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1143 2ND AVE S.PDF1111111111114846 1143 2ND AVE S The City of Edmonds APPLICATION for SIDE SEWER PERMIT NEW CONSTRUCTION 0 REPAIRS 0 OWNER —e . . .... . . ... 4f/Afj.� ....... . ......................... ADDRESSI/ ... .{(--3 ......... ... ah ....... ................... EASEMENT No . ........................................... CONTRACTOR ... ICJ.. PERMIT No. LEGAL DESCRIPTION: LOT No . .......................................... BLOCK No. 1-3 .................................... ............................................................................... NAME OF ADDITION .... .............. ......... APPROVED JUN. 2 Approved: DATE.. ... ........ ... 7 ................ By..4� ........... ................... 0 0 - Date: May 31, 1967 Memo to: John E. Moran Supt. of Public Works From: Leif R. Larson City Engineer Subject: Sewer Connection Charges Property Description: West 110' of the .west half of Lot 9, Block 3, South Park Addition to the City of Edmonds, LESS the North .65' thereof Commonly Known as: 1.143 Second Avenue South Owner: George W. Brooks Z.F.F. Calculation: ( .67 ) x (9667 ) = 64.77 Z.F.F. (64.77) x ( $5.50 ) _ $.356.23 Connection Fee Public Works Department Use Only: ( ) Unit x ($25.00) $ Trunk Charge $ Permit TOTAL i ---- - CITY OF EDMONDS Call PR.oapect 6-1107 when work CIVIC CENTER — WATER -SEWER DEPARTMENT is ready for inspection. (No inspec- NO. 2305 tions Saturday, Sunday or holidays-) SIDE SEWER PERMIT ADDRESS ................... u43 --- Second.--Avelau,e... Sszuth- ...................................... ----------------------------------------------------- ------------------------ ------------ OWNER --------- Ge©r9,a-V1•---�=.OIIks------------------------------ CONTRACTOR.----I!y p3wq _-Septic..Tank � Pith City Sewers in accordance -withapplication o n file and governing ordinances. or CONNECT a side sewer ATTENTION IS CALLED TO THE FOLLOWING: i NOTE No. 1—The owners of the pr employe to onstrope ty uct msewer in atreetrit amreatoDo notuct cover anysewerfnside portion ofsewerprortytbefore itlhae been Side Contractor must NOTE No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 3—f side sewer sharpermthave at than least will0binches coverage at property line and 12 inches inside property line; mini No bd to mum grade of 2%. % 'TE No. 4—Trenches failuredue to improper worstreet must be kawhics may and develowithin one year restore completton��l condition. Contractors shall be responsible for NOTE No. 5—It is unlawful[ eept to insert the pipe into the work than is provided for in the permit, or to do any work on the main sewer or its appur- I �ay5.. �^�R�"�,vcti+.�'�•Ala•�r"�"AVM`^1`+..�,.�..,r�"�+,«HT+rn+rwr.'f.';..,�}N"°.�--.fit-=i^;,fi�3'-y,-ova.". CrrY OF EDMONDS I►it iG lyyl Permit No. COMMUNITY SERVICES DEPARTMENT RIGHT-OF-WAY'CONSTRUCTION PERMIT ENGINEERING Issue Date 3 — �49 1 A. • Owner: Washington Natural Gas Company B.. • Contractor: Wig,eMercer Street �oa 5, Name.,, ddress Mailing Address ���' WA 98111 � O � _ R City State Zip CJ""T City State Zip �wv State License Number Telephone Number C. • Address or Vicinity of Construction: 1143 2 Avenue South Type of Work to be Done: Install New Service D. • Work in Connection With: ❑ Sub or Plat ❑ Single Family ❑ City Projects ❑ Commercial ❑ Multifamily kk Utility E. • Pavement Cut: ® Y ❑ N F. • Size of Cut: 2 X @ Gas and Water APPLICANT TO READ AND SIGN 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,, forseen .or unforseen, 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, court 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. • A 24 hour notice is required for inspection; Please call Engineering 771-3202 • Work is to be inspected during progress and at completion. • Restoration to be in accordance.with City Code. • Street to be kept clean at all times. • Traffic. Control to be in accordance with City regulations. • All street -cut ditches must be patched,with asphalt or City approved material prior to end of working day; NO EXCEPTIONS. 1 I understand the above and that this permit, must be available at the job site for inspection purposes at all times. ., � �, ; 1 Signature: /UIeMA4 " Date: March 28, 1991 Owner or Contractor 1 This Permit Must be .]Posted at the Job Site For Inspection Purposes 1 Call DIAL -A -DIG Prior to Beginning Work a Z 0 w E� U W O U. APPROVED BY: Time Authorized: Void after 3-1—,days. Special Conditions: A.1 A RELEASED BY:. PERMIT FEE: ��, Restoration Fee: Receipt No.: Fund 111.Fee: Street Cut Dimensions: I INSPECTED BY NO WORK TO BEGIN PRIOR TO PERMIT -ISSUANCE. Date Eng. Div. March 1989 1 , I7 FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept.) Comments: Diagram: ` ee n� P . I 6 ►nMOuac+v�►������n ee: II¢3 2 F� S. CONTRACTOR C� Partial Work Inspection by P. W.: Work Disapproved By: FINAL APPROVAL BY: Date: ECPR, I aD ENGINEERING haA, Eng. Div. July 198' Addendum to: �?L4 W City of Edmonds Permit Application Engineering Aide Kerry Walsh Washington Natural Gas 622-6767 x 2588 ww -rc) I � I f / I WATE(Z MAIN 'C �"H� ,. / ut-I W- 1- Oww i was ^n PR'�R'�.�O -r`- IN.�� KEY: -ss- sanitary sewer -s- storms -w- water 0 water valve u is l:� �^ .• �.1 i.� Date: ► .,•g I ..19fa7 Memo to: John E. Moran Supt. of Public Works From: Leif R. Larson City Engineer Subject: Sewer Connection Charges Property Description: West U0 of the west half of Lot 9, Block 3, South Park Addition to the City of Edmonds, LESS the North 65' the:mof Commonly Kno7f: 1.143 Second Avauue Z.F.F. Calculation: ( 67 ) x (9667 ) (64.77) x 0 5.50 ) 64.77 $356.23 Owner: George W, Brooks Z.F.F. Connection Fee Public Works Department Use Only: ( ) Unit x ($25.00) _ $ Trunk Charge $ Permit TOTAL n" I _ LIZ F TH G. wet r La? 5.4,PcX fw �i TE1 e l i Y zia�9 1.5� PVq .f +-, �.� ,ram j� 4.✓ ! L{{ N._R•. _ -r.' 1 i IGo6 �..?, i i.:l S -. _s. 'y.�... �,a�►.7 ���ei_i eS�.wiW5r7�a:�ili