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1035 7TH AVE S
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,. BUILDING DIVISION Applicant Fill
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PERMIT APPLICATION Inside Heavy Lines
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ADDRESS'/o~
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NAME (OR NAME Or BUSINESS)
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L D RIPTION
SUBDIVISION
SHORT SUB NO.
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\MJAILING
75
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PUBLIC RIGHT OF WAY PER OFFICI JL STREET MAP
CITY ELEPHONE NUMBER
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SEAT TLG �� ^L— ga^XV -7
EXISTING _
PROPOSED
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DEFICIENCY OF RIGHT OF WAY
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PUBLIC IMPROVEMENTS REQUIRED ❑
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DRAINAGE IMPROVEMENTS REQUIRED ❑
DRAINAGE PLAN REQUIRED ❑
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CITY
TELEPHONE NUMBER
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UNDERGROUND WIRING REQUIRED ❑
CONNECTION TO SANITARY SEWER
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NAME
CMGB
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SEPTIC TANK PERMIT REQ'D ❑ -NO.
ELEVATION OF PROPERTY CORNERS ❑
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ADDRESS
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8c FOOTINGS.REQ'D
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CITY
TELEPHONE NUMBER
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SEE ENGINEERING, MEMO DATED
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STATE LICENSE NUMBER
CITY LICENSE NUMBER
CHECKED BY �(,.I•.' ``^^
Legal Description of Property (Show Below or Attach Four Copies)
METER SIZE BUILDING SUPPLY SIZE
11
LoT LOCK 4 l T OF 03TS T
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REMA S
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SIGN AREA
ENV. REVIEW
ADS NO.
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ALLOWED PROPOSED
COMPLETE EXEMPT
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PLAT ER _ CO i0 IAJ VOLUME
SHORELINE
OF ^ATS, PgGE(o� k'Ec024S of -rHE
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REMARKS
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STAIE OF WASWIV(SION.0 T
VARIANCE OR CU
PLANNING REVIEW BY
DATE
EET "T E RlFoF
YARDS ` / ` /
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LOT COVERAGE
NEW, RESIDENTIAL GAS
❑LINE
O FRONT SIDE REAR
FIRE ZONE
TYPE OF CONSTRUCTION
CODE
HEIGHT
''LLJJ
NON-RESIDENTIAL ❑ SIGN
EOa
ADD
El
❑ RETAINING
DEMOLISH
WALL
SPECIAL INSPECTOR
REQUIRED
AREA' -
OCCUPANCY
GROUP LOAD
OCCUPANT
❑ ALTER EXCAVATE. FENCE
❑ YES ❑ NO
OR FILL ❑ ( X FT)
❑
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
PRE -MOVE swim
REPAIR INSP. ❑POOL
OF EDMONDS. LOCAL SALES TAX
\. SHOULD BE •CODED 31.04.
Z
NUMBER OF STORIES
NUMBER OF
REMARKS 1'
0
DWELLING
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UNITS
W
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NATURE OF WORK TO BE DONE
STR UCT k)F=W HOMe
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0
W
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0
PLAN CHECK FEE
VALUATION
FEE
0
PLOT PLAN
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BUILDING
IL
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PLUMBING
W
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MECHANICAL
FENCE
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SIGN
"Applicant, on behalf of his or her spouse, heirs, assigns and
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successors in interest, agrees to indemnify, defend and hold harmless
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the City of Edmonds, Washington, its officials, employees, and
RETAINING WALL,
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aagents
from any and all claims for damages of whatever nature,
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arising directly or indirectly from the issuance of this permit. lssu-
SWIMMING POOL
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ance of this permit shall not be deemed to modify, waive or reduce
.Itl\' rl'!i�li 111.'ti' ill i111V ('1I\' + ;; III'i 111 l' 11(+t limit I11 ii rl )' \l';1 )' 1)le
,__----
ENGINEERING F
EMENTS FOR BUILDING PE
CITY OP
PUBLIC WORKS DEPAR' Tff- r
EN(,IITEFRING DIVISION
_T APPLICATION
DATE:
SUBJECT: 77'L
Subdivision —� , —.��� Plat Ply
Multiple
Commercial
GENERAL REQU IRi7'/fENTS
Coordination of the location or any structure with respect to utilities, streets, property
lines and driveway grades is the responsib::lity of the contractor.
The ccnstra,tor.is required to keep the abutting street cleaned of dirt and debris caused
by the construction 7.30.200 Violations - Penalties 7.30.290.
A "Right -Of -flay Construction Permit" is .required from the Engineering Division of Public
Works for any work within the Public.right-of-way or public easement. 7.30.010 Violations
Penalties 7.30.290.
SPECIFIC REQUIRE]`.'IENTS
UNDERGROUi1D POWER
❑ Underground Wiring Req'd Not Req'd
SANITARY SEWER (PERMIT REQ'D)
f�t_lC-onnection to SanitaiW Sewer Req'd ❑ Back Water Valve Req'd on Side Sewer
❑ Septic Tank Periiuit Read. Design Approval Req'd
Approved Dt . Permit Plumber
STORM SEH R SYSaU 1 ( PER CITY CODE
❑ Drainage Flan Req'd
❑ Site Drainage to be Contained on Site
ROADWAY ENPFO�Ei,LEITPS AND DRIVE ,IAY RIY)UIREI IE US
Drive,•iay Slone Not to Exceed_1_4
Driveway Favi.ng Req' d
❑ Vertical Curb Req'd
❑ Street Pavii-4; Req' d
❑.Drainage Plan Anproved Dt.
❑ Site Drainage to be.Connected to.Cit.y System
❑ Driveway Culvert Req'd Size
❑ Sidewalk Req'd
❑ Approved Desig)i Req' d
❑ Bond Recl' d for Public Improvements ❑Submit Cost Estimate
Note:
Inspections F n',i. , Engineering Division
�Foundati_on [Side Sewer Septic Tank
X— Water Service ❑ 1
Fire Protection '�—Drainage
--Site ITT;provements
A 24 - hour notice Is required for inspection :-)y Engineering, call 775-2525, extension 220.
t---J .V�7o gT (Ls=S
FRED F. HERZBERG, P.E.
• PUBLIC ItiIORKS DEPAR-R Ni CITE( ST �.:�� • �� Date
BUILDING PERMIT REVIEW
Address
Street. Right -of -Way Existing
REQD
Access Easements Existing
REQD
Utility Easement Existing. u.� o
:, REQD --
Lot per Subdivision Plat Assessor Map —•
Site Plan Checked for Accuracy
Underground Wiring Reqd. f.- AC=b
Check Accuracy of Legal Description
Environmentally Sensitiv& Area
c
Environmental Checklist Reqd.
0
`Flood• Hazard Zone
Shoreline Management Area
Slope, Soil, Vegetation
Stream, Creek, Drainage Basin
ti196
Existing Zoning Per Code
• S- Lam,
Amenities Design Board Approval Reqd.
►,) Ia. ADB ljt�,_ Approvals
Board of Adjustment Approval Reqd.
&.��4.
.-.Re '. -Z�c �-�1�--
Date:
Edsttirig dater \ lain Size
Water Main Reqd. AIIA
Service Line Reqd.
Hydrant Size Existing:
Hydrant Reqd. Per Fire Code Size
Size .
Detector Check Meter Reqd.
.Cross Connection Inspection A//A
_Fire Department Ccxlments
_ o
Water .Meter Charge -Reqd.
..:Review -by: Ao�i Date: 6- l ` 79
eptic
te:
Septic Tank Permit Reqd. Permit No.
Sanitary Sewer Availability Proj.
Drawing No. - _ File N
Side Sewer Availability
Sanitary Sewer Connection Femme Reqd. a
Review By: ,1 a �4-- _ Date:, t ` • � o�
T-
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Open llitcli E}:isting��<�f, Reqd.��''
Culvert Reqd.._ /�/� , Size —
Catch Basin Rcqd. �/
a�,,e Indicate,on Site Plane
o Shoulder drainage maintain collection on s<•iale open r -ioff
Nvulhole . rc d
q /�/� Indicate on Site Plan
Soil Conditions and Ground I -later Field Checked`���
Rovie�..J by Dote
Street Paving .Read.
I� Curb and Gutter Regd.
w r� Sidewalk Reqd.
w Curb Cut for Drivec:•ay Reqd
c Right -of -:Way Construction Permit Regd.:
H k Bond Reqd. for Public Irmrovcmr_nts
Street Nar;ie Sign Regd.
cn
F` Other Signinc, Read.__��/j•7
Pre Perrni-t Site Inspection made on
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BY: SEt:'ER
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�-+ ��F S'MEET L.. .
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R. } ENGINEERING
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Special P.equire!: izts listed iil 'n3ro "to CorTrain ty neveloprlent Depart r iit
t I3ui_1ding Division
E F� BY Date
J
o = All iten-s filled in on Building Perniit Application
n . BY
Date
a t"
p Drawiu- ,s Stanmed and Notations 1,1-ide
` a t
BY
Date
Approved by Public 1,7orks nepar�z, flit
Re:vi scd: lv 10-].977 0
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OCTOBER 3ST, T FILE
CITY OF EOI"l0AJC3S
200 O/�YTON
FIDMOiyOS LASH, 9,�020
THE CITY OF E17IYI0NDS 1--iAS AGREED TO tPCRt`lIT
JUNE 'I3ARSTC>W TO REMOVE TH E TwO TIRCES ON
7 t AVE, S. IN FRON1% OF N ER HC)T\'tC A-F lO t
c7 LVE- S, `3ECAUS C THE ROTS OF THE TR E C S
iNTE R FE RC w' iTi-1 T11E S'i OR►�'1 i�i��1►NSe
THE uN(JER-SiGPJEp AGREE AND NA'F— NO 013-
SECTIC�)►q TO THE REI�OVAt_ OF THE TWO -TREES.
J
STREET FILE
October 31, 1979
MEMO TO: Art Housler, Director
Finance Department
FROM: Fred F. Herzberg
Director of Public Works
SUBJECT: REIMBURSEMENT OF STREET CUT SECURITY DEPOSIT -
ORDINANCE #1935
R/W CONSTR. PERMIT NO.: 79-272
DATE ISSUED: 8/15
LOCATION OFWORK*. 1035 7th Ave. So.
SECURITY DEPOSIT AMOUNT:_-$123.00
RECEIPT NO. & DATE: �k1066 9/5/79
COMPLETION DT. OF REPAIR: inn n/7q
Please prepare a Treasurer's Check in the amount of $
made payable to the following:
Roger Thompson
Northlake Concrete
5906 - 238th St.
Woodinville, Washington 98072
33.52
The balance of the deposit in the amount of $ 89.48 is to
remain in Street Division Revenue Fund 111-000- - .10.
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CITY OF EDMONDS ermit No.
PUBLIC WORKS DEPARTMENT p_ I Issue Date -j +' ' r c
• R16HT - OF - WAY. CONSTRUCTION PERMIT
A. •Address or vicinity of Construction • Permit Issued To: JS(- -a F' (/ jam• t e� <<� `�
` 2,��C; C1 I
• Owner: - + r • Type of Work to be Done: I �: 1 ► r ���
�.
—: Yp
Name�- r
��
j� :7 _. ')'i' ►i rr= . �' • Work to Connection With:
Mailing Address O Sub or Plat 1�1_ingle Family
l- S O Comml. / Incl.'
❑ .Apt.. Condo.
City, State, Zip Code • Pavement Cut: U-1es ❑ No
• Contractor: -Name t" kl ire t 13 �J � C _6-r, CVc..I V � L:
Mailing Add re s State Licens Numb /
City, State, Zip Code Telephone Number
* yt NO WORK TO BEGIN PRIOR TO -PERMIT ISSUANCE
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or e p ee , he defense of any legal
proceedings including defense, costs, court costs, and attorn i n of an n
` IAL-DIG
Upon issuance of this permit, the contractor is responsib or hi an malria eriod of one year
following the final inspection and acceptance of the restorati n y th neer g ivisBEFORE
_ YOU DIG
Funds held from the Security Deposit (estimated restoratio fe b el til t . e to ch is ompleted, at
which time a debit or credit will be processed for issuance t ,
Work is to be inspected. Restoration to be in accordance a t* raffi____H"16He frfj t n e with Traffic
Section of City Code. Street to be kept clean at all times. A (' �5fi,6i0d GEn ineering. Call
775-2525, extension 220.
I understand that this permit -must be available at the job site for inspection purposes at all times.
Signature: Date +
Owner or Agent
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Voi• after �(��days
Special Conditions: !: - ��c ' e t�)`r r�''� I ry.,_ _
Ammendments:
Permit Fee:..
Security Deposit: �}
Receipt No.: _r-,o
Fund 111 Fee:
Street Cut Dimensions
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
J
CiITY OF EDMONDS 7W
RI5GHT - OF - W DEPARTMENT CONSTRUCAWT 8
A. *Address or vicinity of Construction
`F A Ej t
• Owner: °a� �, E� A':�`�t"�•'.� l�°n .', e,
Name
Mailing Address
City, State, Zip Code
• Contractor. 4'`1• �. r i ►,caa?� _ �,. iJ �¢ )v
Name
r�, 01 it to rf�
Mailing Address
( , n ) .n, CA,
fi r do
City, State, Zip Code
Permit No.
Issue Date
• Permit Issued To:
• Type of Work to be Done: '� ' '' =` 2. `1
• Work in Connection With:
❑ Sub or Plat, Single Family
❑ Comml. / Ind. ❑ Apt. Condo.
• Pavement Cut: ❑ Yes ❑ No
State License Number
r"r -
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit, must be av-aii
Signature . ~ A/I .`A
Owner or Agent
at,, the job site for inspection purposes at all times.
� _6 42-tn. Date
�,t
* THIS PERMIT MUST BE POSTED' AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Void after' days
Special Conditions:
Ammendments:
Permit Fee: —
Security Deposit:
Receipt No.:
Fund III Fee:
Street Cut Dimensions
X =
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
FIELD INSPECTION NOT S (Fund. 111 - Rou e! conv to Street `Debt . )
Comments
IDiagram:
Contractor called for inspection Yes Lid
Work Disapproved By: Date: By: Date:__
Work Approved By:_��' Date:
Inspector:
Ena. Div. December 1971
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. roic P 1.0 VVILlTY '913tRi T� 1�laj: f4.of
' locar� 3 % AV• �.t}:; '���, 1NANa
T �
' N W V4— Z4 . —T 3 At ry `: .�" f...as; saittg 1" =_7.G d
Rea sen for work 't S L"' �_.� _, , L� ! S l'_.1Z F !}�L •inelr ' liih
c t4 .
W�'foe li1o.
PERMIT REQtl1 EO REIGN CONTACTS Osi,Ms$dT NVIR #TlIL . ANAtYS13
Type �� r n 1� 'Coowany SIPA'.:
Pc
R
Date Granted ran r Item C.,
foes reggired Yes fie 3 S.
Log tested In YyPe. SV G :Oats 6rantd J' S
Tronsf.Card 1 t. fion �fe�red,
Poe: Date 8 V 1..=pp . n
Ma Po
Circuit -
Date' Released For Constrtictiona o ; .. *' —ter--r+ •
Date Work Completed
'Circuit Number ' �, " .' a 4 Substatioq ' �' C R `" _ .Clef
b
" .• di, /\ I�61 \ �M } - S - �' h
o O,ox, 0' Bfir
>i�
U �1C1.Ari..—
4 K - • 4 ~ x' 1 _ •' +nr' 'NSF
' .. •. �•� may-.. .t'j � , � � � ' rr -++`+ r .�
' - i ft S %�l'L L C \ 1 S l T({'��[ C.f�\�� ►-ice t�z i, ,�/�t ��Y ���' '}
�S' S:ovTt'i t8 tAST
$'T~A
_ - - ,,. ti _ V � �. i '�Y — .t' +I.J d+ J r, °••� .. J ,�yJ - rh!k
.. ! _ - '.?•: tt,.. -f a a.'C it .•` 3-t .��..:
.. ., -t :,.. ^�' .s r t-.{/a�•, ��T".,7q�.+�'J'+' .ec '2Z _ `t9 ='
.. - .ry _N%-. i � � •fix
EDMONDS
Side Sewer Drawing TREATMENT PLANT ;
The City of Edmonds M- e �.,L E- _.......-_-_
SEMENT NO. ,---------•----------•-•-
nn
NEW CONSTRUCTION REPAIRS ❑ LID NO....-..!--.- ASMT. NO ................... -
OWNER ........ G-O.r-y..... ----------•--------- ------ CONTRACTOR--_..,-i.Xe-w-----.Qm .rt E~...... PERMIT NO. (0-3-4?Z
1 Jr ! T H A UE ---- LEGAL DESCRIPTION: LOT NO ------------- --•------••--••--------- BLOCK NO. -----•- --............. ............
JOB ADDRESS 1_Q.`�... --- •--- ---- --- --- --- 4
---- P 1:at--.�.F...Y s s--- 6r-!t A.: -4 -Q- d --.
NAMEOF ADDITION--------------•--------............................-----•---------•-•-•--•----------•--.....------•---•-......----
z
1 N m.0Ps•z--A•�•z•
1 42� Water Servcct 4Ke
t
I
en i 4„ P.U-C• Side Seiner. roved 6 Cif- E.K�ince-r-)
1
.00
EDMONDS
TREATMENT PLANT
PWW0001-11/75 (REV.11/78)
l`
�ns�ectio�n Tee- (-3'dcc-0
1
l
I
' TN
3 6"S-Fv6 ( 4 i deep)
'Private Pro%e.✓ty Line.
City R jW bq j" Servict Me.+V-v
EDMONDS
TREATMENT PLANT
Ave.
Approved: % �y
DATE ..!._l V .} "!.� �... ByC-
CITY OF EDMONDS4$
�
PUBLIC WORKS DEPQTMENT FOR INSFECTION CA
Permit
Moo .: 0802
SIDE SEWER PERMIT, 775-2525 Ext.
220
Issue
Date
I�V-7�
* PEPMIT.MUST BE POSTED ON JOB
SITE
1. Address of Con7s7ruc7i7n/f),;,9 d-
17'r
AWAIL
":7' k0 • -0
2. Property Legal Description (include
all,
easements)
kjd-Ta
&1'Wfr-nd_S_
1'
3. Single Family Residence Multi -Family No. of Units
Commercial
4'�i�'
4. Owner a, nA/or Bui:lde_r -rkply Oyl, 1
.r
5. Contractor & License No.
6. Invasion into City Right -of -Way: No Yes b-" (If Yes Right -of- 1
way Construction Permit Required - Call Dial Dig (342-5344) before
excavations-V
7. Cross other private property: Yes No 91 Easement required -
attach legal description and county easement number. 1>
READ THE FOL.LOWLNG AND SIGN: 1
a. Property owners must obtain a permit to install side sewers on 1
their property. A licensed side sewer contractor must be employed to 1
construct side sewers in the public right-of-way.
b. The side sewer contractor assumes full reponsibility for each 1�
installation for one year. 1'
c. Commercial establishment requ'res a mini1AzL-*�i ch (6
side sewer line. HONKS
48
d. Side sewers may not be instal ed h Win he s (30") 1
to any structure. 1
'
e. Side sewer lines must be laid at r� V (l. 50)
and maximum grade of 100% (450).
f. No(turn in side sewer greater t 1 81 d d ' $
between cleanout. All 90 turns must d� 1
bend) and wye with removable cap. 0 1
T T COMMINA 116 CO1iNClL
g. No down spouts, footing drains�IE nnected 1
to side sewer system. 1
h. Pea gravel is required for bedding when installing sewer lines 1 ;
through other than granular soil. 1
i. Cleanouts are required at 30"-60" from each plumbing exit line
and At minimum intervals of 100' along sewer line run. ' }
j. Trenches within City right-of-way must be restored to original 1
conditions. Contractors shall be responsible for right-of-way failure 1
due to poor compaction of fill.
.k.. Side sewer must be left uncovered until inspected and approved 1
by the City.
.1. Inspection during normal working hours only. Two (2) working 1 3
days notice required.
DATE:
Pj01k I;' c rtify that I :have read 1 1
}fa d shall comply with the above 1
Lit) � 4 (EdQvwory4s!ffi6 PIP ,3
PERMIT FEE:
O W
p. CONNECTION FEE: .
O
(TnSAPPROVED BY: Date:
�� By: Date:
1
• APPROVED By: Date:14
T MUST BE POSTED ON JOB SITE
CITY OF EDMONDS w
Permit No. 7 -7 7
PUBLIC WORKS DEPARTMENT Issue DateJ ` , l C _7
RIGHT - OF - WAY,CONSTRUCTION PERWREET FILE J
A. *Address or vicinity of Construction •
—
Permit Issued To:1t
• Owner: I u •
Type of Work to be Done:
me
S 1) Z< — :7 - •
Work in Connection With:
Mailing Address
❑ Sub or Plat E�-ingle Family,
.- !M CnA C n .0
❑ Comml. / Ind. ❑ Apt. -Condo. '
City, State, Zip Code •
Pavement Cut: P- es ❑ No
• Contractor: II\ �/� tr"" /1 uei
Name
I
Mailing Addresns
State Licens Number '
City, State, Zip Code I
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or p ee , he defense of any legal
proceedings including defense, costs, court costs, and attorn n of an 1112 .
DIAL -DIG
r
Upon issuance of this permit, the contractor is responsib r hi an ma1@ri�� r a eriod of one year
following the final inspection and acceptance of the restorati ny th neer g vis$EFORE
YOU DIG
Funds held from the Security Deposit (estimated restoral
which time a debit or credit will be processed for issuance
is kompleted, at
Work is to be inspected. Restoration to be in accordance t ff jgJ*1Fraffi5U fghe 66W—M an a with Traffic
Section of City Code. Street to be kept clean at all times. ON IWyfIEn ineering. Call
775-2525, extension 220.
I understand that this perm must be available at the job site for inspection purposes at all times.
Signature: ; ~' �°��✓' vr'� / / .r.� s Date d - j
` Owner or Agent
yt THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Void after _days
Special Conditions:
Ammendments:
Permit Fee: /tiI�-YCYP
Security Deposit: A-1I 9 -
Receipt No.: nA6 C?()g
Fund III Fee: O
Street Cut Dimensions
!-2 x _ 3�
* * N(J WORK -,TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng..Div. December 1978
FIELD
INSPECTION NOTES
(Fund.
111 - Route
cony to Street Dept.)
Comments:
X S"��-•-'� -t-.
5
l)a--
Diagram:
Contractor called for inspection_ Yes No
Nork Disapproved By: Date: Bv:
Work Approved By: —_ — s� _--_Date: � -
Inspector: —
Date:
Ena. Div. December 1978
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NOTICE: NO WARRANTY OF ACCURACY. The Information shown on the
attached map was compiled for use by the City of Edmonds, its employees
and consultants. The City of Edmonds does not warrant the Zc=r. cy of M
anything set forth on the map. Any person or entity reque": 0 a copy
should conduct an indepeoident Inquiry regarding -the Information shown on
the map, including, but not limited to, the location of any sewer stub
shown. Such sewer stub; may or may not exist and may or may not exist Lt
the loczation shorn, Neither the City of Edmonds nor its employees or
officers shall be liable for the information given on this map, nor for any oral
representation provided basEd upon said map
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SIGNED /,
TUWAY MESSAGE
TO l3LDG L/ V FROM/UC RCy DAY
RTRFFT FILF
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SIGNED
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SIGNED
CASCADES L1-C2375
PRINTED IN U.S.A.
SENDER, DETACH THIS PART AND FILE FOR FOLLOW UP.