1258 CORONADO PL S.PDF1258 CORONADO
PL S
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER: t,�v"✓� �Z�D ��i�(i
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT
SIDE SEWER AS BUILT DATED: �1�_5�-- 7 Z
SIDE SEWER PERMITS)
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
LID #:
LOT:(-15'
BLOCK:
WATER METER TAP
GCARDD DATED: , I �
OTHER:MW O�'"'1 I 1 �.�f(A�� �i001i �P-IAA
L:\TEMPOST'sTorms\Street File Checklist.doc
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT EASEMENT No ...........................................
NEW CONSTRUCTION ❑ REPAIRS ❑
401-01800
OWNER........... Fa...Ka---Bru.cp---------------------------------------------------------------------- CONTRACTOR..........-----------••-------.......................-•-•-------.....---.......................... PERMIT No. ......................
ADDRESS --....1258 Coronado Place
................................•-•--........... LEGAL DESCRIPTION: LOT No............................................... BLOCK No.............................................
•
C,
•
NAMEOF ADDITION..................•-••-•-------•----....----•----...........--•----••---.........--•-••--•----•--........................................
Dye Tested On Sewer 1972
Approved:
DATE................................................ BY•---..................---•--....-•---•-•----•-•---....................
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction
1258 Coronado P1
• Owner:
Name
Washington Natural Gas Co
Mailing Address
305 156 RV ATE
• Contractor:
State, Zip Code
Name
SAt2'R AS .APltziP
Mailing Address
,t 91
City, State, Zip Code
Permit No.
Issue Date
• Permit Issued To:11
• Type of Work to be Done:
ZnsLZsll New services
• Work in Connection With:
❑ Sub or Plat HE
❑ Comml. / Ind. ❑
• Pavement Cut: ❑
State License Number
Telephone Number
Single Family
Apt. Condo.
Yes ❑ No
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: 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 City of Edmonds, or any of it's 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 to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit must be available at the job site for inspection purposes at all times.
Signature: Date Anr 24. 1981
Owner or Agent
1r THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES * 1t
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: '
Time Authorized: Void after i.� days
Special Conditions:
Ammendments:
Permit Fee:
Security DepSTU
Receipt No.:
Fund 111 Fee:
Street Cut Dimensions
X =
RECEIVE®
tit tit .NO, WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * NOV 10 1981
Eng. Div. December 1978
FIELD INSPECTION NOTES
(Fund. 11, .oute cony to Street Dept.
Comments:
Diagram:
Contractor called for inspection,. Yes NO
*,Mork DisaPproved By: Date: Bv: Date:
Work Approved By: �--Date: z
Inspector:,
Ena. Div. December 1978
Wa� �+}p l��.ea� Q(�������� b' •m
Y YAMO�C/�ilY @WL9.1 vnm.u..J
Awasrw bnEnergyCo pain
COMMUNITY DEVELOPMENT DIVISION
CIVIC CENTER
505 BELL STREET
EDMONDS, WASHINGTON 98020
Gentlemen:
[Washington Natural Gas Ccrpany hereby applies for perntission to:
Permission is requested to install 2" Plastic gas main in
Coranado Place from 88' to 178' North of the centerline of
14 Street S.W. (Birch Street)
Per Attached Drawing: 813-117
t••e would like to begin construction aboutMay 81 and will rec{ui�-e
approximately 90 da+rs to c— lete the work. If we have your
approval to proceed, please sign and return the original of t-tis form.
(Please enter any special conditions . )
Application Date May 22, 1981
STREET FILE
;,MEdING N NATUPAL CAS C(.MPP2sY
a Douglas V . Darn
Distribution Engineer
Eastern Division
Washington Natural Gas is hereby authorized to perform the woeK described
above in accordance with their fraud -rise responsibilities and are further
subject to all applicable federal,state,c:.ounty and/or municipal ordinances
and specifications.
Approval. Date,_���/
NOV 10 1981
Sf1' i;f-;h A%criue Nt,;th {'„ti1. ficil�'�ur. "%'utihinvion OMv)- lrlr( h+ n_ 120( 'Dir.OfPublic
Works
10
i
•
RECEIVED
NOV 10 1981