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1111 EMERALD HILLS DR.PDF11111111111111 11226 1111 EMERALD HILLS DR CITY OF EDMONDS - SIDE SEWER PERMIT WATER -SEWER DEPARTMENT PERMIT , 0' ' 1,, Cali 775-2525 for side sewer inspections BEFORE covering any portion of the construction.` Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections./ ADDRESS LOCATION OF CONSTRUCTION........13...�...!...-.....- y .4 ! Cam— P .............. .,'.�. ........_rJ1� .......................... PRDPERTY LEGAL DESCRIPTION.---.... 9 ...........�-5-......................................... .................................. .................................................. _.......... _..................................................................................................... _...................................................................................... ...OWNER D/OR BUILDER ......- 5----------. � f' ��................. CONTRACTOR'S NAME & ADDRESS......��—.. 1 6 d L ... .............. 1--•......................................•---.............. Permission is granted ........... .. .......... ...-.....-.-., 19 ..1, =for repair and/or connection of a side sewer to the city sanitary sewer systeun in accordance with City of Edmonds ordinances. ATION IS CALLED TO THE FOLLOWING: NOTE 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. NOTE 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—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 4—Tap 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 % will be permitted. NOTE No. 5—Trenches 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 main sewer or its appurtenances except to in- sert the pipe into the wye. . DISAPPROVED p Date ... _......... By.... Date ........... .. By.... Date ............... _ By.... ......... APPROVED Date..._. ....... .......... By ..... iGtit ......................... v`1 �' �a.�....... ..............::�M_ ........... i : PY � ....... �-I �.r Remarks: --....._.. _.... — BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection — I,--. ..-,-..-...- .......................... ....... hereby certify that the side sewer installation constructed under this permit (Owner of Contracting Firm Performing Construction) rletlled in accordance with all governing ordinances of the City of Edmonds. Dated this..... �.�............day of.........V -� L :.Y------------------•-............... 1 � -� V Check BEFORE you dig for: Water p, Gras 13, Telephone E], Power. ❑, Sewer e, Other p V V 'Oft , STREET FILE Am Or ACCUPACY, The fc: usy it GRY Of Edrriorc', ot Edrnoi�L.,>. ria-- Wa', tov the l6cxt C, C4 0 n 0 �N z La .� •of Edmonds RIGHT-OF-WAY CONSTRUCTION PERMIT � Permit Number. a` 03 Wue Date: �— 3- / A. Address or Vicinity of Construction: i( I E M _ B A L D 1-; 1 L LS ri R. 18 9 O 1 9 B. Type of Work (be specific): P� r o 7 �' IJ L� t2i11'L Yl llt/1 i.LII,J� 1� GTE Northwest Incorporated n C. Contractor: Marilyn Holmgren, Permit CoordinatcLror ntact• l ONn/ I E c 1 ,6LA asino Re Mailing Address: Everett, WA 98204-1440 Phone: (a Q (p) " 1 112 - LI 12_2 State License #: - Liability Insurance: Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision ❑ City Project ® Utility 0.UDJM WNG, CABLE, WATER) ❑ Multi -Family ❑ Single Family ❑ Other Vj,.. � �,_4A INSPECTOR: INSPECTOR: JQF_Ax/ I1 50A) 9 F. Pavement or Concrete Cut : ❑ Yes ®No G. Size of Cd� '� x H. Charge' $, Please see attached sketch. APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT. Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Division, 77.1-0220. Work and material is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. I have read the above statements and understand th.epermit requirements and thepink copy of the permit will be available on site aaiT ins ection purposes. Signature: �pl� Dave Squi res Date: 2/20/97 g (CoiAftc$&OW14gent) Sec Mgr -Access Design CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR. CITY USE ONLY APPROVED BY: RIGHT OF WAY DEPOSIT TIME AUTHORIZED: VOID *AFTER %Z © DAYS DISRUPTION FEE/FUND Ill: SPECIAL CONDITIONS: N A RESTORATION FEE: PERMIT FEE:. TOTAL FEE: COMMENTS: RECEIPT FEE: DATE: ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994 m •� FIELD INSPECTION NOTES Comments Diagram (Fund 111 - Route copy to Street Dept.) CONTRACTOR CALLED FOR INSPECTION ❑ YES Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: ❑ NO I, 2 3 WO: 9P001PF007 ENGINEER: CJB S C O R E C A R D - P L A C I N G EXCH 2100 ZONE n1 FEB 12 ESTIMATED UNITS EQUIV A C T U A L UNIT DESCRIPTION ACCOUNT 2XXX XXXX 6XXX HOURS UNITS-C-HOURS UNITS-X-HOURS UNITS-M-HOURS P43A PL COPPER CBL IN COND 2423.10 106 0 0 2.6 P54A TRENCH 30 DEPTH 2423.10 144 0 0 10.0 P59B BORE PUSH PIPE SNGL 2423.10 106 0 0 43.4 P61A PLACE PEDESTAL 2423.10 2 0 0 2.4 P61B REMOVE PEDESTAL X423.10 0 2 0 1.3 GTE EQUIV HOURS 58.4 1.3 59.7 PLACING SUPERVISOR: SCORECARD -SPL IC I N G S13A PL REPL OR RMV FIXED 2423.10 Z 0 0 5.3 S24A SECTION TRANSFER 2423.10 13 12 0 2.9 GTE EQUIV HOURS 6.8 1.4 8.2 SPLICING SUPERVISOR: WORK ORDER TOTALS 2XXX XXXX 6XXX TOTAL PLACING 2142 50 2192 SPLICING 234 49 283 ENGINEERING 215 215 430 TOTAL. 2591 314 2905 CONST. NOTE: � 1-2"PVC DRIVEVIVIAY pnn4 PUSHES TOTAL 106' � DATE 2/97 P 7 S.TA R •7. C. . 7 . 2 FT 9 COUNT BEFORE AFTER WKR VAC IDEF WKR VAC DEF 2R3:2676-27 20 1 4 20 5 0 2R3:2676-2700 AE25-26 WO Is N USE FOR BULK WO ONLY PRIORITY ECAS IN SERVIICE DATE 03-11-97 DRIVERS FOR WORK ORDER DOR MO / TRANS / SAFETY PUBLIC REQUIREMENT PLANT EXTENSION / COMMDEV / RCTA PERMITS BLANKET SNO. CO. ❑ STATE ❑ COUNTY CITY ofrr m ❑ NONE CONSTRUCTION ®DIAL. A DIG M FLAGGING X5❑ BRUSHING SPECIAL CIRCUITS ❑ CAUTION POWER Q UG 12AE OTHER 113 UG ® All TELCO MUG M AE CUTS REQUIRED ❑ YES 91 NO JOINT POLE ❑ PUD ❑ PSP&L ❑ CATV ❑ GTE ® NONE JOINT TRENCH ❑ PUD ❑ PSP&L ❑ CATV ❑ GTE FEES REQ'S ❑ GOP ❑ LEC ❑ SPEC. CONST. M NONE POINT OF CONTACT TECH. C.J.BUELER PHONE N0. 206. 710-4122 ;FIELDED -BYRICH •EDWARDS-- - -4— MATERIAL CdDE MATERIAL DESCRIPTION ENCR EST. CONST ACT 280625 AKF:25-26 250' THOMAS MAP PAGE 454 H5 IIII EMERALD HILLS DRI Lrbqqblqll EXCHANGE COUNTY HALLS LAKE SNOHOMISH TITLE: FAP PMO IIII EMERALD No 0 C, HILLS DR 2R3:2676-2700 o� �_u 0 � 0 m 0 77 � Z APPROVED BY DATEK Z Tj m �0 -4 T. 27N R. 3E SEC.24D O.3 I of