1057 DALEY ST.PDFiiiiii I iiiiiiii
10727
1057 DALEY ST
r
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS(RECORDED)FOR:
CRITICAL AREAS DETERMINATION: ❑ Conditional Waiver ❑ Study Required 4waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED: U l ( �Ulq
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED: � Q I i Q h+ j �e I
SCALED PLOT PLAN DATED: U l f✓ I q 4
SEWER LID FEE $:
SHORT PLAT FILE: ��
SIDE SEWER AS BUILT DATED:: r , (IN I'J
W ` SIDE SEWER PERMIT(S) #:y 2'
GEOTECH REPORT DA
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED: �)I
LID #:
LOT: BLOCK:
L:\TEMP\DSTs\Forms\Street File Checklist.doc
Critical Areas Checklist
Site Information (soils/topography/hydrology/vegetation)
1. Site Address/ Location:
2.
3.
4.
Property Tax Account Number:
Approximate Site Size (acres or
Is this site currently developed?
If yes; how is site developed? _
yes;
I
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation cha
nge over entire site.
CA File No: b 3' 15tP
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal
distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% (a vertical rise of 10-feet
over a horizontal distance of 33 to 66-feet).
Steep:grades of
g greater than 30% present on site (a vertical rise of 10-feet over a horizontal
distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: �;Approx. Depth:
7. . Site contains areas of seasonal standing water: Approx. Depth:
What season(s) of the year,??
8. Site is in the floodway 4floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
Flows are seasonal? (What time of year?
10. Site is ' ril : forested : meadow ;shrubs ; mixed
an landscape n, shrubs etc)
11. Obvious wetland is present on site:
--------------------------------------------For City Staff Use .Only
.1. Plan Check Number, if applicable?
2. Site is Zoned?
3. SCS mapped soil type(s)? ,A
4. Critical Areas inventory or C.A. map indicates Critical Area on site?
5. Site within designated earth subsidence landslide hazard area.
DETERMINATION
STUDY REQUIRED X WAIVER
Reviewed b Date: —
Critical Areas Check]ist.doc/4.22.2003
°V° ED`"°� City dDEdmonds
Development Services Department
Planning Division
Phone: 425.771.0220
�0C. t gq0 Fax: 425.771.0221
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
The purpose of the Checklist .is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The information
needed to complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventories, maps, or soil
surveys).
Date RecWd: /D-:�?� b
City Receipt #:_=Z2 -7�) ( )
Critical Areas File M .2�3 -
Critical Areas Checklist Fee: $135.00
Date, Mailed to Applicant:
A property owner, or his/her authorized representative,
must fill out the checklist, sign and date it, and submit it
to the City. The City will review the checklist, make a
precursory site visit, and make a . determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. In
addition, the applicant shall include other pertinent
information (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attomey's fees, arising from any action or infraction based in whole or part upon false, misleading, inaccurate or
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and exhibits herewith submitted are true and correct to the best of my
knowledge and that I am authorized to file this application on the behalf of the owner as listed below.
SIGNATURE OF APPLICANT/AGENT
DATE
Property Owner's Authorization
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff the City of Edmonds to enter the subject property for the
purposes of inspection and posti=tt
his appl' n.
SIGNATURE OF OWNER t' � IDATR
PLEASE PRINT CLEARLY
Nam
Street Address
ity Sate Zip
Telephone:S61 ]Zrc --f o— L�
Email address (optional):�,a-j Zd2 ih ,(
Critical Areas Check list.doc/4.22.2003 Cow
_Applicant Representative:
Name
Street Address
City State Zip
Telephone:
Email Address (optional):
�.. a ` .. ar,.. `•v1,:i,,::.;�,_JN^ 1.:.-•G.•ti$:^^.ita"�Y"''• i-�'�+•``'E4f4 YJfi-�i*m,,�„�1�p'�(sr}�•,l�••,.?'wy✓X''w "slair�k¢�'V'� `�`ii�3 r"='aF��' r�s`"A'v
CITY OF EDMONDS SIDE SEWER PERMIT
r8 9 0 1o PERMIT No 8612
r _ .— P-- 0 r 1 .. /
Address of Construction:
Property -Legal Description (Include all easements):
i-
Owner and/or Contractor:
State License No
Single Family
❑ Multi -Family (No. of Units )
❑ Commercial
❑ Public
RECEIVEAD
AUG 0 4 1994
PUBLIC WORKS D&I.
(o Aws iit/U !.
Building Permit No. !?q 6 / 7
Invasion into City Right -of -Way: 0No ❑ Yes
RW Construction Permit No.
Cross other Private Property: �]'No ❑ Yes
Attach legal description and copy of recorded easement
1�
I certify tVat-1 have read and shall comply with all city requirements
as indicated on the back of the Permit Card.
Date
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE USE ONLY
* FOR INSPECTION CALL 771-3202, PUBLIC WORKS DEPT.
Permit Fee: � � � Issued By
Trunk Charge: ��,. ll C110 - Date Issued:
Assessment Fee: Receipt No.:
Lid No.:
Partial Inspection: Date —Initial —
Comments
Reason Rejected: Date —Initial —
Final Inspection Approved: Datelo-'I;'�4Initial G /r
** PERMIT MUST BE POSTED ON JOB SITE **
r
White Copy: File Green Copy: Inspector Bull Copy: Applicant
Revised 3/90
The City of Edmonds
Side Sewer Drawing
EASEMENT NO. ............................................ . t
NEW CONSTRUCTION REPAIRS F-1 LID NO . .................. . ASMT. NO . ..................
OWNER------------------------------------------------------------------------------------------------ CONTRACTOR .................................................................................... PERMIT NO.
JOB ADDRESS .... 1--Zpt Li� . .. ............. .... ............. LEGAL DESCRIPTION: LOT NO.. ..................................... BLOCK NO. ....................................
....................
..................................................................................................................................................................
NAME OF ADDITION .................................... .......
V-0- 'Al. .......................... ..
----------------
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Approved:
PWW-0001-1 1175 (REVA 1/78) DATE ........ By ............................................................
PLANNING DATA
SITE ADDRESS:/ % 2� .. DATE:
ZONING: ~�
PROJECT DESCRIPTION:
SETBACKS:
Required Setbacks:
Front: W Left Side: p Right Side: 4
Actual Setbacks:
Front: QD Left Side: ?,p Right Side: Rear:
FLOOR AREA: �6D
LOT COVERAGE:
Maximum Allowed:
BUILDING HEIGHT: /
Maximum Allowed: D26 l25Actual Height: 4"
SUBDIVISION:
CRITICAL AREAS #: '13 2 41 I
SEPA DETERMINATION:
LOT AR
M
CITY OF EDMONDS
USE PERMIT
ZONE NUMBER 940473
CONSTRUCTION PERMIT APPLICATION
JOB SUITE/APT
ADDRESS S� DAcS-
OWNER NAME/NAME OF BUS ESAid
y
�C T H
LEGAL DESCRIPTION CHECK
SUBOWISION NO LID
NO
ZMAILING
ADDRESS
9 •,...
r.oi�
O
PUBLIC RIGH_ T, OF VJAY PER OFFICIAL STREET P. jESCPAPP1W.d
�yy
O
Parmil Repwred
CITY ZIF�j TELEPHONE NUMBER
7
�Z,ffi/IVf��I+
E%ISTNO REQUIRED DEDICATION Slreel
Uie Parmil Req'd D
PROPOSED Inspection
Sidewalk
Required
Required
AME
METER IZFTI
LINE SIZE
It
NO, OF FIXTURES
W
PRV REQUIRED Q
O
ESS
3
YES NO D 3
_ -1
CI i ZIPqq TELEPHONE NUMBER
REMARKS h '7 e1 \ ���y� _
�'N W I(1� t.l%f f'J CI _
clH TtI A.4 4IX 7,CC�>-) �L(S (!'SP• u77
Lys/
NAM
S �
ll� ..��I—S
r AL- I� Lt Q L1 If`�•�"l."'GT](7N f� ��l%
Q
A ORE
p
O`
ENGINEERING MEMO DATED r REVIEWED BY
q[
CITY /�aZIP
TELEPHONE NUMBER
-
_
!�` C1
FIR MEMO DATED REVIEWEDB
w
STATE LICENSE NUMBER EXPIRATION ATE
SS
SIGN AREA
SEPA REVIEW
AD 0.
Legal Description o Property - include all easement
ALLoweo�
PROPOSED
COMPLETE
ExEMPT
/
SH LLII�NE#
V
O
F
E%P
Yf
o.
iC
VARI
P ING BY
ATE
p
O
<
w
_
SET6AC
FRONT KE T
1 / SIDE REAR
HEIGHT
LO Q�
ParcelNo.;
(.�
NEW RESIDENTIAL PLUMBING
ADDITION
COMMERCIAL'®jj
MECHANICAL `
ElREMODELAPT.BLDG.
L_J SIGN
CHECKED BY
TYPE OF CONSTRUCTION
CODE
OCCUPANT
GR
® O FENCE
El REPAIR CYDS. L—x—m142M
GITYPE
DEMOLISH a INSERT WOODSMOVE
GARAGE RETAINING WALL/
so RPBRi 1:1ROCKERY
❑ Ho M TUB/SPA
El RENEWAL
S
REQUIRED INSPECTOR
DYES
AREA '-•
3
OAD OCCUPANT
MARKS
PROGRESS INSPECTIONS PER UBC 305
OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
WA67
NUMBER
NUMBER OF
CRITICAL
I7
OF
DWELLING
AREAS
m
STORIES
UNITS
NUMBER
DESCRIBE W RK TO BE DONE (ATTACH UOT PLAr )
FINAL INSPECTION REQUIRED
/O p0
VALUATION
FEE
PLAN CHECK FEE
HEATS URGE:
GLAZING/ �D
71-
BUILDING
.-
1
PLUMBING ti
Plan Check No. 7D
MECHANICAL
GRADINGIFILL
This Permit covers work to be done on private properly ONLY.
Any construction on the public domain (CUrLS, sldewPlks,
driveways, marquees, etc.) will require separate permission.
STATE SURCHARGE
41150
Peril Application: 180 Days
3o
Permit Limit: 1 Year - Provided Work is Started Within 180 Days
STORM DRAINAGE FEE
Applicant, on behalf of his or her spouse, heirs, assigns and
ENO. INSPECTION FEE
jQ
H
successors in interest, agrees to indemnify, defend and hold
w
harmless the City of Edmonds, Washington, its officials,
,
i
employees, and agents from any and all claims for damages of
Zwhatever
nature, arising directly or indirectly from the Issuance
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
D
Ox
modify, waive or reduce any requirement of any city ordinance
--6
nor limit In any way the City's ability to enforce any ordinance
TOTAL AMOUNT DUE
/
provision."
1 hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATION APPROVAL
Information given is correct; and that I am the owner, or the duly
authorized agent of the owner. I agree to Comply with city and
THIS PERMIT
This application is not a permit until
slate laws regulating conslrugtl0n; and In doing the work author,z•
ad thereby, no person will bp Pmployed In violation of the Labor
AUTHORIZES
ONLY THE
signed by the Building Official or his/her
Code of the Slate of Washfnglon'relating to Workmen's Compensa•
WORK NOTED
Deputy: and fees are paid, and receipt is
ion Insurarice and RCW 18k27.
INSPECTION
acknowledged in space provided.
I NE OR DATE SIGNEDDEPARTMENTCITY
IA $ $1 ATURE GATE
OFpF
EDMONDSCALLFOR
4SNATURE
ELE B: DATE
E TION
INSPECTIONNC
WFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE���OLG�A
FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
L1
ORIGINAL — File YELLOW — Inspector1Tl
clraTC roc nrrnoANe.Y MAR RGFN (;RANTED UBC
STANDAROD RA/NAGE' DETEN T/(0 SYSTEM
WORKSHEET
OWNER a �... CALL BY:c
ADDRESS !% ���1�� ��� S'� �-
PHONE:
DATE:
*****DESIGN DATA*****
IMPERVIOUS AREA PIPE DIA PIPE LG ORIFICE
:z>
DETENTION PIPE LENGTH
WASHED GRAVEL
OUTFLOW TRENCH, MIN IO' LONG
TOP AND 4`PERF PIPE TO BE LEVEL
RIM ELEV I'MIN COVER 6'MM SPACE ,FROM
ZMA% COVER RIM ELEV CONTROL
Y OUTLET I+
a.k �av
c
41O MIN _ 4'PERFPIPE W/CAPS
.S % —SA, SLOPE 4' 0 PIPE MIN. a
�
L _
z ;-
Zm
ORIFICE RUNOFF SPREADER
r"`"` OUTLET
INV ELEV (RINV ELEV
i'i<R CATCH
BASIN CONTROL CATCH
BASIN
xZzG'DEEP, 4%6'OUARRY SPALLS
z2i3' DEEP, 3/4'CRUSHED ROCK
SYSTEM CROSS SECTION
FROM CONTROL +
OUTLET
RIPRAP OUTLET
FOOTING DRAINS SHALL NOT BE- CONNECTED TO DETENTION SYSTEM
NOTES.
1. Call Engineering Division (771-0220) for a tightline and detention system inspection ,
APPROVED BY
before backfilling and for f In tip
SS `�. I I LE
2, Responsibility for operation and maintenance of drainage systeins on private property is the
the
�6
responsibility of property owner. Material accumulated in the storage pipe must be flushed
/
DATE
out and removed from the catch basins to allow proper operation. The outlet control orifice
must be kept open at all times.
..... Page 6 o f . 6
SITE PLAN
- �
CITY OG EpM OL17� �
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3/,i ciMt7wA1SH CO., WA.
S.I.MTLA.SIN 71iORT T-"-r) -
Melfv1-tT CALC5
A 98.SS
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TCPr*,L :" �9G.lo ; y �. 99.oi5 MEAN
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PERMIT C=OU* � �;� _
SDR 35 (ASTM D3034) `
CIS
y copy
RECEIVED
J U N 1 5 1994
PERMIT *COUMTER
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SITE P L A N
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CITY OK'EpM OAl17S
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T—)AL E Y' ST.
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MEET. FILE,
RECEIVE®
J U N 1 5 1994
PERMIT COUNTS'
STREET FILE.
SITE FLAN
V-TLCEI 'IW Or-
Cv" OF w 7N owv-5
3MOw0►«yN CO.. WA,
3hRR.A.SIN 7140TCT TA-4.T)
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HEIGHT CAtCC5
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APPROVE BY PLANNING
9
Critical Areas Checklist'
Site Information
Project Name: •Sarrasin Short Plat permitNumbee
Site Location. 505 Olympic Avenue property Tax Account Number 4342-044-021-00
Approximate Site Size (acres or square feet): 13.379 sq • ft. /0. 307 ae .
Have you filled out a Critical Areas Chocdist for a project on this site bcforc? n o
General Site Conditions
1. Has the site boas cleared or logged? no Date of most recent action.
Soils / Topography
2 In the Snohomish County Soil Survey, what is the mapped soil typc(s)? 1 d.e rw o o d -Urban land
complex-, - 6/o slopes
3. Describe the general site topography. Check all that apply.
Flat less. than 5 feet elevation change over entire site_
Rolling: slopes on site generally less than 15% (a vertical rise of 10 feet over a
horizontal distance of 66 feet)
.Hilly_ slopes present on site of more than 15% and less than 30Yp ( a vertical rise
of 10 feet of horizontal distance..)
Stoop: grades of greater than 301% present on site.
Comments
Hydrology/Vegetation
4. Site contains areas of year-round standing water. no
5. Site contains areas of seasonal standing water_ no Approx- Depth: n a
6. Site is in the floodway no floodplain no of a water course-
7. Site contains a creek or an area where water flows across the grounds surface? no flows
are year-round? no Flows are seasonal? no
8. Site is primarily forested no : meadow no -shrubs no ; mixed
9. Obvious wetland is present on site: no
10. Wetland inventory or map indicates wetland present on site: no
11. Critical Areas inventory or map indicates any Critical Area on site: none
�`' r , 1=or�GtytlJse Onty >
REQUIRED6aisareas
:Oeterminauon -Number �.- '?-- Rev[
>
anncr :<oIle
r
9
xiy Of EdD1Onds
Critical Areas Ch-
e
CkrI
C
The 0itical Areas ()nccidist contained on
tus form is to be filled out by any person
PnPatiug a Development Permit
Application for the City of Edmonds prior.
to his&cr submittal of a devdopmert pc,,a
to the City_
The purpose of the Checklist is to enable
City staff to determine uihcthcr any potential
Critical Areas are or may be present on the
subject property_ Th6 information needed to
complete the Cheddist should be easily
available from observations of the sift or
data avar7ablc at (pity Hall (aitical Areas
inventories, maps, or soil surveys)-
An applicant; or his/her rcpVesentativey must
fill out the chocldist„ sign and date it;, and
submit it to the City_ The city will Vie,
tic cheddist, make a precursory site vest.
and make a determination of the subsequ
ent
stcPs noccssary to complete a development
permit application -
With a signed copy of this form, the
apPlicant should also submit a vicinity map
ofthe parcel wigs enough dc&il that (sty
Staff can find and identify the subject
paznd(s)- In addition, the applicant is
encouraged to include any other pertinent
information or swdics in conjunction with
this Checklist to assist staff in completing
their preliminary assessment of the site -
I have completed the attached factual, to the best of Q'tical Area C,hecidist and attest that the answers provided ire
my knowledge (fill out the appropriate column below)_
Owner/Applicant:
Applicant Representative:
Jeannette Sarra�in :Jame John W. Mellor P.E.
Name
owner
Tilde
505 Olympic Ave
;-; Address__
Edmonds, WA 98020 7714-5480
Xy, State, ZIP phone
Project Engineer
Title
606 Sater Lane
Street Address
Edmonds, WA o8020 _ 1
City, State, ZIP
Phone
'ignature
12/10/93
Date
�-z
av 12 10
Signature
Date
.�++atp�'�+a ,.r',s:i. *,, a 4C_i+.,.,v.
M
00,001:1-10007-1,
90 19 C)
-� City of Edmonds
RIGHT -OF -'WAY CONSTRUCTION
PERMIT
Permit Number.
Issue Date: 4�
A. Address or Vicinity of Construction: 1057 ✓ a k y l
B. Type of Work (be specific): Si% Xe.t't Sis+sP '%raj+
C. Contractor: l306 C {A -1 Contact: fso6 C.
Mailing Address: 37 //- S 7- Al -ay- Phone: & 52 - 0971
State License #: C Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable): 16& 44-
E. ❑ Commercial ❑, Suludi"vision r: ❑, City Project ❑ Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family, K Single Family ❑ Other'
INSPECTOR: &z-4- INSPECTOR:
F. Pavement or Concrete Cut : ® Yes []No G. Size of Cut: -W 3 x a H. Charge $
APPLICANT TO READ AND SIGN '" n
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from 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 its departments or
employees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application:
A 24 hour notice is required.for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be
available on site at all times for inspection purposes.
Signature:
Date:
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
,APPROVED BY: RIGHT OF WAY DEPOSIT o 0
TIME AUTHORIZED: VOID AFTER .3DAYS
COMMENTS:
L 4/9¢-
DATE:. —.
DISRUPTION FEE/FUND 111: / 72
RESTORATION FEE:
PERMIT FEE: 3-0 4
TOTAL FEE:
RECEIPT 4EE: %8b 7 9
ISSUED BY:.
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments
Diagram
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P.W.:
Work Disapproved By: _ Date:
FINAL APPROVAL BY: Date:
i..wt mv�.vu:r +- +w +i,S t ' t S7 �a'a 4` a•�F.ui. yr r�
City of Edmonds
.a
RIGHT-OF-WAYCONSTRU 'ION
PERMIT
,a Permit Number:
890 lg°�
Issue Date:
A. Address or Vicinity of Construction: 1057 Daley St (9425311)
B. Type of Work (be specific):
Install New Service
C. Contractor: Washington Natural Gas Contact: FBank Swan
Mailing Address: 815 Mercer Street Phone: 224-2278
State License #: Seatt e, WA Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicible):
E. ❑ Commercial ❑ Subdivision ❑ City Project ® Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR: 4Gv t t'
F. Pavement or Concrete Cut: ❑ Yes ®No G. Size of Cut: x H. Charge $
APPLICANT TO READ AND ei
- 3lei � l
INDEMNITY. Applicant understand ¢nd'by his signature to this application, agrees to hol Edmonds harml fr in damages, or
claims of any kind or description whataoeuer, foreseen or unforeseen, that maybe m¢de ag¢insthe City of Edmonds, or, any of its departments or
employees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees b reason o 1 t '
g g p g g y y fgrantindthispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WOMANSHIP
MATERIALS
NAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATEDNRESTORATION FOIE A P, / D OFD C NTILATHEFINAL gTR�MPA1 TCH
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE. TO THE APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or Cit�approved material prior to the end of .(the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit requirements and thepink copy of thepermit will be
available on site at all times for rn echo_ purposes.'
August 5, 1994
Signature: Date:
(Co ntrae or Or Age_
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: 6A1 �l +L vRIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER 1 `i (= n DAYS DISRUPTION FEE/FUND 1'11:
SPECIAL CONDITIONS: A. L, P. C V r S RESTORATION FEE:
r'
/ PERMIT FEE: -
TOTAL FEE:
COMMENTS: RECEIPT FEE:
DATE: ISSUED BY: 7
j
NO WORK SHALL BEGIN PRIOR TO PERMIT Isr DANCE
Engrg. Div. 1991
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City of Edmonds — Water Department
TAPCARD /
Reading: Date, 0.31
No. No.
Meter .3/ " Tap Size
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Purchaser: �955/�� NyiJ?G 5
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Meter Location'/G%�
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Pressure lbs. Test %
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OUTGOING Index Reg. Route Bk. Stencil Card
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ROUTING SLIF"
NEW SERVICE INSTALLA i. iON
ADDRESS:
DATE: L
LOCATE REQUEST NUMBER
LOCATES
DATE CALLED: 8 41 _9jrl0
45
FOREMAN/CREW
FUTURE SERVICE: YES
NO
COMMENTS
BORE: CUT:
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CITY CLERK
CITY OF EDMONDS
121 5TH AVENUE NO.
EDMONDS, WA 98020
CONFORMED COPY
200507110902 5 PGS
07-11-2005 04:29pm $23.00
SNOHOMISH COUNTY, WASHINGTON
AUTHORIZATION TO USE PUBLIC RIGHT -OE -WAY
AND
AGREEMENT TO MAINTAIN SANITARY SIDE SEWER AND LATERAL
}
AT 1057 DALEY STREET
TAX PARCEL: 00 4342 044 02101 .
�ita�Q
C2,41 lajq+
WHEREAS, the City of Edmonds (City) is undertaking a capital project known as the Daley
Street Sewer Line Replacement project (E3GC/C148), the "Project", which includes replacement of the
City -owned sewer main and sewer lateral in. the, Daley Sheet right. of,way in .front of the private property
at 1057 Daley Street (the "Property), and
WHEREAS, the City of Edmonds has established certain public works policies and requirements
regarding public utility improvements construction, ownership, maintenance, and repair; and
WHEREAS, these City policies and requirements include that, for sewer side services and laterals "
serving private properties, a cleanout is to be installed at, the property line (i.e., the edge of the, right of
way), and that the private property owner shall be responsible for the ownership, maintenance, repair, and
replacement of the portion of the sewer line from the cleanout at the property line to the house (the side
sewer), and that the City shall be responsible for the ownership, maintenance, repair, and replacement of
the portion of the sewer line from (and including) the cleanout at the property line to the sewer main in
the street (the sewer lateral), and
WHEREAS, these policies also include that, when City utility work disturbs or damages portions
of private driveways within the City right of way, repairs to the driveways will. generally be made using .
asphalt concrete material, and
WHEREAS, the side sewer and sewer lateral at the Property are located under the private
driveway, and
WHEREAS, the undersigned owner of the Property has requested that the City install the new
sewer lateral and cleanout to be constructed under the Project within the paved street surface of the right
of way to prevent damage to their existing concrete. driveway, insteadof installing the required cleanout
at the property line, and
WHEREAS, the Property Owner agrees to be responsible for the ownership, maintenance, repair,
and replacement of the portion of the side sewer line from the house to the cleanout located in the street,
and to do so at its own expense and that of its successors in title in perpetuity, NOW, THEREFORE
The City of Edmonds, Washington, a.municipal corporation (hereinafter "City") and Diane NL
Gallant (hereinafter "Property Owner") have entered into this agreement in consideration of the mutual
benefits to be derived and the promises contained herein.
1: Undertakings of. City. i\
1.1 Authorization to Utilize Public Right -of -Way. In consideration of the .Property
Owner's promise to maintain, repair and replace the sanitary side sewer line from the house to the
cleanout located in the street, made on behalf of itself as well as all successors in interest to the Property,
the City authorizes, the utilization of the public right-of-way to maintain said sanitary side sewer line
within the City right of way in accordance with established City standards and the terms and conditions of
this Agreement.
1.2 Nothing herein shall be interpreted to limit -the City's authority as a public utility
to establish standards for service, to charge appropriate fees and costs and, in its sole discretion, to order
maintenance of the sanitary side sewer line in the event that said sanitary side sewer line negatively
impacts or damages the City's sanitary sewer system or violates any condition of service adopted by the
City.
1.3 The City authorizes the Property Owner to.tr<aintain the sanitary side sewer line.
in the public right-of-way, provided,. however, that:
1.3.1 Said sanitary side sewer line shall be maintained, repaired and/or
replaced in a manner consistent with all regulations lawfully enacted or promulgated by the City both in
its capacity as a public utility and under its police power regulation.
1.3.2 Any maintenance, repair and/or replacement of the sanitary side sewer
line which cannot be accomplished from. the property of the Property Owner shall be undertaken only in
accordance with a right-of-way use permit from the City.
2. Undertakings of Property Owner.
2.1 On behalf of itself, its successors and assigns, the Property Owner promises to
maintain, repair, and replace the sanitary side sewer line from the house to the cleanout located in the
street at its sole expense to the standards established by the City in its capacity as a public utility and
under its police power regulation. All such maintenance, repair or replacement shall be conducted solely
at the Property,Owner's expense.
2.2 The Property Owner, on behalf of itself and its successors and assigns,
acknowledges that the City had no obligation to install the.cleanout within the paved street surface to
avoid damage to the Property. Owner's driveway, and that the agreements as contained herein, provide
suffigient consideration for the Property.Owner and its successors and assigns to maintain, repair and/or
replace said sanitary side sewer line from the house to the cleanout located in the street at their sole
expense in perpetuity.
2.3 In the event that the sanitary side sewer line should fail, cease to meet any
adopted condition of service, or otherwise prove inadequate for its intended purpose, the Property Owner
shall repair, reconstruct, and/or replace 'it at the Property Owner's sole expense. Such repair,
reconstruction, replacement or any maintenance of said line within the City right of way shall be
undertaken only in accordance with a right-of-way use permit and shall meet all.conditions imposed by
the City, either as part of the right-of-way use permit process or utility service established by the City as a
public utility.
Repairs of non -emergent situations shall be commenced within 45 days of the mailing of written
notice by the City to the Property Owner, by U.S. Mail, postage paid. The notice from the City shall
specify whether the required repair is an emergent or non -emergent repair. All repairs necessary to correct
a violation of conditions of service shall be considered emergent. Any emergency repair, including any
repair of a condition which violates a condition of service to the Property, shall commence within 5.
business days of such notice: All repairs shall be completed in a timely manner, in no event later than 5
business days from the date commenced, without the express written consent of the City.
3. Location of Side Sewer, Sewer Lateral and Cleanout. The side sewer, sewer lateral and
cleanout shall be located approximately as shown on the attached Exhibit A.
4. Touch and Concern the Land; Subject. Property. This agreement touches and concerns the
subject Property herein below described, and shall run with said property binding all future property
owners, as well as their successors, mortgagees and assigns, and any other party acquiring. an interest in
the subject Property. The Subject Property is described as follows:
City of Edmonds BLK 044 D-01 — PAR B OF CITY ED SP S-93-237 REC AF NO 9404140151
&c BEING FIN, OF LOTS 2
This agreement shall be recorded by and at the expense of the City. In addition, the Property
Owner promises to notify all offerers, purchasers, or any other party acquiring any interest whatsoever in
the Property of the obligations imposed by this agreement.
5. Termination of Service. In addition to any other remedy provided for by law, the City
reserves the right to terminate service in the event that the sanitary side sewer line shall not be maintained
in accordance with the City's regulations as a public utility or conditions imposed by the City through its
police power regulations. In the event that the sanitary side sewer line is not maintained in accordance
with such requirements, the City may. terminate sewer service and/or water service, at its sole discretion, .
as may be necessary to prevent damage to the City's sanitary sewer system, wastewater treatment plant,
or any other public facility which may be impacted by the Property Owner's failure to properly maintain
the sanitary side sewer line.'
6. Entire Agreement. This is the entire agreement between the parties. Any prior
understanding or representation, written or oral, made by any party, shall be deemed merged with its
provisions. This agreement may not be amended except in writing in a document filed of record with the
auditor of Snohomish County, Washington.
7 Not Severable. In the event that any provision of this agreement is struck down, the
entire. agreement shall be at an end. Property Owner shall immediately commence removal of its sariitary.
side sewer line from the right of way and install a sewer lateral extension > and clean out at the property
line, and the City shall be under no obligation to continue water or sewer service until such time as said
sewer lateral extension and cleanout are installed to City standard.
0
1057
STAMPED CONCRETE
DRIVEWAY
i n SIDE SEWER
® WM
CONCRETE CURB
CLEANOUT
8" PVC SEWER MAIN LATERAL
EXHIBIT A
1057 DALEY STREET
NTS
s
11
DONE this day of 20V
5
ATTEST/AUTHENTICATED:
Sandra S. Chase, City Clerk
APPROVED AS TO FORM:
OFFICE OF THE Y A RNEY:
W. Scott Snyder
STATE OF WASHINGTON )
COUNTY OF
CITY OF EDMONDS
By:
Mayor ary en on
PRO ERTY OWNER
iane M. Gallant
On this day, personally appeared before me 4Hj5 G -4- ,y r , and declared that
he/she/they signed this instrument. as his/her/their free and voluntary act and deed for the uses and
purposes therein mentioned.
SUBSCRIBED AND SWORN TO before me this % D day of Loz)-- , 2004.
'�► ' 4 t16TA N T Y
'AVB �I C Print Name
My Commission expires: - / 9 - D'7
per'••:.: s='•