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HomeMy WebLinkAbout1028 ALDER ST.PDF11111111111111 10033 1028 ALDER ST ................... _....... District City of Edmonds ---Water Department TAP CARD., DAJAY.-A..195UAM .. MeterNo............................... Ta No.......----- ............................ Size.............................. P Size ................... ..... .............. _. Mfgrs. Npe.- ----------------------- �..Q.... S e4.11._ ................ _.............. For------ �........ .................................... ---------------------------------------------------------------------------------------------------------------------------_.......--..... --------------------------------------------------------------------------------------_...................-------------- Lot..No ........................................... Blk..No.----...........---................._.............. Add.* ..................................................... .. ..... Service. Location ..::,1 �.. ...... ............... .....................:..... --------------------------------....... --...... --- - .......... ............ _....... -......... --... MeterLocation-----------------------------------------------------.......................................... -------------------------------------------------------------------------------------------........---.............----------.......--.... MakeTap-----------------------------------------------------------------------------_................................ Pressure..............................lbs. Test ..................................... % SendBills to.................................................................................. Date of -Work .:..... ,...... �..tJ...-.Z#...- Foreman OUTGOING Index ........Reg......Route � k..... _..StenciL ..... Card ...... _ INCOMING Index .... _... Reg ....... Route Bk---------- StenciL ----- Card ........ Orial Chargeable to Installation )Ors NO. SIZE DESCRIPTION RATE AM U T .. Meter...... ............................... ......... _... ......._.. O - ---------- ... .......... Meter Box ................. -........... .............. ..... - .......... - ... .......... Meter Plate ................. -......... .............. ............. .- .... _. .............. --•------- Check Valve .......................... .............. ........ _... .......... .............. ......... Pipe, Galv. Screw ................ .. .............. ............. .......... .............. ----•----- Nipples .................................... ----••-•---•-- _..... ..... .......... .............. .......... Bushings .................................. ------•------• ............. ............... .......... Plain Ells ................................ ••---•------•• •---------• .......... -•-••..... ... .......... St. Ells .................................... .............. .......... .... .......... Tees ------------•-----•-------..._•--..-•-- •-••-•--_.... _-. . SC .....•... � •--....--• ............... ...... 72 .... -- ..�--o-- ... --••-- • .: -- ---- .. •.•------------•--•-----•-........... ... •-•---.----. ............. --- -.------ Material Chargeable to Taps Connected NO. SIZE DESCRIPTION RATE AMOUNT .............. .......... Pipe, Black Screw .................. ............. ............. ..... ... .............. .......... Pipe, Galv. Screw ................................ ............. --••----- .............. ------•--- Lead Connections .................. ......... •--- --------..._ ...... CurbCocks ---•------------------------ .............. ------•-•� ---/••-•• •• Corp. Cocks ........... _.............. ............. ........... ...- - -........ Unions -•-•-- ------•-•------------------ •-•-------•-. •--•-•------ .......... .......... Saddles ................................ . Nipples .-• .............................••....-• -•--------•-•. ---- f -- ----- - - - ......... Bushings ............... -•----•--• Plain Ells ..................... --.......... ............ -•---------•• .......... .............. --------•- Street Ells .......................... ... ............. .......... ... ............. ....... Tees .......................................... .............. -------- •-------• -------------• .......... Curb Boxes ....--•--•---•--•---•-...... .............. ............. --•------• .............. .......... S. O. Extensions ----••--•----------- .............. --••--••---- .......... ............... .......... Gates ........................................ ............... __......... ........... ------•--•- .......... Plugs ........................................ •---•-•---- --•--•-- ------... .......... Couplings ............................... . ----------- .............. .............. -----• .......... .......... Gate Boxes ............................ .................................................... ---................................................ •----_._.. ............. . •------------- .._ _...... .... --......... _.... ........... •------•-- --•---•..............•-• --------•--•-- ----------- -----••-----•• .............. ••-•------ ........ -•-•---•-- -........ •......................................................... ........................................................... ........................................................ ... ....................................................... ........................................................... ......... ... ......... .... .............. .............. .............. ............ --......... -•.---•-• ---•-------• ............. .......... - ....... -- - ........ .......... .............. ............... ............... •--•----•----• ---•--..._..... .......... .......... -........ ----.g9 • ,�`.. ........................................................... •-•.....------•........--•--•..........•......................•--•-...... .......................................................... Hours Time —Day Men --•----- Hours Time —Monthly Men ................ .............. .............. ............•• ............ ............ -----•- - -------- ....... _.............. -........ _......... --•------ - ;61 .............. ------... Hours Time —Auto ----•--•--•- .....---... -•- .............. _.._ ... Superintendence - -.-....._ _./1.�... - Total N N ADDRESS: (1 AfcU 5t TAX ACCOUNT/PARCEL NUMBER: D(D4?)4M ' )1bDb BUILDING PERMIT (NEW STRUCTURE): 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): PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED. kq III lD SIDE SEWER PERMIT(S) GEOTECH REPORT DA' STREET USE / ENCROACHMENT PERMIT WATER METER TAP CARD DATED: 5 d LATEMP\DSTs\Forms\Street File Checklist.doc APPLICATION The City of Edmonds for EASEMENT NO. .--. --------------- ______________--__. SIDE SEWER PERMIT 103-04800 NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO. ----- .------------ .ASMT. NO. -_-__-_._ OWNER Carter Collins --- CONTRACTOR---------------------------------------------------------------------- PERMIT NO. -------------------- --------- JOB ADDRESS ---1028 Alder_ -Street------------------------------------------- LEGAL DESCRIPTION: LOT NO. _____ -------------------------------- BLOCK NO. -------- .------------ .------------ --------- ---------------------------------------------------------------------------------------------- NAMEOF ADDITION-------------------------------------------------------- - ------------------------------------------------------------ W —j U— L LIJ CD T,. DYE TESTED ON SEWER - February 11, 1976 By Jim Jensen Approved: DATE- --------------------------- --------------- By --------------------------- ----------------------- - -- ye �, ins