if~~- 9/~C)
(7) Name of Mine
(8) Location of Mine
Section(s)
(9)
Quarter of the N tV 0-- quarler
Township 2..2.Jl Range ~
County(jes)
Page 2
(10) MateriaJ(s)
(.) Gr.vel
(b) Sand
(c) B....lt
(d) Si lime rock
(e) Lim..tone
(I) 8uilding Stone
(g) Other
to be mined:
}
o
o
o
o
(12) Typels) of Deposit(s):
(a) Glaciol
(b) River Flood Plain 'alluvial I
(c) Ri'fler OHUlneJ Deposits
(d) Talus
(e) Bedrock
(I) Unknown
(g) Other
(13) Total Production to Date: U"I!"'''d~'1 tons or_
(J4) Estimated Annual future Production: $&".410
lons or
(15) Depth to Water Table:
feet below datum (j,e. sea level) or ...........
Unlr::nownj( (Do not check this box in Spokane. lshnd. San Juan or Wi1.Ih. Walla
Counti..)
RECLAMATION PLAN
yds.
o
o
o
o
o
o
yds.
(J) County/Municipality form SM-6 attached proves that both mining and
lhe proposed subsequent use of this mine site have been approved by
the county Cwne~ b y~a,~~"t. /Zd,. yes _
(2) Subsequent Land Use: (3) Post-Reclamation Topography
(.) Industrial 0 (a) Les. than 10 % Grade 0
(b) Agricultural 0 (b) Low rOiling hills ~
(c) Foreslry )'l. (e) Lake/pond 0
(d) Residential 0 (d) Bedrock Cliffs 0
(e) Wet land 0 Other
Other
(4) Minimum setbacks to be mainlained continuously along boundaries with
adjacent properties not owned or leased by the permittee:
(a) Sand & Gravel Pits
i. 25 feet for highwalls I..s than 50 feet high
ii. 50 feet for high"alls greater than 50 feet
(b) Bedrock Quarri..
i. Setb;u:ks as above
Ii An undisturbed 10 feet together "ith a 15 foot "ide x 15 loot high
bench at the top of working faces steeper than adjacent JH to tV.....
(c) Written explanation for request for variance from setback
requirements attached
:Ror ....
o
DOL...
o
o
Page 3
(5) Maximum Finished Slopes for Sand and Gravel Pits:
tal Stopes in deposits which comain alleasl 50: clay 1w'ill be reclaimed to
1.5 horizonlal (H) 10 I vertical (V) 134"
(b) Slopes "hich "ill be dressed "ith a minimum one-loollhicl: topsoil
or clay cover will be reclaimed to 1.5H to I V 134.\
(c) Other slopes "ill be reclaimed to 1.75 H 10 I V (30') 10 lacililale
nillunl revegetation
o Of.....
o or.....
Xand/or..
(6) Maximum Finished Slopes for Bedrock Quarries:
(a) All bedrock ...octing faces will be reclaimed with a bench no less than 15 feel "ide no
greater chan 15 (eel high continuously a!ong the lOp of aU cliffs in excess of 30
leet high Ilor salelyl 0 and/or..
(b) High"alls benched 10 10 leel "ide by 30 leel high 10 enhance sceneic values
o or........
(c) High"alls sloped to an average 01 I H 10 I V 0 or .....
(d) No slope-reclamation will be undertaken because existing nalurallopography
at Of adjacenllo the proposed quarry constititutes a safety hazard indigenous to the
area. 0 and/or..
(7) Maximum Finished Slopes for mines reclaimed as lakes or ponds:
A!! lake/pond bOllOWS "ill be sloped al 1.5 H 10 I V 10 a deplh at
least 2 feel ~ the 1000est water level to assure egress for
non-S1ilmmer5. (Operations using dredges should consider this
requiremenl cuelully "hi Ie planning Ihe mine) 0
(8) Post-Mining Topography Should be Designed to Blend with Adjacent
Natural Topography:
(a) Contours will be a.rcuate when viewed in pian 0 and...
(bl Contours and profiles "ill be Bfaded 10 avoid 90. angles. especially at
section corners and/or property boundary corners 0 and...
(e) Chules and buttresses "ill be Bfaded periodically along reclaimed ,",orting
faces 0 and...
(d) Restored contours will be graded to tie existing onsile natural contours 0
(9) Post-Mining Water Control (Note: even minor sedimentation and/or minor
water-pollution is prohibited by state and federal law. Please help
protecl the water and fishing resources):
{al All vater including water originating Cram rainfall. dust
control. breached water tablet;; elC. contained on Iiite ?
(Do not check: this box if the deposit contains greater
than 501 clay) yes-J(. no_
(b) Drainages armored with riprap and otherwise restored in such a
Cuhion uta "tablilih a permanent. erosion-r81Oililant dr;a.in18e yes: _ no_
(c) Low topographic.relieC areas sloped at approximately 21 into
armored dra..ina.ge yes.- no_
Page 4
(9) Posl-Mining Water Comro! (conlinued):
(d) Water lr'i1 be routed around newly dislUrbed slopes taht ha'Ve clay contents exceeding
SO~ by installing tight-lines or at'moured drainages yes_
(r) Lates created by mining operations will be of surriecient size fOf recreation. ....ildlife.
and residential purp01iies yes _
(gl All exposed coal beds covered ",ith topsoil yes _
(10) Landfil!/backfil! (Nole: backfilling is generally an unacceptable re-
clamation technique and will be approved only in unique circumstances and
only upon submission of a detailed operating plan. This plan should identify
the source of fil!, commit the operator 10 maintaining this fill source for
reclamation only, and give evidence that backfil!ing is an economically
reasonable method of reclamation for this mine.
(a) Noxious or combustible materials will not be plaCed in the mine Yes ~
(II) Revegetation
(a) Natural revegeta.tion (natural revegetation is acceptable for final reclaimed
slopes of 1.75 H to I V and in some other cases). ~
(b) Hydromulching 0
(c) Grass 0
(d) Noxious ",eed control planned 0
PLAN OF OPERA nONS
(I) Area to be disturbed in next twelve months to nearest 0.5 acres:
(a) Access Road --.L. . M acres
(b) Pit Floors and HighvaJls ---'2. (2(2acres
(e) Spoil 8anks/Overburden ~. ~res
(d) StOCkpiles -L. ~res
(el Total --1l:" .(}e! acres
(2) Probable total area to be disturbed during life of the mine (This cannot
exceed the total permitted acreage given on Form SM-2) ---.t..r.CL acres
(3) Natural vegelative screening from residences/roads wiJJ be
preserved yes -X-
(4) No stockpiling around the base of screening trees yes-X-
(5) Water Control d!;ring Mining:
(al All mining operations ",ill be kept a minimum or 200 reet rrom rivers. 1\../
lues, and "'8lJands yes ....Jle..- or.
Page 6
EXPLANATION OF MAPS AND CROSS-SECTIONS ACCOMPANYING TIlE
RECLAMATION AND OPERA TING PLANS
The fOllowing maps and sections are required in order document the pre-
existing geography, the proposed mining operations, and final reclamation of
the site. For small mines, accurately hand-drawn maps on graph paper are
acceptable. For larger proposals, an enlarged USGS 7 1/2 minu te
topographic sheet or engineering drawings may be appropriate.
(1) Map I: A regional index map showing the mine in relation to adjacent
towns and highways should be attached unless this information is
shown on Map 2 below (we suggest photocopying a ponion of a road
map).
(2) Map 2: A topographic map showing all of the fOllowing:
(a) Existing Contours (b) Proposed contours upon final reclamation
(c) Access (d) Boundaries of mined property
(e) Boundaries of disturbed areas (f) Location and names of streams
(g) Railraods (h) Roads
(j) Utilities (j) Parks
(k) Names of adajcent surf;.,:e o..ners (I) Localion of cross-sections
(m) Map scales and north arrow (n) Setbacks from adjacent pJ"opertie3 and
utiHties
(Note that most of these items are shown on USGS topographic sheets,
Consequently, we recommend photocopying the relevant portion of
a topographic sheet to use as a base-map for the reclamation plan)
(3) Sketch Maps showing the mine development as presently envisioned at
five year intervals. These sketch maps should indicate direction of
mining on easch working face, position of noise generating equipment,
water-controil measures, etc. (These sketch maps are unnecessary
for mines less than ten acres),
(4) Photographs may be attached 10 document pre-existing topography of
mining activities (oplional but it is generally it is in the operator's besl
interest to submit a photo),
(5) Two intersecting cross-sections showing:
(a) Final reclaimed slopes (b) Setbacks
(e) Existing topograpby Idashedl (d) MineraJs exposed at surface
(e) Proposed yegeution (C) Benches
(g) Berms (h) Lakes/ponds,
(j) Waler lobfe if kno..n
Page 6
EXPLANATION OF MAPS AND CROSS-SECfIONS ACCOMPANYING THE
RECLAMATION AND OPERATING PLANS
The following maps and sections are required in order document the pre-
eXisting geography, the proposed mining operations, and final reclamation of
the site. For small mines, accurately hand-drawn maps on graph paper are
acceptable. For larger proposals, an enlarged USGS 7 1/2 minute
topographic sheet or engineering drawings may be appropriate.
(I) Map I: A regional index map showing the mine in relation to adjacent
towns and highways should be attached unless this information is
shown on Map 2 below (we suggest photocopying a portion of a road
map).
(2) Map 2: A topographic map showing all of lhe fOHowing:
(a) Existing contours (b) Proposed contours upon Iinal reclamation
(c) Access (d) Boundaries of mined property
(e) Boundaries of disturbed areas (0 Location and names of streams
(g) RaifraDds (h) Roads
(i) Utilities (j) Parks
(k) Names of adajcent surface owners (I) Location of cross-sections
(m) Map scaJe3 and norlh arrow (o) Setbacks from.adjacent propertj~ and
utjJities
(Note that most of these items are shown on USGS topographic sheets.
Consequently, we recommend photocopying the relevant portion of
a topographic sheel to use as a base-map for the reclamation plan)
(3) Sketch Maps ShOWing the mine development as presently envisioned at
five year interVals. These sketch maps should indicate direction of
mining on easch working face, position of noise generating eqUipment.
water-controil measures, etc. (These sketch maps are unnecessary
for mines Jess than ten acres),
(4) Photographs may be attached to document pre-existing topography of
mining activities (optional but it is generaHy it is in the operator's best
interest to submit a photo).
(5) Two intersecting cross-sections showing:
(a) Final reclaimed slopes (b) Setbacks
(c) Existing topography Idashedl (d) Minerals exposed at surface
(e) Proposed Y"1letation (0 Benches
(g) Berms (h) Lakes/ponds.
(j) Water table if known
Page 7
SIGNA TURES
Signature of applicant: ~~xLV
Date: (/ /tJ 4 q /f?R9
Signature of Landowner approving proposed sUbse~ent use:
4?;!...Y.....!Y ~LV
~ 13lit ~9P9
'" ~.. (7,,~_~
Date:
Print Name of Landowner:
- - - - - - - -- - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - --
FOR DEI> AUMENT AL USE ONLY
(I) Are the facts accurately presented in the application and supple mental
material? _yes _ no
(2) Can reclamation be reasonably and economically be accomplished as
specified? _yes _ no
(3) Should a permit be issued? _yes _ no
(4) Recommendations and comments:
Page 8
Inspection Date: District:
Bond amount (No maximum per Ilcre):$ rJ fA
Copy of Bond Calculation Form attached
Signature Of Department of Natural Resources
personnnel approving project:
NIA
Print Name of DNR personnel
Date:
Area Approval
Date
yes
CAW INC.
1824 LAKEHURST DRIVE
OLYMPIA, WASHINGTON 98501
CARLA, WILLRlCH
President
TELEPHONE
(206) 3S7-SZZ1
1
RECE~VED
APR 2 'I 1989
JEFFERSON COUNTY
PUBLIC WORKS DEPT
April 23, 1989
Robert G. Nesbitt P.E.
County Engineer
Jefferson County
P.O. Box 1220
Port Townsend, WA 98368
Re: SW 1/4 NW 1/4 See 23 T27N R2W WM
Dear Bob:
Enclosed are the odds and ends I have on the property survey and
DNR permit. I thought Evan Ertman had filed a plat when surveyed
the property boundaries for me, but I guess he just marked the
lines and put in monuments. Hope this is of some value to you.
Sorry I took so long. Seems something is always coming up. I'll
drop a letter to DNR at Forks and tell them the county is the new
land owner. Give me a call when you're in Olympia and perhaps we
can get together for lunch.
?l~~
President
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Department of Natural Resources
OLYMPIA, WASHINGTON
98504
BRIAN BOYLE
Cuw..m_iI,lOC!f l,lf i'uLlic Landa
November 18, 1982
Carl A. Will rich
1824 Lakehurst Drive
Olympia, WA 98501
Gentlemen:
Re: Revised Surface Mining Operating Permit No. 1~
Enclosed is your Revised Operating Permit No. 10898, chan9ing the name of 'the
operator from J. D. Dutton and Carl Willrich to just Carl Willrich and permitting
surface mining on a portion of Sec. 23, T. 27 N., R. 2 W., w.r"., Jefferson County.
This permit is issued in accordance with the provisions of RCW 78.44, and in
accordance with the conditions set forth in Exhibit "A" attached to and made a
part of the permit.
The i ss uance of thi s permi t requ i res the fil ing of a surety bond in the amount
of Six Thousand dollars ($6,000.00). We have received Bond No. 505058l in this
amount issued by Hartford Accident and Indemnity Co. The bond has been approved
and accepted by the Department of Natural Resources. A copy is enclosed for your
file.
The law requires that reclamation activities on the lands covered by your permit
shall be completed not more than two (2) years after completion or abandonment
of surface mining. The Department of Natural Resources must be notified within
thirty (30) days after completion or cessation of surface mining or realization
of reclamation. Forms are available from our Olympic Area Office, Department of
Natural Resources, Rt. 1, Box 1375, Forks, Washington, 98331, for reporting the
completion or discontinuation of surface mining, fulfillment of reclamation
requirements, or accomplishment of seeding or planting.
An annual billing for the permit fee and copies of the form for the annual report
of reclamation activities will be mailed to you approximately thirty (30) days
prior to the anniversary date of the permit.
Please refer to the above permit number when submitting inquiries or reports.
Sincerely,
~4~
Dona 1 d M. Ford
Assistant State Geologist
Division of Geology and Earth Resources
DMF:kp
Enclosures
cc: Olympic Area
Equal Opportunityl Affirmative Action Employer
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MINING PERMIT
.;..)
STATE OF WASHINGTON
BOARD
of
NATURAL'RESOURCES
Olympia. Wac 98504
Ope rator:
Carl A
Wi 11 ri ch
AddrC8tj:
lA?4 litkphllrc;.t nr
nJy"'pi.
IJA
QR5nl
Pursuant co RCW 78.44 (Chapter 64, LaW8 of 1970) an OPERATING permit ia hereby
granted to the above-named operator to engage 1n surface mining on the property described 1n the app.licatlon
and macerial on file under this perlllit. The total area. to be disturbed by Burface mining. including the
deposit-ion of surface mining refuse. shall be in accordance with the reclamation plan filed with and
approved by the Board of Natural Resources under this permit, and in accordance with the" conditions
set forth in Exhibit "A" attached hereto and made a part hereof.
~
This pennit shall be in effect from the date of issuance and shall remain in effect so long thereafter as
the operator pays the annual basic fee of $25 per aite and the additional acreage fee if applicable.
complies with the Surface-Mined Land Reclamation Act and the rules and regulations promulgated thereunder,
complies with the reclamation plan. and maintains a performance bond as required by the Act.
Chan~e or Modification of Reclamation Plan
The operator shall obtain wri tten approval from the Board prior to any change or departure from the approved
reclamation plan. The reclamation plan may be modified as provided in RCW 78.44.100 at: any time during the
tern of the pemit after timely notice and opportunity for hearing.
Transfer of Permits
The transfer of this permit. to another operaJor through sale. assignment. lease. or otherwise shall not be
made unless approved in writing by the Board. A transfer shall not be approved unlesa the successor
operator assumes all duties of the former operator to complete the reclamation of the land and the Board
approves the success:)r operator's bond.
~
A performance bond in the amount of Si x Thollc;.;mn .~.
(~ n,nnn on ) Dollars shall be submitted to and approved by the Board prior to commencement of
surface m1ning. 'the operat:or may submit a cash deposit or an aSsignment of a savings account in the amount
apec1fied in lieu of a performance bond. The amount of the bond shall be subject to adjustment annually,
based on the number of acres to be surface mined and the number of acres to be reclaimed.
~
This pennit may be suspended. cancelled. or revoked if the operator violates any of the applicable
requirements set forth in the Act or the rules and regulations promulgated pursuant thereto. or if the
operator fails to conduct his operations as specified in the approved reclamation plan.
The operator shall be guilty of a gross misdemeanor for conducting surface mining without a valid operating
permit. Each day of operstion without a valid operating permit constitutes a separate offense.
Issued this~day of
November
19~
(REVISED THIS 18th DAY OF NOVEMBER 1982)
BRIAN J. BOYLE, secretary
Board of Natural Resources
23
27 N.
2 W.
Sec.
T.
BY~
Donald M. Ford; Asst. State Geologist
,'aRM RES 35-1501 (7-75)
R,
Pt!' rmi. t No. --1.D.8.9B.-
r.1I^Nr,r. nF OPFRATOP
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EXHIBIT "A"
18, 1982
Carl A. Will rich
1824 Lakehurst Dr.
Olympia, WA 98501
Revised Surface Mining Permit No. 10898
The fOllowing conditions are hereby made a part of Permit No. 10898:
1. This permit applies to the following described property.
Pt. of the SWl;" NWl.; of Sec. 23, T. 27 N., R. 2 W.. W.M.,
Jefferson County.
2. Operations shall comply with the Maximum Environmental Noise
Levels as set forth in RCW 70.107 and WAC 173-60.
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'PIl:IL pol 1'1; of t,llt~ UOIJLhwll::L }1, or Lho Nort;hw(:nl; }' of" tj,:(:tiofl ;~)
'l'oWJ1:~ldp-;?7-Nol.t;h, H:IlII~{~-~-\Jcnt;, W.M., d(~:;cJ'l.b!:d :I:: tbo wf::;l;
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County, WnDhinl"Lon.
PAHCEL "B":
Thnt pnrt of the Southwest ~ of the Northweut ~ of Section 23
'l'ownnhip-27-North, Hanr;e-2-West W .11., described as the weHt
;230.00 feet of the east 11;!0.00 feet of snid Southwest }4 of the
Horthwest ~ lyinr; southerly of State Highway No.9, in Jefferson
County, Washington.
PARCEL "C":
That pnrt of the Southwest ~ of the Northwest }4 of Section 23
Township-27-North, R~nr;e-2-West W.M., described as the east
190.00 feed of said Southwest }4 of Northwest }4 lyinr; southerly
of State Highway No.9, in Jefferson County, Washington.
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REAL ESTATE EXCISE TAX
n
Thl. lorm I, yOUf taceipl wfl... IiIlampecl
by e..hier. Pay by ca.h or eertllled
ehf:tck 10 Co~nty rr..,ur.'.
Submlllo Courlly Treasurer 01 the
county In whIch property 1,loc8ted.
PLEASE TYPE OR PRINT
CHAPTER 82.45 RCW
cttAPTER 458.61 WAC
THIS AFFIDAVIT WilL NOT BE ACCEPTED UNLESS ITEMS 0 THROUGH 0 ARE FUUY COMPLETED
0)
Nllma
C.'\rl
A. \1iJlrich
and
ffi~
::l'Z
w'"
",a:
"
",jllvl H Y.
1';:f.l1ric11
Str.et
1 f! '! !~
L.lkel.u1:-:;t
llr,
". 01y~'~~',iH,
Citll
'\-!A
98snl
Stalo Zl
J.:-ffcr"flo,,: County
CD
NEW OWNER'S
PERMANENT ADDRESS
FOR ALL PROPERTY
TAX RELATED
CORRESPONDENCE
Name
p.lj. :~o:"~ 122{j
Slteet
Port To\.;us<=.uc 1
',JA
Clty/Stala
o
LEGAL DESCRIPTION OF PROPERTY SITUATED IN UNINCORPORATED
~~~ nttnchcJ 8tatuto~y ~~nttBll~Y n0ed
@ Is this property currently:
Classified or designated as lorest land?
Chapter 84.33 RCW
YES
NO
o
o
o
o
o
~~~~~~~=~;u~~~~~:.u:r~l~~~:)i~~:~t~~~4.34 RCW 0
Exempt Irom property tax under nonprofit
organizations Chapter 84.36 RCW?
o
o
Receiving special valuation as historic
property under Chapter 84.26 RCW?
Type Property; [2;] land only 0 land with new building.
o land with previously 0 land with mobile home
used building
SEE TAX OBLIGATIONS ON REVERSE SIDE
o
(1) NOTICE OF CONTINUANCE (RCW) 84.33 or RCW 84.34)
lithe new owner(s) 01 land that is classified or designated as current use or lorest
land wish(es) to conllnue the classification or designation of such land, the new
owner(s} must sign below. II the new owner(s} do(es} not desire to continue such
classification or designation, all compensating or additional tax calculated pursuant
to RCW 84.33.120 snd 140 or RCW 64,34.10B shall be due snd payable by the seller
or transferor at the time ot sala. The county assessor must determine if the land
transferred qualities to continue claasiticalion or designation and must so indicate
below. Signatures do not necessarily mean the land will remain In classlllcation or
designation. If it no longer quslifies, it will be removed and the compensating tsxes
will be applied. All new owners must sign,
This land 0 does 0 does not qualify
for continuance.
DEPUTVASSESSOR
DATE
(3) NOTICE OF COMPLIANCE (Chapter 84.28 RCW)
II the new owner(s) of property with apecial valuation as historic property
wlsh(s} to continue this special valuation the new owner(s) must sign below. If
the new ownar(a) do{ea) not dealre to continue such special valuation, all addi-
tional taX calculated pursuant to Chapter 84.26 RCW, shall be due and payable
by the seller or transfaror at the time 01 s8la.
(3) OWNER(S) SIGNATURE
@
The following optional questions are requested by RCW 82.45. 120
Is property at the time at sale:
YES
.
a. Subject to elderly, dlsablllt}', or physical improvement
exemption?
b. Doell building, If any, have a hPClt pump or 1I0lar
healing or =oollng lIystem?
c, Doeathla conveyance dlvlll~ a curront parcol 01 land?
,0
,0
,0
,0
d. Does sale Include el.lrrrJnt crop or merehenl"bl"
timber?
CD
Name
W
a:w
w>-
>z
"'"
ilia: Slreet
"
J,~ff(~r~on Sount'l
.fJ<
Boy. 12 L 0
ell
Port
-,~nwr:fle\1t;
Slale
ALL TAX PARCEL NUMBERS
702:~J20():'
[};-; ~i (, :~
Zip
,J~:> f f c-r 9 07"', COUNTY 0 OR IN CITY OF
@ Description 01 personal property it included in sale (Iurniture, ap-
pliances, etc.)
S"1,,
II et~g'~)ig~c~iIT~~i txPI~; e n c :1
Type 01 Document S tat u tor)" ;';f\ rr en t y
Date 01 Document
Gross Sala Price 11 $ i t.1. O(fU ~ !'l)
Personal Property (deduct) 21 $ 1)_
Taxable Sale Price $
Excise Tax: State $
Local 31 $
Delinquent Interest: 4/Stste $
Local $
Delinquent Penalty: 4/State $
Total Due $
(SEE 1-5 ON REVERSE SIDE)
l,,: :\ Zin :; '~; '3 f, ~"
to n
u(~erl
<D I CERTIFY UNDER PENAL T~F~~~~I;JURY UNDER THE LAWS OF
THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE
AND CORRECT (see #5 on reverse for penalties),
SIGNATURE
NAME (print) Roher t G.
q(><lhttt
DATE & PLACE OF SIGNING:
SPECIFY (circle): grantor/grantee/grsnlor'S
agent/grantee's agent
,~ 0 r t
7ov\lsencl.
'IA
Address 01 residence or place at business of person Signing (specify):
') 836f'
",0.
}'l,ox 122 (.\
NO
e. 008S conveyance involve a trade, partial
Interost corpr,rate aUmsles, related penias,
trust, receivership or an estote?
I. is tho grantote acting 88 a nominee tor a third
party?
g. Principal uae;
1 0 agricultural
., 0 apt (4 + units)
7 0 commercial
2[J
20
20
20
2 0 condomInium
5 0 Industrial
8 0 mobils home
FOR TREASURER'S USE ONLY
FORM REV 84.0001 3m (71118) ",6&.
L
YES
,0
,0
3 0 recreational
6 0 residenllal
9 0 limber
TAXPAYER
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
P.O. Box 1220
PORT TOWNSEND, WASHINGTON 98368
Phone 385-3505
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3. Nollly UlI immediately II you are unable to ship as SpeClllOd.
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Courthouse
PORT TOWNSEND, WASHINGTON 98368
Phone 385-3505
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
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1820 Jefferson Street
P,O, 80x 1220
Port Townsend, WA 9B36B
(206) 3B5-9160
Gary A. Rowe, P.E.. Director
Robert G. Nesbitt. P.E., County Engineer
February 10, 1989
FAIR OFFER LETTER
Carl A. Willrich
1824 Lakehurst Pro
Olympia, WA 98501
Re: SW l/4 NW l/4 Sec 23 T.27N R.2W W.M.
Dear Carl,
Jefferson County wishes to purchase property and property rights
from you for the purpose of gravel source and erecting a
maintenance shop.
The County has appraised the market value and offers Seventy-Eight
Thousand Dollars and no cents ($78,000.00) for the purchase of the
property.
The above amount is the fair market value as determined by
Jefferson County through the appraisal process.
Payment for your property will be made available to you within 30
days after you accept the County's offer and tender the conveyance
provided there are no undue delays in closing the transaction due
to title clearance. The date on which payment is made available to
you will be the possession date, and the County becomes the owner
of the purchased property.
Jefferson County will pay all filing fees and proportional 1989
property tax.
We sincerely hope our offer is acceptable, and we will be able to
close the transaction in the near future.
Sincerely,
~~
Robert G. Nesbitt, P.E.
County Engineer
100% Racycled Paper
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Fold .lli"'lIo 111171 OU.O.VUE~ En,.tI~
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JEFFERSON COUNTY
DEPARTMENT OF PUBLIC WORKS
Courthouse
PORT TOWNSEND, WASHINGTON 98368
Phone 385.3505
TO .....4?.~ (..d'./LI/ I~i'~ ./::-.
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REOUI$ITIClNEP BY
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1. Please send _ copies 01 your Invoice.
2. Order IS to be entered in accordance With prices. delivery and specillC8lions shown abOve.
3. NOllly us immediately if you are unable to ship as specified.
'-', -
ORIGINAL
:~' JUDrrj6~~U
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fiLED fOR RECORD AT REQUEST Of
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i THISlIPACE PAOVIOEO fOR RECORDER'S USE, !
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WHEN RECORDED RETURN TO
H.IM....d.~.f..~.~.!..~.<?n....9.2.~.~E.'I......I?..~.P..~.E..!.IE.~.~..~.....<?E....~..lf..l?J..~.S.....W.? r k s
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CUy. Stat.,' ZJP....!?!?!:.~"..'I!?!t.I.1.~.~.P.-.~..,.....W.~...........?.~.2.g..?..................................
THE GRANTOR Carl A. Wil:lrich and Mavis Y. Willrich, husband and wife.
Statutory War..lnty Deed
loundlncouaidaralionol Ten Dollars and other valuable considerations
In lw>d paid, conv.yund WarraDla to Co u.n t y 0 f J e f fer son
lbo 10UowinI doocribod naI .lalo, oilualod in tho Cow>ly 01 J e f fer son
. Btata 01 WubiniIon'
The Southwest quarter of the Northwest quarter of Section 23, Township 27
North. Range 2 West, W.M. EXCEPT 3D' wide strip along the Ea~t side
of a portion thereof conveyed to Jefferson County by deed dated
February 3, 1930 and recorded in volume 98 of Deeds on page 171, and
EXCEPT portion conveyed to the State of Washington for State Highway
by deed dated April 24, 19~5 and recorded under Auditior's File No.
74051, and EXCEPT 60' wide strip of land conveyed to Jefferson County
for county road (old state highway) by instrument recorded May 10,
1909 in Volume 1 of Road Waivers on page 4a records of Jefferson County.
EXCEPTING there from that portion of premise lying southeasterly
margin of State Road No. 9
D.tacI........................................................................................... 19............
.......................................................,................................................... ................................................................................................................................
:~:~~:.~.~~~~~~.~..............J IL
On lhl. d.y ~nonally .ppearod bol~r. m.
to me known to bo &h. individual dMCribod In and
who ..KUted the within and lor.,oina' inltrumant.
and acknowled,ed that .................. aiped the urn.
.. ....................,... free and voluntary act and deed,
lor the UHt and purpoaea therein mentioned.
GIVEN und.r my hand and oIIlc:ial ooal lhiI
............ ~ 01.................................................... 19........
......,............."......"..............................................................
Notal'l' Public in and 10' tho 9..le 01 Wuh.
In, ton, rMidin, .L......................_....._................
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belo~n~~'U;.~~.~i~:x, ~ N~'iA;:;:.~.biic..~..;~..,~;.th;..Sta~ ~~..W~.h:
llllllon, duly COIDlIliulonod and IWOrn, ponona1ly .ppoa,od................................
and........................................................ ...........................................................................
to m. known to be th.e ............................PrNid.nt and..........................SecretAry.
reJpectively, 0(.....,........................................................... ................................................
the co~r8tion that uecuted lhe (oreloinl INtnunent, and acknowlodged
~~~i,o;~u=~t;~~ee ~:ei~OI~::;'ti~n~~ :~~ t~ O:t~.:~~rrh:t
................................ authorized to eJ:ecule the aaJd lnatrument and that the leal
alliud 10 tho corpor.l. ...1 01 laid corporaUon.
.bov~~~::..my hand and oIIlcial ooal borelo dud the da,y and Y'" /In'
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-PIONEERTITLECOMPANY
o F
JEFFERSON
C 0 U N T Y
February 6, 1989
Jefferson County Public Works Dept.
County Courthouse
Port Townsend, WA 98368
Attn: Bob Nesbitt
Our No.
Reference
26838
23-27-2W, SWNW N. Hwy, ARB 33
Enclosed is your preliminary commitment for title insurance in connection
with the above captioned transaction.
Please refer to this number in any correspondence or telephone
conversations with us, thereby enabling us to provide quicker response.
You may be assured that this matter will receive our best attention. 1f
you have any questions regarding this transaction, please do not hesitate to
contact this office.
Sincerely,
W-~ AJj~
Robert R. Wheatley
Title Officer
2037 E. Sims Way I P,O. Box 59BI Port Townsend. WA 9836B/12061 3B5-1322
-PIONEERTITLECOMPANY
o F
J E F FER SON
COUNTY
PIlEL1MINARY COMMITMENT FOR TITLE INSURANCE
Order No: 26838
Prepared for:
Jefferson County Public Works Dept.
County Courthouse
Port Townsend, WA 98368
ATTN: Bob Nesbitt
Effective Date of Commitment : January 3, 1989 at 8:00 A.M.
Policy or policies to be issued:
(xl WLTA Owner's Policy
Standard Coverage
Proposed Insured:
JEFFERSON COUNTY
LIABlLlTY
PREM IUM
TAX
79,000.00
426.00
33.23
$
$
$
Ticor Title Insurance Company, by and through its agent, PIONEER TITLE
COMPANY OF JEFFERSON COUNTY, agrees to issue on request and on recording of any
appropriate documents, its poli.cy or policies as applied for, with coverage as
indicated, based on this preliminary commitment that title to th~ property
described herein is vested on the date shown above in:
CAIlL A. WILLRICH and MAVIS Yo WILLIlICH, husband and wife
subject only to the exceptions shown herein and to the terms, conditions and
exceptions in the policy form.
This report and commitment shall have no force and effect except as a basis
for the coverage specified herein.
by
2037 E, Sims Way/ P,O, Box-59B)P';-rt Townsond, WA 9836B I 12061 385-1322
The land referred to herein is located in the County of Jefferson, State of
Washington, a.nd described liS follows:
The Southl<est quarter of the Northwest quarter of Section 23, Townahip 27 North,
Range 2 West, W.M., EXCEPT 30 foot wide strip along the East side of a portion
thereof conveyed to Jefferson County by deed dated February 3, 1930 and recorded
in Volume 98 of Deeds on page 171, AND EXCEPT portion conveyed to the State of
Washington for state highway by deed dated April 24, 1935 and recorded under
Auditor's File No. 74051, and EXCEPT 60 foot wide strip of land conveyed to
Jefferson County for county road (old state highway) by instrument recorded May
10, 1909 in Volume 1 of Road Waivers on page 4a, records of' Jefferson County.
EXCEPTING therefrom that portion of premises lying southeasterly of the
southeasterly margin of State Road No.9.
STANDARD EXCEPTIONS:
1. Encroachments or questions of location, boundary and area, which an accurate
survey may disclose.
2. Public or private easements, streets, roads, alleys or highways, unless
disclosed of record by recorded plat or conveyance or decree of a court of
record.
3. Rights or claims of persons in possession, or claiming to be in possession, not
disclosed by the public record.
4. Material or labor liens, or liens under the Workmen's Compensation Act not
disclosed by the public records.
5. Water rights or matters relating thereto.
6. Any service, installation or construction charges for sewer, water, electricity
or garbage removal.
7. Exceptions and reservations in United States Patents.
B. General taxes not now payable, matters relating to special assessments and
special levies, if any, preceding the same becoming a lien.
9. Right of use, control or regulation by the United States of America, in the
exercise of powers over navigation.
10. Any prohibition or limitation on the use, occupancy or improvement of the land
resulting from the rights of the public or riparian owners to use any water
which may cover the land.
SPEC1AL EXCEPTIONS:
2 -
-.oJ
~lrl~l~ra~Yi'ii~~~iiri~~~
For Year
1989
Being County
Parcel No
Affects
as
o
ows, p us interest after delinquency
Amount Billed Amount Paid
807.79 0.00
$
Treasurer's
702 232 002
'fhe above amount
$6.9B.
reflects fire protection in the amount of
12. Lien of real estate excise sales tax upon any sale of said premises, if unpaid.
13. Claims of security interests which would be disclosed by a search of Uniform
Commercial Code filings.
14. Any conflicting claim of ownerstlip or security interest in the mobile home
located upon said premises which may be evidenced by a Certificate of' Ownership
issued by the Department of Licensing.
NOTES TO REPORT:
1. There must be included in the forthcoming deed a reel tal after the description
'together with that certain ____(Brand Name)_____ mobile home, model No.
Serial No. '
2. The language contained in the printed exclusions from coverage and conditions
and stipulations of the policy committed for may be examined by inquiry at the
office which issued the commitment, and a specimen copy of the insurance policy
form (or forms) referred to in this commitment will be furnished promptly upon
request.
3. Investigation should be made to determine if there are any service,
installation, maintenance or construction charges for sewer, water or
electricity.
4. In the event the transaction fails to close and this commitment is cancelled, a
fee will be charged to comply with the state insurance code and the filed
schedule of this company.
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RESIDENTIAL APPRAISAL
Roll t~o........_.............._... Page No...... ........_......n... D'.-'ncr..
Mop NO........_.._.._n......... Phoro No.......................... Addrt,'S~
MOnlhl( Renl..........._...........
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Sold 19..2:'lJ:':~mounl $:"::O':':.:!.~.'I5a..(t.O,.. Oct..
BUILDING CON5TRUCTlor~ 5TO.;IF~.-=r;r~;;r:~;~,'J~..1
DwcllinlJ SinOlc No. p.oo~~-[-rr-I-'-
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Cone. 6 B 10 II'I$uloliol'l
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Low Cou
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Cenerefe Block
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Raman
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Floor Rod.
Electric
Wall Unils
Baseboard
Glo$1 Panel
Ceiling Rod.
Floor Rod.
fiREPLACE;
1 Sly. Singlv
1 Sly. Bkd.
2 Sly. Single
2 Sly. Slid.
2 Sly. Slkd.
EXTR/,S
B. I. O'..en
B. I. Ronge
Hood and ran
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BUIL1.INS
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FLOORS
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CONSTRUCTION
EaUIPMENT AND
SAFETY SUPPLIES
5950 . 41t1 Ave. South
Seattle, WA 96108
(206) 762.8080 FAX: (206) 767-5969
E. 3107 Trent
Spokane, WA 99202
(509) 534-1592 FAX: (509' 535-6073
1702 Ship Ave.
Anchorage. AK 99501
(907) 276-5494 FAX: (907) 27a.o996
13691 NE Whitaker Way
Portland. OR 97230
(503) 255-n67
SEATTLE. SPOKANE. ANCHORAGE. PORTLAND
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CONSTRUCTION
EaUIPMENT AND
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Seattle, WA 98108
(200) 762-8080 FAX: (208) 767.5989
E. 3107 TranI
Spokane. WA 99202
(509) 534-1592 FAX: (509) 535-6073
1702 Ship Ave.
Anchorage, AK 99501
(907) 276-5494 FAX; (907) 278-0998
13691 NE Whltakar Way
Portland, OR 97230
(503) 25s.n87
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SPECIAL AnENTlON
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