1224 8TH AVE S.PDF1224 8TH AVE S
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..City , d Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number:
Issue Date:
A. Address or Vicinity of Construction: 1224 8th Avenue South
GTE to place opperate and maintain a buried sery ce
f B. Type of Work (be specific)'.Wi re from extstin edestal # A473 located at 1230 8th
1.g 9 Avenue South then west to a residence at 1224 '8th Avenue South. GTE to p ow 35' , a
push one driveway•10 feet, and push no road. R.O.W. Footage 5 feet..
GTE Northwest"Incorporated
C. Contractor:'', Marilyn Holmgren. Permit too rd i nator Contact: Jerry Scott 425/774-5921
Mailing Address 2312C W. Casino Rd
Eo.ot%, WA 98204-;4.0 Phone: Marilyn 425/710-0786 or 488-1628
State License #: Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project ;0 Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
GTE W.0.,# 2100-9P001DB 242310
INSPECTOR: INSPECTOR: i
F. Pavement or Concrete Cut: ❑ Yes x ]No G. Size of Cut: H. a'ge $
Please see attached sleet x
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application 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 INSPEC-
TION 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.
Two sets of construction drawings 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 trench work shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
1 have read the ab v stat met d understand the.permit requirements and the pink copy of the permit will be
available on site al ti es f r pecti urposes.
Signature: David Squires Date:
(C nt c or or Agent) Sec. Mgr. -Access Design
CALL IAL-A-DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: —i? �6 RIGHT OF WAY FEE:
TIME AUTHORIZED: VOID AFTER _` �� DAYS DISRUPTION FEEIFUND 111:
SPECIAL CONDITIONS: RESTORATION FEE:
T O.TAL.
RECEIPT
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997
CONTRACTOR CALLED FOR INSPECTION ❑ 'YES ❑ NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
LEGEND
PERMIT SUBMITTED BY
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APPLICATION
The ity of Edmonds for EASEMENT NO - -------------------- ....................... Ac SIDE SEWER PERMIT
FILENEW CONSTRUCTION REPAIRS F LID NO. ASMT. NO. -- ------------
OWNER......... --------------- ------------------- CONTRACTOR -------------------------------------------------------------------- PERMIT NO. --------------------
JOB ADDRESS -1WtZ .................... LEGAL DESCRIPTION: LOT NO . ...........� ..................... BLOCK NO- ------------- ......................
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NAME OF ADDITION -------- ............ % =-- V=�t--L
.......................................................
DATE..... ................. By .......... :1-111, ------- .....................
CITY OF 'ED°M'O° _� S,IDE S'EW;ER rr m ff
.WATEW EWER DEPARTMENT i
I - Calls 776-262Ry'for :side se wer.inspections, BF.FORF.. covering .any 'port iom,oP''the --construction 1
• Inspection_ will be.provided. within 24-;hours.after requst. NO' -Sat., -Suns; or holiday inspections
/,
DRESSY LOC'r1TION OF CONSTRUCTION :.. �?� ���r?T1i i �'nS i� P1
r �...:X1t11W D1d LSIc?17
(fAROPERTY- LEG � ,MDESCRIPTION.... ......: ....... ..
ii
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$ELT •HC'S ? r
f .. OWNER AND/„OR>BUILDER ........ .. , r
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t CUNTR`ACTOR'S'NAME' & ADDRESS........... .. Cdll$TSG CATS•,••
Per»1lsslon is, granted �11111c1>^V , ,,19 7 -,.for repair and/or�connection•of•.a side sewer to tho city _sanitary sewer
s• vn"W accordance with City°of Edmonds ordinances.: " r `•+
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ATTENTIONtISpCALLEDaTOyTHE'FOLLOWING
- NOTE•.No:;•1=The' owners_of. the,property-'may •obtaliv a-:permlt to -construct sewer.-. Inside property,line:•- A llcen_sed Side Sewer, Contractor -must beyemployed ,to;'conatruct=
=:`side•,aewer in'street area.' Do not cover any`portion of sewer.beforeAV has bees -inspected. '+
.NOTE°No..-2 All work'performed`In•jcity'right=of-wayrequlres-,an•Invaslon of Rigiit-of:Way•Permitotitaln2ablr�fromthe Ctty)Engineer a office •( n
,NOTMrNo:, 3 . Obtafn: full'information.,regazding, Ordinance 11.16.030' and 'Regulations ,governing side: sewers -:when' -you- get ,permit.., °
t ;iNOTE: No: 4' -T' .•of, side. sewer>;must ,have'at', least, 30 inches, coverage at ro ert - line::and',12 finches.-inafde, property line;. minimum grade° oP 2 /, ,:+No bends' in -grader
sharper than='/e.will; be -permitted.
p NOTE No.;:5- (-Trenches in :street: must�be,water settled'.and surface,of, street�restored_�'to�orlglnal .condi_tl_on , Contia,cEors shall be :•responelble.'for 'failure due to, Improper
work; which may develop ,within one year of completion,.
+ NOTE No'B—It. fa 'unlawful:fo alter•or.do: any other work than;ls provideda',for In'. -the -:permit; or tondo any•work, on�,the.main!.sewer or it a!appurtenances 16xcept to, in-,'
'F_•),teertAhe•p!6e.lnto-the:wye.-- - - -
S DI5APPItO�'ED ; ❑F. ,Date- ..: •�. ,.,..:.., By..... ...... Date ..:..... � - sy,..:. .. . - Date.:.. -By.:.
APPRO�'EED ]'.,•Date ..... .................... -' By � '.
Remarksr /r..........................................
.: ....: ..... ............................_........ ....... . ......
Permit.Coples:DiUST BeSigned; By APefmuctionPRIORTo ReqestFtion, FCn
_ I� / hereby !certify that the, -side seweriin'stallation constructed under this permit
77
(Owner of Contracting-Firm,Performing .Construction) -
was,installed in'accordance with; all-governing,.ordinances Of th'e+City 'of Edmonds -
DatedAhis .•.-- day. of „.1
9.......:,
Tel hone Power
Check BEFORE ou di for Water Ga Sewer Other , F f
liA y ❑i a❑r P J❑r {, ❑r ❑r a❑
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APPUCATION
A4 City of Edmonds for SIDE SEWER PERMIT — EASEMENT NO. ....... ......... -----------------------
NEW CONSTRUCTION E] REPAIRS E] LID NO. NO- ------------------
OWNER
------------------------------------ CONTRACTOR ------- l�2(�tA - -------------------- PERMIT NO.
JOB ADDRESS I ............. -------- LEGAL DESCRIPTION: LOT NO. � ------- q ------------- BLOCK NO. - -----------------------
---- ------------- . ---------
.........................................................................................................................................................
NAME OF ADDITION ...... ff
S
Approved:
DATE---------------------
32
RFCFIVED-
JAN 2 1976
Public Works Dept.
By-----------------------