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1024 BROOKMERE DR.PDFIIIIIIIIIIIIII 10448 1024 BROOKMERE DR �. CITY OF EDMONDS - SIDE SEWER PERMIT r , WATER -SEWER DEPARTMENT PERMIT 0 Call 775-2525 for side sewer inspections BEFORE covering any portion of the construction.1 Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections./ ADDRESS LOCATION OF CONSTRUCTION..... ...... ...".f-,c;Ecwliwn 6 a? a(?.k3:a............................................ ....... ................ _................ PROPERTY LEGAL DESCRIPTION.......... '.--_-..:� �'.... �..... n'} ...... ............... -"� c ..........................OWNER AND/OR BUILDER.... R- - d +:: t� _ C"" ; ?. r-.l.:"-.: "!. ' c s4-}rti s�'L...................... CONTRACTOR'S NAME & ADDRESS ......... a < it .`a---.....- s. . • N Y:.r--fit :.••i -. ,;...... �......_................... ---_....................................................... .n r - Permission is granted ...........e ? kNSA.......... ^ ........ 191 for repair and/or connection of a side sewer to the city sanitary sewer system in accordance with City -of -Edmonds ordinances. A ENTION IS CALLED TO THE FOLLOWING: No. 1—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct side sewer in street area. Do not cover any portion of sewer before it has been inspected. NO No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office. NOTE No;: 3-L Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No.' 4=Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade sharper than 3% will be permitted. NOTE No, ..fTrenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper work which may develop within one year of completion. NOTE No: 6—It is unlawful to alter or: do any other work than is provided for in the permit, or to do any work on the madn sewer or its appurtenances except to in- sert the pipe into the wye. DISAPPROVED ❑ Date..._........ By ................ Date........... - ..... Y---...>� .... Date ............... - By ................ 1 APPROVED eDate...'.. 8 � ............. By........................................................................................................ Remarks:....... _ ...... _.......................... -................................. ......................... _....................................... .......... .... . ................................................... — BOTH Permit Copies MUST Be Sign d By Owner of Firm Performing Construction PRIOR To Request For Inspection — I .............. ................. ..:.....--.--..................-..... , hereby certify that the side sewer installation constructed under this permit (O er of Contracting Firm Performing Construction) wInstalled in accordance with all governing ordinances of the City of Edmonds. Datedthis ............... _........... day of................................................................ 1 19......... J J Check BEFORE you dig for: Water ❑, Gras ❑, Telephone ❑, Power ❑, Sewer ❑, Other 0 J d 4 - r,� - I. TAX ACCOUNT/PARCEL NUMBER: 0 O 3q-1 LD O O b O 402- BUILDING PERMIT (NEW STRUCTURE): I c{-� UZZ�p I rX ) COVENANTS (RECORDED) CRITICAL AREAS: DETERMINATION: []Conditional Waiver ❑ Study Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): I CM PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: L_'1?-l. 11U7 SEWER LID FEE $: LID #: SHORT PLAT FILE: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: �0 6L- GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: FOR: G WATER METER TAP.CARD DATED: G!I I b LOT: 14 LATEMP\DSrs\Fomis\Street File Checklist.doc ,. - - A A• .17 ;_7 7 BUILDING RARTMENT. Appreant Fin • ZDN[ LICATI�W' Inside Heavy Lines Moe 'PERMIT A R. ADORCSS RAMC ION NAME OftlV VARIANCE OR CON // Y LOT CO VHEHAGE .l1 ,....X' = MAI LING,ADORCSs ' / .� / z - q,z6 . - Z3S r"5 ,. / p !' ASl R[AR i S FROMT YID[ ' EN L REVIEW,, V NUMBER � A -CTITI N NT U k Nt HM ELEPHO NV,RO ED .ON D LLO — , Sl _'I{� . • _-O AIW [OA' 'PROPOS[D ❑ COMYLCT[ %EMR = Z AM .. REMARKS ' � � ' / U ADOH tas N IN [FT. •A R AL. V —' TELEYHON[ NVMtlEH _ 1 1V YU YDI VI[ION NO. - ' • - Z CITY .LCO AL lOT AMCA "YES•LINO 0• .T e[T H/w ` 1 ,[NCY TH,Y PHOPL«TV - F OEF C l _ S O T. nn .I /` W 1 TING LTN[ET R/ 5 . "ps'rYFN( c [xY • - _ �—.—Y-"_"—_ COMP. VLAH ST. RjWADD- ESS T I -- P � �—: — i 1 se . . 5 ec 0 MARKS a IlO t to exec .�6 Lr n �f5 C CITY T�-- TELEVHONL 'JMBtH y�o-�: t, v I • I indicated en standard fhat.rin S`�-6'.�•9�-.ZO. C. CKE, d [— 1 z r — ITV TCLICCNYE N'JM DCH L' ,T E LICC rsE N-S1Bi,fyr I ', - _ y 1 r YTR CCU ANOldH V�ILIT.VIe•WOH H' HjK' YCHMIT H[OVIR tp t I • :iY1G.•. vr=•'IpC%1 F.+ur COnItlSI- f-�. y�NO "'� Lrydl OrSi:ip:lun J, r-'J;).':t� Imo•.• RED"D. VtS _ Z UhIDCRGROUNO -_ �aY r --- WIRING NEO'D. ,. -:YEs PRO r 57- rS'0 FEi! of �� — tH T /4/ I y F'Itp Y _._.— 'TYPE L•ONNEC a1V YEY ' 1 ! • l _ /; /1 ,,// M _ y/ - aANIIARY SCwEN lJ NO " • ��� I OC-k 1 !r �V ._._.-- R—__— - •ENMIT rwllM bh:H I ! - A PTIC SVYTEM �,� YES AFPY'p B" CITY [HO. • .j •, .I_—_ - r_.- __.__.�----_.—.___— REMAH .I METE size SERVICE SIIE CLEARANCE CHtCH{O BY - Z 1 •' r i GAS -" E ZONE TYPE OF C N✓STMll�T10 N. CODE ! , _ - r ,IA% INSP[CTOR R[AJ. ...... _-. _ __-. _-, ..0 _ OCGUPANCv �OLC UV ANT I 1 • p- ^ r- H ETA , R D • .I •-- ,I i Ur. !nO Lre t I'rvALL - • ! _ r—� RI No THIS` —$IT IS LOCAT e"CE ED Itl TMF. CITY - 1 I ^' D'.' •' -L EOMON OS. LOCAL SALES TIA, I` oO _ R `_ iN�Mut .. Cr J•+ ev I:=i^. bEN Jr •i •. A '_ —... __ ._._—^i J_i — ! • �•.i,UPC LU '_-t ILA 0�_—_—_i —u•J: L:II�:: St.TJ AC ..S .�—...—_— _—.--_.__ � � I I / Co . -Ie-..' .. :.•UPIC •T,. _ BUILDING -- J/ CJ _� __ =- RE 1' _ _.. TOTAL AMOUNT ' r__ ....• ., •.. —^.e :ram `MOUNT Dl •I I' �itJ Ua ATT-ENTION APPLICATION, APPROVAL .. . __ �r.. . -- - r.--), sa Vie:,. •I j . :'.,::'Fr - .' •' , ,:,ly?.,., o• a„r.:r;;on - THIa PE«Mir Thl., application to;lot,a Pernut until ::; LJ.:: e....;,�:,,, .,: ^•r ,.:'. „e' .•-.uTHo«Izes I• I �:::,•:: •..-:r..'• t.... �.�•, •.:^•:'i-,...,a: r. oNLr THE 1 signed by the Building Official or his w ONH'NO rCU uty:.and feed are pnld: and re:clpt ds I - NOTE: Permit limit One YeOrl:. :r4: r+t o'`� io"1`,Ir :t �`- }LzoWled6ed in apace prDYfied. ' ^r:mr.. p Arc SIGNED OEPA«,MENT I n . '-��__`-_� ♦ �-Y�� /ram - .�.Y �/ CITY I C CATE 715. .'' —A'r+Y.un,u ucuo„ �n W Jdmon..m onIcuornt»v.,vNdP.rwo•P6.T,y ONLY I TILLOW t no Parmtud,i... GOLD PINE In. Pe. ' I'" +.•'•" m1MI� �.•�� nurV�•ti. •lE.l will r.Uu v. Nb.r. t• Wr �'•' ' The City of Edmonds .4, APPLICATION for SIDE SEWER PERMIT EASEMENT NO - -------------------------------------------- NEW CONSTRUCTION F-1 REPAIRS 0 LID NO . .................. . ASMT. NO. ------------------ ........l................................... CONTRACTOR ---- ---- ------------ -OWNER --- n./...I..u.SPERMIT NO. JOB ADDRESS J.P-t9_51 ------- 2 46 Q. ---- ------- OR- LEGAL DESCRIPTION: LOT NO. -!--q ............................ BLOCK NO. -------------------- --------------- 0 10 .......... 5�.o ... .......... to I I y ...................................................................................................................... NAMEOF ADDITION ....................................................................................................................... Approved: DATE............................................ By --------------------------------------------------- j-j7.j6. APPLICATION The City of Edmonds for EASEMENT NO- -------------------------------------------- SIDE SEWER PERMIT NEW CONSTRUCTION ❑ REPAIRS E) LID NO . .................. . ASMT. NO. ------------------ OWNER .... CONTRACTOR --- ...... PERMIT NO. JOB ADDRESS ..... LEGAL DESCRIPTION: LOT NO. --- 14--- BLOCK NO------------------------------------- dlL 4 4 NAMEOF ADDITION ----------------------------------------------------------------------------------------------------------------------- Approved - DATE ....... By. . ............ /7 5 CITY OF EDMOPJDSO �`s TO ;�{E' BILE SI/ PUBLIC WORKS DEPARTMENT; ENGINEERING D VION APPLICATION FOR RIGHT-OF-WAY CONSTRUCTION PERMIT THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PURPOSES Applicant to Complete Parts A and B A. Permit to be issued to: U O)A (1 „ \ASJ_N,` For Work at : Caress or vicinity) Lr�S �D l nS Type of Work to be done: j eL x► C.I.A. �� VSV Y? L-r D �� (attach drawing when applicable) Time Required -- Start: 1 0 A•`t Finish: Owner: f, t�, _�k Name Mailing Address N ; �.! tine City State Zip Telephone Number Contractor: Name State License Number Mailing Address City State Zip Telephone Number B, INDEMNITY: 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 applicant or the City of Edmonds, or any of its 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 subject to inspection and restoration in accordance with City Code. A `24 h.our,'Y;notice is required for:' nspe—i to oii by Engineering. Call - 775-2525, ext. 220. --I understand that this perms-be._avai f`able°atxthe .job site for :inspection purposes_at. all. -times. - -_ Signature: r" Date: Owner.or Agent TO BE COMPLETED BY ISSUING AGENCY: Date Issued: 61-3 Q 'Permit No.: 7? -/3 ? Fee: /,r± Security Bond: Time Authorized:_. _3 0 �a.IjS APPROVED B Date:j 134/,7�y 1.0-7 71 v iRr..v i cn.i 1 foie PUBLICJMLITY 'DISTRICT Noa-_of Snohomish ty a l_ U ra-AREA Rev.10/77 - ? y Z L '' 4: L U �i t-W •�'�� Date .'c o W.O. No. f � Location- . _ �~ _ N_1/4_' 4 S a.1_T 3 R Revisio Scale lO G Reason for work .1 `1 ? . ? Q' l� �S �< D i1 Engineer t`A A G As Built L A f, E7 L.G '0 0-S -' `(L rs U+Cs. File No. Apprtivdis _. PERMIT REQUIRED ---fQREIGN CONTACTS _ EASSMENT, ENVIRONMENTAL'.--A'NALYSIS: TVpe Company 'Ezemp.t under-Distritt,`SEPA J.RN. No.'` `procedures, SeEiwo Date GrantedGrantor Paragraph - Fees required Yes(I NOR'3 �BY.. Log Posted Inventor Type V, �1 C \fG . = '©ate.GraMed Dated ' L Transf.Card Pole De t. a v Interpretation Referred To : P Date j - Amour Ma Post Circuit MaPI Date Released. For Construction Date BY Date Work Completed" By Foreman ; Circuit Number 5 '3 4 'J Substation O.H. U.G. Cond KV - Add Ckt Ft PH Remv, Ckt--Ft nH <� ' - Net ..Ckt Ft �J i L=3�00 - X Water I = _- Sewer ;) i !! Gas Backhoe - , O.Kw 1. L 1-1 �•�. �) 3`1'1 z KV,A C L�S t vS� S� C _�?1S`L� L L fi ci- LIZ KA P�.��c :S 6) AS '_"S <. W.o. No.^ r. a mr.1, 1,15'r r7r—),e?4 !',!!I LDT NC PIT"IT Street Pi fht-of-fray Existing zi- n 1) I ! T . )B F IIAccess Fasoments Exii stnp 'n F AT O Utility Easement Existinf, or. 1:n Lot ])or Subdivision P3 at M s 0 s s, T) L/ to Pl.bn ('J,.ccl:c(l for Accuracy Underground P,(:od, LU P4 xCif cc, . ! 1'.xi.st;,1�� !;' to .!nin Si.z^ � •� Gv= J CO: _ I 1,0rant j'c(,u-L-rc-(! Fire (-zc(-- size 1.10tector (Iloc': -Ctcr Pcollired II II 3;y Tl,,,l to Scptic Tonl, Tlcsi!;Jl Anproved Rate IiSmitlic Tan't: Tlemit (a I i. red U141- t To. Im..,or Availahility "roj. L, h File 'To. Ii Sj.(Ic Scv.:cr Avaijal.lfl.16, 4EJ &22 Culvcrt Rc(.-,udrcd Size Ag Catch !',cnuj7-oc!— Tr(licate on .'i to Plan M( �;r1l')OW.�-.-'i, d I c-'Cul'm in :�,vcdc - 'I cy Nr 1:111,1101-C requirc," T11"lic'Ite oil Site 111m Soil C.C.116i'Liul"s Ground t%'atcr Field TVI t C, CD LEI\ h � • �+�.d t� �'r t.• •to 'Sr.s � �, � :.3 f .rr.- •�`r � i� -� '"f} - t � �`-} ofo EzdmoridkiL Wcri ,r —D pariment`�`z >z Jy � Nf 9�f No Meet r k ,.�. , w.,p.;,�.N S`�ze r =.. Size - Ivlf ,' Styl`e YLc PQ +g r Y PCs �•r`^ �," s i r Fo Pam, L. //�7 T v c a d ,y'cr�'t-� '// f L�• ' ��J' •(� a'YD /--\ �Lot;uNo Ads �B1kr; rNo`�{ ..........�} 4 Servieelocationr IvleteriLocation�' . . :? iT/ y IVlake ap r �, ; c ..� ... f� .. +c , ^ ` � Sericlr�Blllsr to z t . .. . t x� ,r aD`ate o`f 'Work' I ` 7 . . -r ' �` . Forem� A y Y uar Voucher �No ` ` u� $4 Remarks .................. .6'? y i r.. a a .. - V ty.i �- �• '"'"_• 4 r t 4 H y . - F. .. •f.-. 2 ... •< }., i — a u <. (fit M. } Y a 4' r 4•H" tOUTGO?N,G' 'Index y `'� Rego; Route Bk^`t Stencil Card NEW SI;R\'ICE INS'E'ALLA'.l'EON 0 7 . DfAL A UI(;#, . P.U.D. TELEPHONE CABLE T.V. GAS STORM SEWER OTHER FUTURE SERVICE INSTL: YES NO LORE.: CUT: SURCHARGE: YES NO LOCK DATE: INITIAL: NLOCK DATE: E INITIAL: S. 5 '.HOP ACCOUNT NUMBER: SUPPLIER: S ;NGR. LAN TRRE�ATMENT,PLANT .lF J B L T SIDE -SEWER PERMIT �E ITENDENT INITIAL: DATE:., j d ' TAP CARD METER SHEET APPLICATION, I DISPATCH 7 7 t 9 . iina+„,,.,,•mow/% •. _ ,.. .. t CRUSHED,I ROCK 2�y4„X 16„ STAKES / I CoMPACTEb 5�Ulb GRADE 1� T_'YPICAL PAeKlNG AREA PISUNG DETAII ; .�. i 157. 50 =SETBACKS: FONT � s SIDE 0 REAR AS — OTHER HEIGHT ' --�� PATIO ,-- I 0. ! aI NORTH — - - — - — --•�, - - - o! to -Q t • <) D[ I slop! zc.oc .4 7• > z AlINC— , �C lGfla� .Z�lJ OI• r->20t-GV-- I L(N1--4 -I-- _ — '7(.811 k 66.50� CITY Of EDMONDS ENGINEERING DEPT. Examined by - e Date Remarks PL OT - pLAl, 11-1 SCAt-I ;o I � 0 � 11 4 [r , Lu t • H� �I at rQ � 00 ,31,E-, O t► i \WUUIJ �utv•rcLn -dl ABOVE --��. t II✓u L.f/J,�. LEGAL I( EAST ,?0 FEE I nF LOT /4 I3RO,OK;MERE E'bMONbS ti � To GE TNEfK I114rH AN EASFM(=NT Fok ING- RESS t=CRESS RIJo �. uTILt7-/ES OVER ANb ACROSS THE NORTN 20 FEET OF THE GO. e(o.5 FEET o l' _rHE wEsr 133.5- rEET of SAID LoT /41 45 `Prg 'SLAT RECoIRDED IN VOLUME 1�7 OF `PA Cr E 17/ R E;C OTR b 5 OF SNOHOMIS,N CouA/T-y SITQATE• IN ,,+NE COUN- TY or SNOH.,, STATE OF WAS". REVISION 54 CITY Ov vl'�IfIJiTI�`.'E<}� Yam*("'iiT ADDRM' /Q0.2 OWNER. U 9OZ-QZ- '�' BY KEEP THESE STAMPED PLANS ON JOSSITE F0F ALL INSPECTIONS PERMIT NO, SHEET — ?7�17Gj / pAtE 0C-SCRt? ION [_=IJE;LA' CG` It-'L wrt \_try Zoom ciw4c L. ,OS Z LO F =u1v,QN�=