1124 6TH AVE S.PDF111111 lill IIII III5393
1124 6TH AVE S
the Cit,y-"' of Edmonds
APPLICATION
for
SE SEWER PERMIT
FIL ID
E-OUTSIDE INSIDE E] REPAIRS Ej
✓ CONTRACTOR .......
OWNER --------- -----------------------------------------------
STREET
HOUSE No..____-_ .... . .. -- ---------------- AVENUE LOT No.
.. . . ....... .......
Date
BACKFILL WORK ORDER ISSUED ................. ................. DEPOSIT,
SEWER WORK ORDER ISSUED ..........................................
CARD No. ..........
EASEMENT No . ................
........ --- PERMIT No.
-----------------------------
BLOCK No - ---------------
......... ................................................ ---------------
I
NAME ADD . .........................
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APPROVED
Approved:
------------------------------
By...... ----------
P U e9A f �'D RC— , L FSTAT� � I N S U f �� N C� �G� N CY
42 1 Mc6a Street
C—imo.nl, WaAington
P Rogpect 8-3177
The East 140 feet of the South 108 feet of the following described property:
That portion of the SW quarter of the NW quarter of Sec. 25, Twp 27 N, R3E.0
W.M., described as follows:
Beginning at a point 867 fee6 South and 330 feet East of the NU corner of
said subdivision; thence South 123 feet; thence East 300 feet; more or less,
to the county road; thence North along said county road 123 feet; thence
West 300 feet more or less to the point of beginning, situated in the County
of Snohomish and State of Washington.
CITY OF EDMONDS,
CIVIC CENTER'- WATER -SEWER DEPARTMENT Calf rRospect 6-1107 when work'
is ready.?or lnspeetlon. '(No InsPec:. O
= . �SIDE. SEWER �PERMIT�., _. Ilona $atordaSunday or holidays.)
ADDRESS ............1124...... ixth Avenue--:South................
....................,........................------...........---...........---------....---........ _.........
Allan E
OWNER: ..:.:.....:................... ngler .......................................
:... CONTRACTOR ................ Roy ... A-1.1en............ ...........................
':,Permission is granted ........ QC.tob.er....251:.......... 19.64.., for .....................,: days, to REPAIR or CONNECT a side sewer
with City Sewers in,accordance with application on file and governing ordinances.
ATTENTION -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 sewerbeforeit has been Inspected.
NOTE No. 2—Obtain full Information regarding Ordinance 11.16.030, and Regulations governing side sewers when you get permit.
NOTE No. 3—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 % will be permitted.
NOTE No. 4-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. 5--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 ap-
purtenances except to insert the pipe into the wye.
CITY OF EDMONDS
PUBL, WORKS DEPARTMENT, ENGINE* NG D I V I S AO'N�i� �� ,..� FILE
APPLICATION FOR RIGHT -OF -MAY CONSTRUCTION PERMIT
THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PURPOSES
Applicant to Complete Parts A and B
A, Permit to be issued to:
For Work at:(address or vicinity) //Z !� _� �UE .S'O /j'DA, 5 Q
Type of Work to be done: 1,WW-4 % ,¢(/l V6/
(attach drawing when applicable)
Time Required -- Start:
Owner: J '44y . CA4 /V
Name
Mailing Address
Finish:
City State Zip Telephone Number
c^
Contractor: ,V/C& vSA* i d ��/ZL�/��- ��- C/� - J �-:2Z Z. As'
Name State License Number
Mailing Address
5:5, GU f .9�/.3? 3G-7- 1-70 �
City State Zip Telephone Number
** NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE **
B, INDEMNITY: Applicant understands and by his signature to this application, agrees
to hold the City of Edmonds harmless from any injuries, damages, or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be made against
.the applicant or 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, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance
of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until
the final street patch is completed, at which time a debit or credit will be
processed for issuance to the applicant.
Work is subject to inspection, and restoration in accordance with City Code. A
24-hour notice is required for inspection by Engineering. Call 775-2525,.ext. 220.
I understand that this permit must be available at the job site for inspection
purposes at all times.
Signature: •. , W.40� Date:
Owner or Ag nt
TO -BE COMPLETED B IS UING AGENCY:
Date .Issued: _Permit No.: ���(%� Fee:
-Security Bond: lk
Time Authorized:
1 n-77111 (Rn1,i on A)
APPROVED BY
S-7R i.. (,-n.-; o A)
Date:
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CITY OF EDMONDS
LOT APPROVAL STREET �ru cU E T FILE
NAME Barbara Ingler ADDRESS 1121 - 6th Ave. So,.,Edmonds..
ADDRESS OF PROPOSED BUILDING.
LEGAL DESCRIPTION: `LOT BLOCK ..,. ADDITION
TYPE OF USEResidentiNd.. OF BEDROOMS SIZE OF LOT
SOURCE OF DRINKING WATER: Public Supply $ Private Well
a. SURFACE DRAINAGE
1.. Is disposal field site well drained? Yes
2. Any water course (stream,,.drainage ditch, etc.) through site? No
b. TOPOGRAPHY
1. Any heavy slopes infield area? ' No
2.. Will present topsoil in field area be removed or graded before field tiles
are installed? No
3. Will any fill material be used in the disposal field site? No
If yes, how much?
c. SOIL CONDITIONS
1. Hasa hole at least 4 feet deep been dug in the disposal field area to deter-
mine the type of soil present? Yes
2. After hole is dug record the soil conditions at the following depths. (Re-
cord as sand, gravel claayy packed sand, loam, etc.) -- - --
12 inches fiopsmil 30 inches Loose sa
IS inches sa W7 51 6 inches
24 inches FY48 inches Coarse sa wl 11P11 gr
3. Any ground water.encountered before reaching a depth of 4 feet? es
If so at what depth? 4311
d. WATER TEST
A simple water test will show how well this soil will drain or percolate water.
To perform this test:
1. Dig hole at least 36 inches deep, Use a shovel or post hole digger ---
size of hole makes no difference --only depth.
2. Fill hole with water. Now let all water run out of hole. This soaks
the ground and will give a more accurate reading.
3. Again pour water in hole to a height of 12 inches from the bottom.
Let water run out until there is just 6 inches from bottom left in hole.
4. Note how many minutes it takes for this last 6 inches to seep away.
Record this time below.
Number of minutes for last 6 inches to seep away
5. Divide this time by 6 to obtain Apthe fate fg2 inch 3 tests)
6. Date water test was performed 20., 9
I hereby certify the above information to rrect and the above tests were
performed by me as prescribed.
Signed
Address
NOTE: A septic tank permit is issued on the basis of the abo a information. If
there are any changes or alterations in the above stated soil conditions it may
result in the installation being rejected at the time of inspection.