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1200 HIGHLAND DR
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT b 4 0 6332
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rCall 7.76-1107 for side sewer inspections BEFORE covering any portion of the construction.)
\Inspection will be provided within 24 hours -after request. NO Sat., Sun., or holiday inspections./
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ADDRESS LOCATION OF CONSTRUCTION... �°..... �. r `a_..H i g h 1 d nd Dr 1 yEa
..................
PROPERTY LEGAL DESCRIPTION ......... Dnf-_...............................
...........................:.............OWNER AND/OR BUILDER._Rpj._An.dei .son...
CONTRACTOR'S NAME & ADDRESS .... ll_yed... aCfte_,... UK! ...-__.Kth_.P1.,...%.,...EdfllmdS.....9ROZO
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Permission is granted ..__....JL.�........................................ 19..... 3, for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City of Edmonds ordinances.
AT*ON IS CALLED TO THE FOLLOWING:
NO o. 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—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. 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 maln sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED ❑ Date ...
_....... By ................ Date ...
........... ...........
......... B .. .... Date ............... _................... By ...
.............
APPROVED ', Date.._.. .. !?� _. y Cam.: _.�l./�,�?By..._. . ......................................................................
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 Perfcrming Construction)
w gulled in accordance with all governing ordinances of the City of Edmonds.
Dated this ..... 2.0 ...........day of......�.li-fY.4-........a........................ 19.2..$.
V V Check BEFORE you dig for: Water ❑, Gas ❑, Telephone ❑, Power ❑, Sewer ❑, Other ❑ V V
The City of Edmonds
APPLICATION `
for
SIDE SEWER PERMT
NEW CONSTRUCTION 0 REPAIRS
EASEMENT No ...........................................
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OWNER I�Y...____I�N(.....ERCONTRACTOR .. ..ALL-IED Bbb CKHOE 43a2
..............•---.._......_..._....._......----•---.........--------......... PERMIT No.......................
ADDRESS ../...............................................H LL�ND--- ........................ LEGAL DESCRIPTION: LOT No............................................... BLOCK No.............................................
NAME OF ADDITION ...................
HIGHL/.�ND
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Approved:
DATE ..... w
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APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT EASEMENT No ...........................................
NEW CONSTRUCTION REPAIRS
OWNER ..... JeAa7 ...... ............................................. CONTRACTOR /a el .... 13.a /t ............................ PERMIT No.
...... ADDRESS ....... .... . ..... ....... D.A ........... LEGAL DESCRIPTION: LOT No .. ........ -------------------------
BLOCK No...... .................................
NAMEOF ADDITION ........ ...... ....................................................................
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Approved:
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DATE................................................ By ............................................................
INTER -OFFICE COAAI U10ATIONS
DATE Apri 1 24 19 75;.
T o UTILITY BILLING FROM BUILDING DEPARTMENT
SUBJECT: Change of address
On April 23, 1973 Ray Anderson was issued a new residence
permit for 1204 Highland Drive, permit #730210.
He put house numbers on with the address of 1200'Highland
Drive. Mr. Albert A. Beal bought the house and had every-
thing., with this address except the utility billing.
Please change the address to 1200 Highland Drive.
Thanks
Ann
CITY OF EDMOl DS LARRY S. NAUGHTEN
250 - STH AVE. N. • EDMONDS, WA 98020 • (206) 7713202 MAYOR
COMMUNITY SERVICES: PETER E. HAHN
Public Works .Planning • Parks and Recreation • Engineering DIRECTOR
890.199
January 22, 1990
Mr. Lars Matthiesen
1200 Highland Drive
Edmonds, WA 98020
Dear Mr. Matthiesen:
ST S,F�JF��F
It is the intention of the City of Edmonds to proceed with the raising
of the sanitary sewer cleanout located on your property and lying in
the utility easement.
This letter serves as a notification that the City crew will be
accomplishing this task depending on weather conditions and or unknown
factors.
We ask that you remove any shrubs that are in the utility easement. As
planned for originally, the City of Edmonds will remain in the designed
location within the utility easement.
Should you have any concerns, please call 771-3202, extension 317.
Thank you for your cooperation.
Sincerely,
Archie Brena
Water/Sewer Section
AB/lk
cc: Bobby Mills
Public Works Superintendent
HIGHLAND/TXTSEWER
• Incorporated August 11, I890 •
Sister Cities International — Hekinan, Japan
C.
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT
Permit Number. q
,
Issue Date '5
'1L
A. Address or Vicinity'of Construction: 1200 Highland 'd
GTE to place, operate, and maintain a buried service wire
8 9 9 B. Type of Work (be specific): from existing pedestal #5540 1 mated at '40R 17th AV N
0 1 then north to a residence at 1200 Highland. GTE to pbow 80 feet, push one
driveway and no roads.
Mary A Bower, Permit Coord.
Contractor: GTE Northwest Incorporated Contact: Dennis Alaxandpr 771-4019 nr mobile 'ARR-1158
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Mailing Address: Fvwrntt, ULa a820401s-1k00 one: or 206/710-4130�ianT—�96,�488-1628
State License fi: Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit 11(if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project ® Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other 2100-9P001 DB '-242310
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut : ❑ Yes ®No G. Size of Cut: x H. Charge $
APPLICANT TO READ AND ', _ :SIGN
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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, 771-0220.
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.
1 have read the above statements and understand the permit requirements and the pink copy of the permit will be
available on site at all times or inspection purposes.
Signature: � Date:
April 30, 1996
(Contractor or Agent) Oprns Supv-OSP Engrg.
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: 4-. , 4 A RIGHT OF WAY DEPOSIT_
TIME AUTHORIZED: VOID AFTER �''� K' DAYS . DISRUPTION FEE/FUND 111:
SPECIAL CONDITIONS: r�!'r RESTORATION FEE:
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PERMITIFEE:, 3(v n
TOTAL FEE:
COMMENTS: RECEIPT FEE:
s
DATE::- ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
FIELD INSPECTION NOTES
Comments
Diagram
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
(Fund 111 - Route copy to Street Dept.)
❑ YES ❑ NO
Date:
Date:
N' PEWIT SUBMITTED BY
GTE
LEGEND a;
PO ES o
ROAD BORES
OVERHEAD LINES
i.D. UTILITY POTHOLE G7
UG TRENCHING --iJGT
19
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