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111 12TH AVE N (2).PDF1111111111 589 111 12TH AVE N Crh�� ,�vaSah� �► APPR 1/EDY p ANNING 5 F l 2 N, 0 — � 3L ro� ---- _ �Z�)------- Zone /� S Corner Fla&_ Setbacks Required Actual Front Sides Rear -3 46, e sue% Other Hei-ght ZS WA C[Ye�P y' n _ MOW P�O-O/ �;vp sT I— min . \ O k--9��' ouS� ExrsTrh� //r/ (2.. �;,Al 441M q/ �tvet 9 Vt vw WAJ RECEIVED MAR Z . jWQ-_ BUILDING DEPT. VA, PLANNING DATA SINGLE FAMILY RESIDENTIAL STREET FILE Date: vv/�? Site Address: ` pu ( N Plan Check #: g� G;� _41 Project Description: Reduced Site Plan Provided: (YES / NO) Zoning: Map Page: Corner Lot: (YES O Flag Lot: (YES NO Critical Areas Determination #: — ❑ Study Required Waiver SEPA Determination: Exempt ❑ Needed (for over 500 cubic yards of grading) ❑ Fee ' ❑ Checklist ❑ APO List with notarized form Required Setbacks Street: �O / Side: /�_ Side: Actual Setbacks Street: ' / Side: i Side: —7S Rear: 23/ ❑ Detached Structures: Nam• i�� �$ ��j ; �Gq� �d ci �S' /�-'� ❑ Rockeries: ,-�(/�-eco�de� ❑ Fences/Trellises: / r� �'►�- of fh 1lS C�/�-n �' �.�-. �� s-t�-rG�t ❑ Bay Windows/Projecting Modulation: ,.,- � Gf � d0� ��-�Cp� /{ft-�.• ❑ Stairs/Deck: �-- L ffA71 Buildin Height Datum Point: Datum E Maximum Height Allowed: Actual Height: Other Parking Required: 2�_ Parking Provided: Np 6AAP-, Lot Area: Z OQQ Maximum Lot Coverage: 35% Proposed: 18< Lot Coverage Calculations: to— a" t"- ` e v ADU Created: (YES Subdivision: Legal Nonconforming Land Use Determination Issued: (YES / NO) Comments Plan Review By: i Planning Data Form 04-11-06.doc Zone fzS �CC Setbacks Required p= STEET FILE Front _ 30 Sides5- E F I2 4v nl0Frk Rear O 23 — — Omer - -- — - - - ' IVA Cr` /v i..c If N �i�eh�s' wQ g�aZv CG 5/ sgfT> APMOVED kY PLANNING /c//aeon av,Q Oar concr��e I cCAcre� 2y" N.#w co N4e d x,'sT+n y 7'6 r, RwIsTlAq ofeck y 4pp�- lcr<I � 1 � 14 �04 f cf ExiS7n9 III 17- avc /N. cdmend ..., Si wct(k RECEIVE®_ +" _J 2033 DEVELOPMENT SERVICES C?R. CITY OF EDMONDS N 1 • > RECEIVED PLANNING. _ JUN a 9 1995 PERMIT COUNTER 10 w � K Y $ s�-RECE-IVED JUN <s_ 1995 PERMIT COUNTER >�?""'."�YF��9f - ;h: ..,}�. -S:L,Yi,.;'S wry••'• P? k. Jam. C ,K q • :- r . r. s ^ u. .,,,., t , 1.RG_ - G : �;:, . � City of Edmonds ,, .{.,.',...... Critical Areas-, ChecklistY The Critical Areas Checklist contained an 1!and submit'it to the City. Tlie City will this form is. to :be 5lled out by any person, j ;. review the checklist, make: a precursory site - .. preparing a Development Permit ;;��.�.visit, and make a determination of the ' Application for the City of Edmonds prior ,, subsequent,steps necessary,to complete a to his/her 'submittal of a development ` j.:. i _::.development permit application.— permit to the City. nth a' signed `copy of this `form; the The purpose of the Checklist is to enable v ' `+' ` - `.,applicaarit should also submit a vicinity map,-' - City staff to determine whether any _ _ or plot plan for individual lots of the parcel potential Critical Areas are or may be _.. with enough detail that City staff can find present on the subject property. The ,,.Af-.and identify. the subject parcel(s):-In:�< information needed to complete the addition, the applicant shall_ include, , . Checklist should be easily available from - other pertinent information (e.g. site observations of the site or data available at plan, topography map, etc.) or studies in City Hall (Critical Areas inventories, maps,-.: conjunction with this Checklist to assist ." or soil surveys). staff in completing their preliminary c.,., assessment of the site.. An applicant, or his/her representative," must fill out the checklist, sign and date itw I have completed the attached Critical Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). Owner / Applicant: Applicant Representative: Name Name:. II I a1 k , { VEMI / Y V•11.j*...". i. t'i :?' .> _ �f.r .+ ?^: f• • ' ... Street Address Street Address ....# . .... , . , -... r ... A c� �78,15ZAJ CI City, State, ZIP ric5''' :::` - .••..a Phone..,: .:City , State ZIP ": • c 4 Phoney Signature -._ _.__.._... ! t -Date Sigiiatune , _ _ h�F . Date 'Yr ,i : CA FILE NO. Critical Areas Checklist' Site Information (soils/topography/hydrology/V egetatim!) 't'. Site Address/Location: M,k 2. Property Tax Account Number: -%5,0 boo - v 3g — 60 Approximate Site Size (acres or square feet): I DDT Y J)-D' Is this site currently developed? no. _yes; If yes; how is site developed? Describe the general site topography. Check all that apply. 6. 7. 8. .Flat:., less than 5-feet elevation change over entire site. '(a vertical f Rollifig-,, slopes on site generally less than 15% rise o 10-feet*over a horizontal distance'of 66 eet). A Hilly:' slopes present on site or more than 15% and less than30% '(a vertical rise of 10-feet over a horizontal distance of 33 to 66-feet). Steep:,, grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal distance of less than 33-feet). j; Other (please describe)" 7-. Site contains areas of year-round standing water: Iv Q Approx. Depth: Site contains . areas of seasonal standing water: 0 Approx. Depth: ---------- .What season(s) of the year?, Site is in the floodway -i0r .'floodplain of a water course. 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? Site is primarily: forested meadow ;shrubs mixed. urban landscaped (lawn,shrubs etc) Obvious wetland is present on site: CITY OF EDMONDS USE % J J 1 0 ZONE PERMIT n NUMBER r03 CONSTRUCTION PERMIT APPLICATION JOB SUITE-APTX ADDRESS /`�� / / _ /::'� , 'f '✓ L. /V AA1E NAME OF BUSINESS OWNE ! LEGAL DESCRIPTION CHECK SUBDIVISION '+O uD NO ^ (0-•N E 57 )Vf) 6A-N.) w MAILING ADDRESS �^'' Al j /� ,t AV Ltj L No2,IN TESCP Approved ❑ p C PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP ❑ EXISTING REOUIRED DEDICATION RW Permit Required Street Use Permit A, d ❑ ❑ CITY _ 21P TELEPHONE NUMBER ' �Cj —71 PROPOSED Inspection Required Sidewalk Required ❑" � w NAME METER SIZE LINE SIZE NO. OF FI%TUBES PRV REQUIRED < YES ❑ NO ❑ 3 O ADDRESS w REMARKS w 2 2 CITY ZIP TELEPHONE NUMBER Z NAME 0'w � m � A D_REsS j/�' �� /i.t'- (�- ENGINEERING MEMO DATED REVIEWED By U R CITY ZIP TELEPHONE NUMBER FIRE MEMO DATED REVIEWED BY w i ¢_ STATE LICENSE NUMBER EXPIRATION DATE SIGN AREA ALLOWED PROPOSED 1 SEPA REVIEW COMPLETE EXEMPT ADB NO. Legal Description of Property include all easements /� � SHORELINE/e Z O EXP VARIANCE OR CU Pl. BY 1 / DA E q (\ i 'INCq/+A,VIEW f/ (( rl 0 SETBACK —FEET HEIGHT LOT CO ERG = Z CC FRONT /C/) SIDE 1 V REAR %,.`y L �) -57 Q i J Property TeX Ac ount J 0- O D 0— 0 3`56 - 043 S O U REMARKS a Parcel No. ' © D NEW RESIDENTIAL PLUMBING © ADDITION COMMERCIAL MECHANICAL O REMODEL O APT. BLDG SIGN { CHECKED BY TYPE OF CONSTRUCTION CODE .{/ L// OCCUPANT GA- GROUP RADING ❑ IENCE K—� REPAIR a CYDS. �J '11`/AREA WOODSTOVE SWIMPOOL DEMOLISH ❑ INSERT HOT TUB/SPA SPECIAL INSPECTOR REQUIRED O YES ��: OCCUPANT LOAD GARAGE RETAINING WALL/ O RENEWAL CARPORT ROCKERY MARKS O _ PROGRESS INSPECTIONS PER USC 305 = tTYPE OF USE BUSINESS.OR ACTIVITY) EXPLAIN: W NUMBER NUMBER OF DWELLING I CRITICAL / AREAS O m OF STORIES - UNITS NUMBER O -r DESCRIBE WORK TO BE (ATTACH PLOT PLAN) FINAL INSPECTION REQUIRED ��-'S % 'tit �' % C- VALUATION FEE PLAN CHECK FEE BUILDING HEAT SOURCE: GLAZING D/D PLUMBING Plan Check No. L C'. MECHANICAL GRADING/FILL This Permit covers work to be done on private property ONLY. Any construction on the public domain (curd, sidew?Iks. �• driveways, marquees, etc.) will require separate permisSlon. STATE SURCHARGE Permit Application: 180 Days STORM DRAINAGE FEE Permit Ltmlt: 1 Year - Provided Work is Started Within 160 Days . ENO. INSPECTION FEE ' 'Applicant, on behalf of his or her spouse, heirs, assigns and 1' ) `C �\ 3v W successors in interest, agrees to indemnify, defend and hold Edmonds, Washington, its officials, hethe City of for damages of �� s employees, and agent$ from any and all Claims from the Issaancie .Y whatever nature, a rising'di'rectiy or•indirecdy CHECK DEPOSIT Of this permit. ISSUanCe Of this permit shall not be deemed to - PLAN modify, waive or reduce any requirement of any city ordinance / C i nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE provision." _7 I 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 stale laws regulating construction; and in doing the work authoriz• AUTHORIZES signed by the Building Official or his/her ed thereby, no person will be employed In violation of the Labor ONLY THE WORK NOTED Deputy; and fees are paid, and receipt is Code of the State of Washington relating to Workmen's Compensa• acknowledged in space provided. do Insurance and RCW 18.27. INSPECTION OFFICIAL'S Sl Cr tIfTURE DATE SIG iOWNER OR AG EN OATS SIGNED DEPART OF ` i p / A / jo Y l J EDMON — CALL FOR RELEA$ av;, �/� DATE ATTENTION INSPECTION ,f'L�r" ,%;' r�'�-'�7 r IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE ��� -oAAo' UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR LL ORIGINAL —File YELLOW —Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER J. PINK — OAner GOLD — Assessor _ CA FILE.NO. 'l I C2 `. Critical Areas Checklist �FSite Information (soils/topographylhydrology/vegetation),7= ��-' " 1. Site Address/Location: �Z-%{n „�.ea►,. Dr{ a 3 2. Property Tax Account Number: '.5� 600 — U'J$ — 00 3. Approximate Site Size (acres or square feet): j DD" Y. 120� - 4. Is th currently developed yes no.,V �,u;�° is site a. x3 a: i If n n 3J = yes; how is site developed3?• .s_ . A r.,� �, r . a,, _ R; «.• , :: y. �` �v G °'Iq �xj � "I n.• _?i' '"fi '`''v k L�'`.i t�a+� 'k s 'f' 'tw..5• r..'- : --:; M,✓: �i .+'.+ '4A .3 R .o�'.�.�C;f#�' . LS'��h1tY •" -• 5. Describe the general site topography. Check all that apply. Flat: less than.5 feetrelegation change over. entire site: L •a 2g— ti»�6;+1 Rolling.: slopes on'site gendW1y less than 15%-(a vertical' rise o5.f 1 t= t over a f:k ..,. ;sw. ,....:'horizontal d'ceof66-feet). "�=t`s.;r 1r��';,�rtt��4: ' v � ', -. ,: .-. ..._•rf ,+r.•t pq'Y P. t, r3 -. ,ri �'•`•}. ;:r A�f�-,�{itfii'l�i:�,��?I� Hilly. {slopes present on site of more than 15% and less than` 30`� (. a vertical rise - of 10-feei over a`horizontal distance of 33 to`66-feet): "`' ' '::::ar"`f n¢y"` ;± '; Steep: • grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal distance of less than 33-feet�' .. 1... • Other:(please-describe): yµ_, 6. Site contains areas of year-round standing water: Iv ;'."Approx., Depth: 7. " Site contains areas of seasonal standing water: NJ D , Approxl, Depth: .What season(s) of the year?, 8. Site is in the floodway AiSr,, ., - `floodplain 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 yeah 10. Site is primarily: forested ; meadow. • ;.shrubs.., urban landscaped (lawn,shrubs etc) !Ll. Obvious wetland is present on site: For City Staff Use Only •1. Site is Zoned? 2 .SCS`mapped soil type(s)? '3 - Wetland inventory or C.A. map indicates wetland present on site?: A _ / I- :4 Cnttcal:Areas inventory or C.A. map indicates Critical Area on site? (,t`/c�v v� vl, ::Sate within designated earth subsidencelandstide'haraid area? 27 6 Site designated on the'Environmeata]ly 'Areas Map? DETERMINATION . STUDX REQUIRED ` CONDITi.IONAL WAIVER WAIVER Planner :, s: .: Dalki:. T j _ E., ham. •>i 4;,C° f( >..''� F i� - s -�' t ri - -.r f Rev0110494�r �: 7 3 S �'' t � � ,� .��� fir, l�•p�iy,�s',1�., i�'a�'rrY.<� � r rryg � ¢ s S � x` ;. � 6.�: •.�► �+�t' h�+#�r. :�•�.��, S 1 r�- r ,> - v - . i Tr�' �. ,s �' r -S= ii+:>�" �'��<x"�� � �'c � o � i yc 8>s4�/.M+✓�_ f i`ip � ..i.,� _ dC s.,�„ g,, ±. _ .+t'1'�- - YnRie _ k¢.. s SS y __. a+e -+ y "'f' .4 '�tT i•.. '4t'id Si ►7: �3%: '.atlY =t P. i ��.,hP�e {.F� �+t Ki4r,'Le C �C �} a� °.�-.�.• '� a 3K 'rt a ',' xi°$`. -5;.: y�':"-.fJ<S.! .'a:]> ,. '�i6 >�a•'. r.. - '0'i l•.t Bg0 _199_ City of Edmonds Critical Areas Checklist, ... :.:�� 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 a development permit 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). 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. With a signed copy of this'form; the applicant should also submit a vicinity map or plot plan for individual lots of the parcel with enough detail that City staff can find and identify the subject parcel(s). In ;.. addition, the applicant shall include other pertinent information (e.g. site Plan, topography map, etc.) or studies in conjunction with this Checklist to assist staff in completing their preliminary assessment of the site. . An applicant, or his/her representative, �. must fill out the checklist, sign and date it, I have completed the attached Critical Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). - - Owner / Applicant: E- ✓MAW P Name Street Address .. 178-157-1 City, State, ZIP z;; :`'k s Phone Signature Date Applicant Representative: Name , Strom Address City, State, ZIP = Phone ' Signature _. _. __. Date nloEW 1ao' f l ' � r i ` APPROVE BY PLANNING f I X �►{ �l� i t IM Vh 1 tilt r EX ! STi Ai G D Ec r, v, I I� '1 � �•�!r I rn ;u T S I C^� O. to 1T1 CA FILE NO. Critical Areas Checklist Site Information (soils/topography/hydrology/vegetation) 1. Site Address/Location: 2. Property Tax Account Number: JO 600 - U'j$ - 60 - OU 3. Approximate Site Size (acres or square feet): I OD1 X Q-0' 4. Is this site currently developed? yes; -)L no. If yes; how is site developed? 5. 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 30% (a vertical rise of 10-feet over a horizontal distance of 33 to 66-feet). Steep: grades of 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: !v D ; Approx. Depth: 7. Site contains areas of seasonal standing water: I� 0 ; Approx. Depth: What season(s) of the year? 8. Site is in the floodway - floodplain a— 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? —a (What time of year? ), 10. Site is primarily: forested ; meadow ;shrubs ; mixed urban landscaped (lawn,shr ubs etc) 11. Obvious wetland is present on site: For City Stall' Use Only :1. Site is Zoned? 2., ; . SCS mapped soil type(s)? 3 - Wetland inventory or C.A. map indicates wetland present on site? 4 Critical Areas inventory -or C.A.- map indicates Critical Area on site? 3 Site within designated earth subsidence landslide hazard area? i7 / 6. Site designated on the Environmentally Sensitive Areas Map? DETERMINATION:: STUDY REQUIRED CONDITIONAL WAIVER _ WAIVER Reviewed by: Q9A X,43 Planner Da f 7—M Rev 01m4/94 ego _199" City of Edmonds Critical Areas Checklist 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 a development permit 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). An applicant, or his/her 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. With a signed copy of this form, the applicant should also submit a vicinity map or plot plan for individual lots of the parcel with enough detail that City staff can find and identify the subject parcel(s). In addition, the applicant shall include other pertinent information (e.g. site plan, topography map, etc.) or studies in conjunction with this Checklist to assist staff in completing their preliminary assessment of the site. I have completed the attached Critical Area Checklist and attest that the answers provided are factual, to the best of my knowledge (fill out the appropriate column below). Owner / Applicant: -S VA "P Name No2 Street Address -719-157-1 WA IWO City, State, ZIP Phone 9- ITS Signature Date Applicant Representative: Name Street Address City, State, ZIP Phone Signature Date 1� v V r � v C ' �n I I I Zo, STREET FILE t• U TR-o A T STREET FILE t• U TR-o A T OQ -tip T;4 &I IF, G PI'll1)::!,T. WIT!, LIST goo r- IT PVTF! T .. _. � SET FILE Strcet Pdp1it-of-V:aNr EaistinF_ /&040 Access I'asmacias Yxisting RE N) Utility Miscunont Rxistincy Lot Per Subdivision Plat Assessor "op Site 111,m (lecl:od for Accuniov 6:) (4512 —1 1:,atcr si-n H\ (I 1-a! it izc J,A:isnin�, I - or (J:ccl, ­Ctcr Pc(-iii-cd ISUptic Tzm: Date Ponlit -0j Sanitary Avnilahility_ vs I I Dra'.dil- No. File .,0. sidc scv.-Cr Avni)ahi I it'! Sallitan, �),o":er Ccmincctioll Yoc Pooldrod P'iVic,,: hv N 1 C,11 colvort Room C 0 1: �,_ 0 Catch 1"asill P(I�itlirc(l 71 n N,111,101c required 7— Soil c -ound 1�'a*er Field (lioched onclitions F, Ci L Revio.; bv size o-'T-ndicate oil '�il:c Plmi $ Talc .111dicnto or. Site Flan— aate . ­ __­_,- I Strcct Paving; Rccliii rccl _ :Ri• crin C;, `t`ea \cctli-rccl - ----- �, j Sicicl:�lll: I;cciTr I - Curb rut for Privc;:av Baru IPiz llt-of-,.'ilk Cons lon PClrli.t IZCClltlircd t� I Boncl ' lrecl for Pul�l.ic Illlpro%rerlents _ c: Strcct Pc(,ilirccl Otlicr Sionii1ST Rcnuirecl —-_-`--- i_---- (� T'rc t Sitc Inspcction macic on — c H II ~' c I h'atcr ((� Strect_�_ Pc'(:I',i-rc .cats listed in memo to Building, ll:P !Tti:iCi,t P'A'__ J-V—(/ "C� — —Date i.tcc:s fi.11ecl iil on ljuilclim; Pcrriit Application I -f Datc C 1'•1';'; Stli'll)cC: a;ld i'Ot lt].C11, Data ! �: j �l airc vccl by Puhli c l;'0i -s P�c;part! ent <. III RC-ATION hir SIDE SEWER PERMIT EASEMENT NO . ............................ NEW CONSTRUCTION REPAIRS❑ LID -.-ASMT. .......... . _CONT ACtO .__ ba-L-L EE 'i R R ............. I ................ .......... -------- --------------------------- PERMIT- NO. ----------- - LEGAL DESCRIPTION: LOT NO. ........ .............. -4, , K - NO. - ...... : .... BLOC a ._. ............................ ------------------------------------------------------------------------------- .................................... --------------------------------------------- NAME OF ADDITION ................ ............... ---------------------------------------- DATE ....... ... ... .............. By ,� .... ............ Ci, d­ -J R SIDESE ',"WE .","PE T 4 7 iT E SEWTWD IEPARtMENT 2, °` )4j, 7- TREE FIL S Call 775 2525.'for sidesewerPnsrpectl,ns,,JSErORF'co vering .)portion of theiconstruction (,Inspection1willi. egustNOSat4suh Holiday uspections:' i -:;, -.T2ten*ue­.Nb�th-. ADDRESS ,!i,,O�C�A-nON�,,OFi:;CONSTRUCT.ION,...�.- 1 TK-A ......................................................................................................... ................ ................. Z� )PAOP,ERTY;,LEGAL,-,',DESCRIPTION.,... . At-- ';jjj ..Fd.. ........ /-� .............. ...... .......................................... : ................................ ------ .......... ­� .............. ............ . . ........................ .................... ................................ ........................................................... MOICBUILDER-RAY. MIMERS_(1N ........... . . ......................... �RGNr -T.0R.'SWMTEp&.ADD9kSS TRAC A T ??Rai.:. ........... h_n... .... .......... 1975 1: ;.kfor, repair, and/br :eo' finec,116ii of Ai:.side' illelllk, the, pity . _�.',oU Edriidnd kLLE&"T0;;THk'FOLL0 ING:* O'- Tk- 0. e4�heliownelri,�.of .':the �property'',may obtain -x,permic, o construct _sewer inside property line. :A llcinsed,.Side port lon`�of, .mP edl to)(construEtt,".- area. -Do• not -cover,,' sewer before 19y e It has,bedn inspedted.'- city•right -of,way.*..,requ'lreii - a n Invasion* of:'Mght-of-Way�iae�mit;o' i' �e`clty NOTE!�IVo 3- bts, na le from,,t Regulatioris! gove'rnihg,;sidc)sew r en, yclu.get'.perinit' t. :NOTEkN'6* at Iea�6301iincfies coverage,,at, property. line:. 1. ".. ­� 1. ­ and, 12 inches, -inside proper't y1ollinli;: -m1nimi1rii-*;`gradb ;o'f�,2 S' permitted sharper"t than _.ireit' f;street restored" r 6,,.o rigin W.mcondttt on.� responsible- , .Jor) `,mu�t he -wM�r� settl�d.an& surface io t Contractors,. �hallajbe'4 , a i I i�e �j o41,-rn -Woik.,whlch,��maY..,.'develbp.,;�ithin :onel year -,of �cizlmpleit16n.- -'VOTEII)N6�1'fl�'_-* WWs, e,�o it;.ap purtenances i 2 ""urd d�v rovided for :in: thepermit ,,or,,toodo'any work' oniAfietjr ,.�tenanceh excipttoUin; k� p! pe: I ri to,kthe�. .2t�ih %�Ye.,. ..­ .................... ....... y ... :. Date.1 .... ................................. Y: ... ....... ...... ... . .............. ...... ........ ............................ B Y ...... ..... . ....... ....... ......................................................................... v Remarks ............................................................................ .......................... ....... .............................................. ............................................ 7­1 ...... ............. ............ ................ ........... ...... .................... ........... .... . .. .... �+BOTHFeirhit-iC6pies,MUST -3c:s.>�gned By-OWnei-ofFirm Peiform'ing­1C onstructlon,PRIORI`r R'equest'For­l�s& t­IM 4 t I, ..�.........* *� lh6reby,�c rtif ls6wer.*,�instbIlationidonit'rudte( un erithis-permit­ -(Own6r;'of:contractingFirm,Peri�rning;C6nstructtonvi .* wasrmstalledliniaccordance lnaikes-i of the City, of.,)Ediri6rids:,.: i, �W. Qated, 9::. this day>;of 7­ V" Wa 0 �u-j,(qg,1,for,* i fiirtjE�11.,` it c �Cxasijgi' �':­,.e ep�oneqgl, 1PbWer'11Ej11:.;,.- +s6wer Ul: her t APPLICATION for list, l.liy .,f Eclmondx SIDE SEWER PERMIT A:ASEMENT No- ------------- .. NEW CONSTRUCTION RN,L'A llta / v LD %/LLS i �� !'..Y.......... �..'.... /:. %. / :. PERMIT No.k,5 - WNlat ........1i.' / +�l� G ..... CONTRACTOR �:..`........./..'..,:.`. �i , AI)DRLSS //./ ....'.... % h_/�.-ti/.....<.:................................. LEGAL DESCRIPTION: LOT No............ .:.i......................... BLOCK No....L/......---•----..-----------------. NAME OF ADDITION ..........�t.7 5M... /....../....,L�a.................................. _........................... 0 t PC LL. �a 75