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1123 EMERALD HILLS DR.PDF11111111111111 11231 1123 EMERALD HILLS DR CITY OF EDMONDS - SIDE SEWER PERMIT WATER -SEWER DEPARTMENT PERMIT '�` � � . 4 (Call 7.76-1107 for side sewer inspections BEFORE covering any portion of the construction.l \Inspection will be provided within 24 hours after request. NO Sat., Sun., or holiday inspections./ ADDRESS LOCATION OF CONSTRUCTION.1123 Emerald Hills Drive -•--•...............•----.............................--......................................-..................-............................-... PROPERTY LEGAL DESCRIPTION ........... Lot ..�7........................ .................................................. ............. OWNER AND/OR BUILDER ......... Rav Anderson ......................................_....................................................... Allied Qackhoe 22821 e 85th P 1 o H o CONTRACTOR'S NAME & ADDRESS..................•-----........---.---.........------..........--...........----......_......................................- Permission is granted............................O'!AI'Y..?Qs ........., 19.73., for repair and/or connection of a side sewer to the city sanitary sewer system in accordance with City of Edmonds ordinances. *NTION IS CALLED TO THE FOLLOWING: E 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—Obtaln 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 'A will be permitted. NOTE No. 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 ❑ Date .... ........... .............. j3y ...... Date.......... .'.. By ....... ............. Date..............._....-•----•........ By................ APPROVED Date..._... 237B... l....................._...- ".Itanarks: ....... _.... ... . .. . ...... ........ ... . ......... • ........ ...... ... ._ ......... I ......_.............. ..................................................... ......... ......--------••-•----...---•-------------•-----------......._-----------.------------------------.--••------------..................................._.................---.......----..-_.......................---.....................--...... — BOTH Permit opies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection I ............. /llL. ..- ..�................................... hereby certify that the side sewer installation constructed under this permit ner of Contracting Firm Performing Construction) Oinstalle accordance with all governing ordinances of the City of Edmonds. Dated this .......0-.............day of....---..�.�.................................. 19. t %/ Check BEFORE you dig for: Water ❑, Gas ❑, Telephone ❑, Power ❑, Sewer [n, Other ❑ V d APPLICATION The Cityof Edmonds for SIDE SEWER PERNIIT EASEMENT No ........................................... NEW CONSTRUCTION REPAIRS ❑ OWNER .- +L►Y.........I H N............... CONTRACTOR ....i��. +. ...... .K ^Q PERMIT No.�t4 �. ADDRESS I• I ——.JNI Q�L-�....- L -�t LL LEGAL DESCRIPTION: LOT No..... A2 ... BLOCK No.... NAME OF ADDITION ........................................... ........................ .. �o Approved: / DATE i .. �• By .................... . 0 APPLICATION for The City of Edmonds SIDE SEWER PERMIT EASEMENT No ........................................... NEW CONSTRUCTION � REPAIRS 0 OWNER ............ E-f" ......... .............................. CONTRACTOR ..... ...... ---------------------- PERMIT No. ADDRESS ...... A X .. ............... LEGAL DESCRIPTION: LOT No.....---.. .. *7 --------------------------- BLOCK No . ............................................ ............................................................. NAME OF ADDITION .............�,. I -1 D 3Y , f I -/A Approved: N DATE................................................ By ......................... 1 City of Edmonds RIGHT-OF-WAY CONSTRUCTION PERMIT Permif'N O-;52 Issue Date: ` 3'00 A. Address or Vicinity. f Construction: 1123 Emerald Hills* Rd. �- k Q•. B. Type of Work (be specific): Gte to replace a buried section of defective cable GTE to trench approx. 73* on South side of Emerald Hills-1Rd.,then use existing xinS to go North. See Work Order print for details C. Contractor: GTE NORTHWEST INC. Mailing Address: 2312-C W. Casino Rd State License D. Building Permit # (if applicable): E AJG R : Oow gRA N01_ty Contact: DOW BRANDLEY Phone: 425-710-4118 - Liability Insurance: Bond: $ Side Sewer Permit # (if applicable): -. E. ❑ Commercial Subdivision ❑ City Project X EUC (PUD, GTE PSE, CHAMBERS-r"OVWD) ❑ Multi -Family Single Family ❑ Other .J GTE WO# 2100-9g001FG-011 2423.10 INSPECTOR- F. PAVEMENT: ❑YES ®NO r f�.--~SIZE OF CUT X H. Charge: $ CONCRETE CUT: ❑ YES NO APPLICANT TO READ AND SIGN IDEMNITY.• Applicant understands by his/her signature to this application he/she holds 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 Nqany of its departments or employees, including but not limited to the defense of any legal proceedings including defense costs and avorney fees by reason of granting this permit. THR' CONTRACTOR IS RESPONSIBLE"FbR"WORKMANSHIP AND MATERIALS FOR A PERIOD-70,F ONE KEy R FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATEII 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. ♦ Traffic control and public safety shall be in accordance with City regulations as required by the City Engineer. Every flagger must be trained as required by (WAC) 296-155-305 and must have certification verifying completion of the required training in their possession. ♦ Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City - approved material prior to the end of the workday - NO EXCEPTIONS. ♦ Three sets of construction drawings of proposed work are required with the permit application. I HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE THAT I MUST MAKE THE PINK COPY OF THE PERMIT AVAILABLE ON SITE AT ALL TIMES FOR INSPECTIONS Signature: Date:. 7 - / d ' o0 g Dave aw ns Group.M Mgr -Access Design (Contractor or Agent) n 8 8 CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK UPON COMPLETION OF PERMITTED WORK, AN ENGINEERING FINAL INSPECTION IS REQUIREWPER.CHAPTER 18.00 OF THE EDMONDS COMMUNITY DEVELOPMENT'CODE: C�05t ,�C�• FINAL APPROVAL OF PERMITTED WORK.---- INSPECT 'S SIGNATURE DATE: For inspection requirements see Engineering Information Handout:,, b NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE TO FLD 2R3o2676-2700 AKF25-26 #12534 LO M 2R3o2676-2700 AKF25-26- #6613 CONSTRUCTION NOTE: RECORDS SHOW EXISTING XING TRENCH APROX 731 0 SEE PLACING DETAIL BELOW. 2R32676-2700-J -AE25-26 #?aa TO CO 2423.10 1 WRECKING CABLE TYPE MAT. CODE FOOTAGE YR. PL'. AE25-2E 221625 100' 1968 EDMS ORM COUNT BEFORE AFTER WKR VAC DEF WKR VAC DEF 3:2676-270 20 3 2 20 5 0 (WKR = WKR + DED) PLACING DETAIL I certify that work I completed on this work order and As -Built is in compliance with GTE Quality standards as identified on the IPQIP checklist. (Signature and Date) USE BULK WO ONLY IN SERVICE DATE 8-30-00 PERMITS CONSTRUCTION ❑ BLANKET ❑ STATE 6 DIAL. A DIG ❑ COUNTY [d FLAGGING 0 CITY ❑ BRUSHING ❑ NONE SPECIAL CIRCUITS CAUTION ❑ YES ONO POWER ❑ UG ❑ AE OTHER ❑ UG ❑ AE CUTS REQUIRED YES ❑ NO TELCO ❑ UG ❑ AE JOINT POLE ❑ PUD ElPSP&L El ❑ GTE NONE JOINT TRENCH ❑PUD ❑PSP&L ❑CATV El GTE [ NONE FEES REO'S POINT OF CONTACT ❑ GOP ❑ LEC ❑ SPEC. CONST. 16 NONE ENGINEER DOW BRANDLEY PHONE No. 425-710-4118 FACL. TECH. BOB V. PHONE -.Ng. - 425-710-4144 FIELDED BYBOB FOSTER MATERIAL MATERIAL ENGR CONST CODE—, . DESCRIPTION EST ACT 280450 AKF50-24 125' THOMAS BROS. MAP NO. I� EXCHANGE COUNTY HALLS LAKE SNOHOMISH TITLE: N REPLACE DEF. SECTION CD EMERALD AND 12TH AV CD O o � m APPROVED BY DATE 3 m m m I R. 3E SEC.24D SHET.27N NO.: 1 OF 1 -