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1421 9TH AVE N.PDF1421 9TH AVE N CITY CLERK CLERK 5-18-90 E��RIHs�wATER 98020 CITY OF EUfdONDS S.P. N0. 5_�ti_a7 LEGAL DESCRIPTIONS LOT 2 That portion of Government Lot 4, Section 13, Township 27 North, Range 3 East, W.M. in Snohomish County, Washington described as followsl Commencing at a point on the East line of said Government Lot 4 N 0009'00" W 271.08 feet from the S.E. corner of said Government Lot 41 thence N 84°17144" W 10.05 feet to the POINT OF BEGINNING; thence continulng N 84°17'4fit" W 160.25 feett thence,N 0009*00" W 80.00 feett thence S 84°17,t4" E 160.25 feett thence S 0*09*00" E parallel with the East line of said Government Lot 4 80.00 feet to the POINT OF BEGINNING. TOGETHER WITH a 113 undivided interest in an Easement 10.00 feet in width for utilities hnd storm retention over and under that strip of land more particularly described as followst Commencing at a point on the East line of said Government Lot 4 N 0009'00" W 164.08 feet from the S.E. corner of said Government Lot; thence N 71050'44" W 167.91 feet to the POINT OF BEGINNING; thence continueing N 71050'44" W 109.54feet; thence N 0009'00" W 117.39 feett thence S 84017'41" E 10.05 feett thence S 0009'00" E 109.14 feett thence S 71050144" E 88.48 feet; thence N 0009'00" W 48.32 feet; thence S 84017'44" E 10.05 feet; thence S 0009'00" E 61.13 feet to the POINT OF BEGINNING. FO;-i I ":0- DING CITY 1;:;= EDMOND3 ; C.Y �S PAGES 9101-290623 CITY C EMIONDS P.1'. ['_PT. [NGINEEpIr4G DIV. DA !! 0222 o W"011 e- 10 I I za 41 M. PROPERTY UNE OVERHANG ABOVE 7n L^ i/�/�' j-\pr6p0sjDd' DECK Prop�se4 \Giara" ge e S(clenc/e LU ELECT. 0 / i' SERVICE ul hy ENTRANCE DRIVE % NY APRON /—SHALL :ONFORM v.-q r4 4PAVEMENT 1 USPHALT TO CITY STANDARD I t". . DESIGN REOMEMENTS DRIVEWAY 0 C0 -3 �. I ... -1 -,1 " _N PROPERTY UNE it It, Ivor,,. C Ot tec 0 tv/ 4. sus.0, A. "e, Derelv TO r/O QFIA Li '�le�,-.' - _ rs ,ia►. aN... ..KYK`��"4r�r�yn't'a'^+arid,-li.'(sWiv�'i'r+'y;�wy`� Ya�5+�,7nv+R+;..�ttw,h,.x�`i:..,�ti^ a Z O W V) E- U <x O w V itCITY OF �EET ILE RECEIVED COMMUNITY OSERVICESIEPARTMENT RIGHT-OF:WAY CONSTRUCTION PERMIT AUG 2.. 3 1991 FNr0% A. • Owner: Washington Natural Gas Company B. • Contractor: )Me Mercer Street Njd ieglAeddress WA 98111 GO 01 2 City State Zip y,�p,N� Permit No. Issue Date Name Mailing Address City State Zip State License Number Telephone Number C. • Address or Vicinity of Construction: 1421 9 Avenue North Type of Work to be Done: Install New Service D. • Work in Connection With: ❑ Sub or Plat E Single Family ❑ City Projects ❑ Commercial ❑ Multifamily ❑ Utility E. • Pavement Cut: ® Y ❑ N . F. • Size of Cut: 2 X 4 (1) @ Gas h 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 orbemployees, including or not limited to the defense of any legal proceedings including defense costs, courtAosts,- n attor�ey fees by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD 4ONE 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. ,l • 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. I understand the abgve and that this permit must be available at the job site for inspection purposes at all times. Signature: Date: August 13, 1991 Owner or Contractor This Permit Must be Posted at the Job Site For Inspection Purposes Call DIAL -A -DIG Prior to Beginning Work APPROVED BY: R� Time Authorized: Void after C0C._T Z9 days. Special Conditions: WA RELEASED BY: PERMIT FEE: Restoration Fee: Receipt No.:_ Fund III Fee: Street Cut Dimensions: x = $ W—,23-7/ . INSPECTED BY NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Date Eng. Div. March 1989 FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept. Comments: Diagram: CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Eng. Div. July 1985 s � A M M M WhshkKjton M� Nahn-M&W�I� AVA hii EnergyG-paW 1421 q A--V ► A WN V�p'Wa un 2 Addendum to City of Edmonds Right of Way Permit Application Submitted by: Kerry Walsh Engineering Aide Washington Natural Gas 622-6767 x2761 pager 995-6914 1 (ZK4)g? 815 Mercer St. (P.O. Box 1869), Seattle, WA 98111(206) 622-6767 iydrant Q water valve APPLICATION REQUIREMENTS TO: Permit Coordinator, Building Division FROM: Lyle Chrisman, Engineering Inspector OWNER: PLAN CK # ADDRESS: DATE: 41J25� 1 /--1 1 After review of the subject permit application, the following requirements mustbe met. 1. Construction hours are: WEEKDAYS .......... 7:00 A.M.-10:00 P.M. WEEI ENDS/HOLIDAYS.....10:00 A.M.-6:00 P.M. 2. A separate RIGHT-OF-WAY- Construction Permit is required for all work on Publicproperty. (ECDC 18.60) 3. Truck haul route plan must be submitted and approved prior to permit issuance. 4. Builder/Owner is responsible for containing all temporary runoff and erosion control on site. (ECDC 18.30.030d) S. NO WORK SHALL BE DONE WITHIN 15 FEET OF STREAMS OR 10. FEET FROM ANY CLOSED DRAINAGE FACIL- ITY.. BUILDERIOWNER IS REPSONSIBLE FOR IDENTIFYING CONDITIONS ON THE DRAWING. (ECDC 18.30.50G) 6. FILTER FABRIC FENCE SHALL BE INSTALLED AND INSPECTED PRIOR TO CLEARING AND CONSTRUCTION. . (ECDC 18.30) 7. INSPECTIONS ARE REQUIRED ON STORM DRAINAGE SYSTEMS, TIGHTLINES, FOUNDATION DRAINS, AND CATCH BASIN INSTALLATION. INSPECTIONS ARE REQUIRED PRIOR TO BACKFILLING. (ECDC 18.30) . 8. Repair or replace all defective existing curb, gutter, and sidewalk adjacent to the property. If an intersection is involved a handicap ramp maybe required. Contractor shall meet with the City Engineering Staff to determine the extent of repair prior to issuance of the permit. (ECDC 18.90) 9. Driveway slope shall not exceed 14 % without a waiver. Every attempt should be made to keep the slope below 14 %. Waiver granted to %. (ECDC 18.80.060D) 10. Driveways must be paved from property line to City RIGHT-OF-WAY. A separate perimit is required. (ECDC 18.80.060C) 11. INSPECTIONS ARE REQUIRED ON DRIVEWAYS AND SIDEWALKS PRIOR TO AND AFTER POURING. (ECDC 18.30) 12. No burning of construction refuse without a permit from the Fire Department. 13. Connection to City water system is required. There is a separate charge for the water meter. (ECDC 7.30) 14. Aback water valve is required if downstairs plumbing is below the elevation of upstream manhole. (ECDC 7.20) 15. Water and sewer main lines should be separated by 10 feet minimum. (ECDC 18.10) M. Connectio a to the City sanitary system is required. A separate permit is required. LID# zO Fees paid: Yes \,,/ No Charges (ECDC 18.10) 17. Underground wiring is required on all new construction; and for additions, alterations, and repairs that exceed 50% of the total assessed value of the structure. (ECDC 18.05.010) 18. A FINAL ENGINEERING INSPECTION IS REQUIRED PRIOR TO THE BUILDING DIVISION GRANTING OCCU- PANCY OF THE BUILDING OR STRUC77IRE. (ECDC 18.90) 19. 9N -- 59i6 h}e4 our) t;Z60- ) STRU s ;+ L "I REET FILE PROJECT REVIEW CHECKLIST PROJECT NAME: 00 PROJECT ADDRESS:1A J , ' . jai Reviewed By: w fi� s tt'�.�" r PLAN .CHECK #: RECEIPT DATE:-=; D BY: (nitiat/Da e PLAN. WATER ,COMMENTS .' ': FIRE RLDG.` SEWER STRE ENG Setbacks/Variance/Setback Adjustment. Conditional Use Permit ? ADB Requirements Other ZoningRequirements Underground WiringRe uired 5 Lot Slope 15% SEPA Environmental Checklist/Hydraulics Permit Tree CuttingPlan Plat/Subdivision Requirements 5-2G-0-7 . Legal Descrition Verification ©[L • .: fir. Quit Claim/Street Dedications:" t ZF 11 Easements - Public/Private 42 12. Engineering Storm Drain Review Fee Z� _°.<`<': <:.v•«<>h.:° '_<<s> °<;>..;->`<> En ineerin Inspection Fee r; � �.,,v>> aa� > > T' t�<��;w�G>r, :< 2 ,. 14 ." Drainage Plan On -Site �-261.t;G:. v+••'•>i.i:G i::.,,V.,�{:•'iv^-•.tr'G}l+,k;:. rJ1r.',:••i^'•Y:+•'jyj•. ' y ]i'fi• Yl. f.4`vr ,.< ;::, Zj 15' Setback - To of Bank; Stream, Water Courses �•' `16 < S Setback -Storm Drain Line vn - 17 Open Ditch - Existing Culvert Required;;...:..::.:,,... r �{ 2 -y g Culvert Size YG h:. f.... .... .............<. ::: z 1, 20.. Shoulder Drainage/Shale O en.Runoffx x f` Y ' z j 21...' Catch Basin Required ,.... :<: f 22:.. DrivewaySlope & Vehicle Access 4� 4 G Sidewalk Required — Curb & Gutter Required: �� v• :•.:sv.`'`.. ZS -25 Curb Cut -For DrivewayRequired ;Jo:: `>`;:<: �]C Street PavingRequired27 .... Right -Of -Way Construction Permit Required ,;.. f; ° Street Name Sign Required .. rrr, r ` fv% •� zs 29; Other Signing Required4::•>:'•:f:;<:.,•:.::' :.;;:t.;ri<;.30 Bond Required For Public Im rovementt N FEMA Ma Check: Check/Water Table :: 44:; rw k >;:w:>:::w <F:r«>><>:<:: Z 32 Side Sewer Availabilityej k:; a:::r «:"::: Z " S 33" Calculate Sewer Connection Fee If No LID # :ff; •:<:;;;V:>:;<:.:,;:.�•.: ><>« <<<• •. 5- . 34<. Create Street File {4 1 5 ExistingWater Main Size :..:. ......... ..:: _ 36 Water Meter Size :. 37 Service. Line Size �� :} 4 >:38 Water.Meter Charge Required - (5 o w 39 Hydrant Required ' .... 40 Hydrant Size Existing :.::.......:::. 41 Fire Line. Charge Required - Sprinkler s r,N,v.--'42 �_ Street Cut Miscellaneous '< °„ ::: `'• 43; -.44' ; FIRE PLANNING c. i s, /�A L-E!-- i>{•' ENGINEERING PUBLIC;WO.RKS• t Sji�f j�rn .i'?a 1 r._ o.. r� CITY OF s SIDE SEWER PERMIT �89p 19PERMIT '',l 8319 Address of Construction: Property Legal Description (Include all easements): a TREATMENT PLANT Owner and/or Contractor: PAAi Xvsco OUb_4I 4 State License No, ` hjM tfS 6AT5057,T Q Building Permit No. C7 Single Family ❑ Multi -Family (No. of Units ) ❑ Commercial ❑ Public I Invasion into City Right -of -Way: /No❑ Yes RW Construction Permit No. Cross other Private Property: I No ❑ Yes Attach legal description and copy of recorded easement I certif th I•have read and shall comply with all city requirements as in cat d on the back of the Permit Card. :l f� y Date * CALL DIAL —A —DIG (1-800-424-5555) BEFORE ANY EXCAVATION * OFFICE USE ONLY _ * FOR INSPECTION CALL 771-3202, PUBLIC WORKS DEPT. � � Permit Fee: Issued By ,xq_- J Trunk Charge: ' Date Issued: 7 // /— VN Assessment Fee: / Receipt No.: Lid No.: — Partial Inspection: Date Initial. Comments Reason Rejected: Date Initial Final Inspection Approved: Date'Z_-�4 Initial ** PERMIT MUST BE POSTED ON JOB SITE ** White Copy: File Green Copy: Inspector Buff Copy: Applicant Revised 3 !90 The City Of Edmonds Side Sewer Drawing EASEMENT NO - -------------------------------------------- NEW CONSTRUCTION [j� REPAIRS ❑ LID NO- ------------------ -ASMT. NO................... QWNER CONTRACTOR PERMIT NO. U-3.------.--- JOB ADDRESS k-4 Al q.T'll ------------ ------------------ -dim N (b -9!5< PWW-000 1 - 11/75 (REV.11/78) LEGAL DESCRIPTION: LOT NO- ------------------- ------------------- BLOCK NO. -------------------__--------- EDMONDS TFEAI tviE.�vT PtA�- -- NAMEOF ADDITION----------------------------------------------------------------------------------------------------------------------- J 1. q 1.1 m " 1 -0-1 l 2 J•c to c"jo. C d) Joy %�,D•� -.5 Ve- Approved: C� / o _ DATE .��-� 1 1........--•--••-- BY---•-C,j/ i M + — USE ZONE `C' PERMIT /�� NUMBER 9-1051. /ry CONSTRUCTION PERMIT APPLICATION jogADDRESS �' ) SUITE/APT# OWNER NAME/NAME OF BUSINESS .r /4j 91)a�- XA&A) LEGAL DESCRIPTION CHECK SUBDIVISION NO. LID w MAILING ADDRESS ���-•- S — az /NO.. '�`� 3 �714 /J1p n /�y_ 7/q L TESCP Approved ❑ O / / PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP, pp oved CITY ZIP TELEPHONE NUMBER {�%�f / 3 �� I� EXISTING REQUIRED ( DEDICATIO RW Permit Required Street Use Permit Req'd ❑ /�I / � PROPOSED O Inspection Required )41 Sidewalk Required I,U_; ❑ 0 Z NAME %Z�LI ,Aa Pi:2 / �t l Y�1 REMARKS w w V l�i�/ ADDREEESS T (� U,Ca �,LI[ %Yi f� Z 0 = 7 n i 5;H Av E S. W CITY ZIP TELEPHONE NUMBER G� I O�7 '7'7 1IL- 9400 NAME1(tiLnC� ice- /OV �''n�f „�n� �,J� `( ENGINE RING EMO DATED �i EVIEW V �g ��ZrJ I cr U ADDRESS / �J q' I a S 3 Z n7 (,�J„��J��-% 6T METERS E, BUILDINGUPPLY SIZE I NO. OF FIXT RES / CITY ZIP LEP�HOONE NUMBER 1G� w O {� REMA t' r a 3 U STATE LICENSE NUMBER to 3 /-Y/i�rv/�-- r— /� SIGN"AREA SEPAREVIEW ADB N0, ALLOWED, PROPOSED COMPLETE EXEMPT Legal Description Of Property - Include all'easementS Q � L SHORELINE# O jQ /7 T C/ EXP .. - a VARIANCE OR CU PLANNING REVIEW BY �7- DATE m u, SETBACKS HEIGI�T ? W —FEET FRONT Zp SIDE 'S� REA IL6T'COVtRyf3 G C z J Tax Account Parcel NO.,,, REMARKS c a 11 LO NEW RESIDENTIAL PLUMBING ElADDIALTER COMMERCIAL MECHANICAL ElREPAIRAPT. BLDG. : SIGN GRADING FENCE ElDEMOLISH CYDS. ❑- I x_FT)' -;,,11. CHECKED BY' TYPE OF CONSTRU . TION CODE HEIGHT El REMODEL CARPORTSWIM, POOL SPECIAL INSPECTOR AREA OCCUPANCY GROUP OCCUPANT REOUIRED ❑YES LOAD WOOD STOVE RETAINING WALL/. INSERT ROCKERY RENEWAL. . REMARKS O P0 (TYPE OF USE. BUSINESS OR ACTIVITY) EXP IN: PROGRESS. INSPECTIONS PER UBC 305 Z 0 to y NUMBER OF STORIES NUMBER OF, . "' 0 DWELLING m UNITS DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN) 1n1z40N V FINAL INSPECTION REQUIRED -- U�+ VALUATION FEE PLAN,CHECK FEE_,'499 BUILDING L% 976 �• PLUMBING Plan Check No. ( _ MECHANICAL as GRADING/FILL This Permit covers work to be doneonprivate property ONLY. Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE Permit Application: 180 Days STORM DRAINAGE FEE; cra Permit Limit: 1 Year - Provided Work Is Started Within 180 Days ���) "Applicant, on behalf of his Or her spouse, heirs, assigns and ENG. INSPECTION FEE 3C — successors in interest, agrees to indemnify, defend and hold W harmless the City of Edmonds, Washington, its officials, 5 employees, and agents from any and all claims for damages of Cr whatever nature, arising directly or indirectly from the issuance PLAN CHECK DEPOSIT ,. of this permit. Issuance of this permit shall not be deemed to 0 modify, waive or reduce any requirement of any city ordinance = nor limit in any way the City's ability to enforce any ordinance TOTAL AMOUNT DUE �j provision." I hereby acknowledge that I have read this application; that the ATTENTION APPLICATION APPROVAL information given is correct; and that I am the owner, or the duly authorized agent of the owner. I agree to comply with city and THIS PERMIT This application is not a permit until state laws regulating construction; and in doing the work authoriz- AUTHORIZES THE signed by the Building Official or his/her ed thereby, no person will be employed in violation of the Labor Code of the State of Washington relating to Workmen's Compensa• ONLY WORK NOTED Deputy; and fees are paid, and receipt is tion Insurance. INSPECTION acknowledged in space provided. ATURE (OWNER OR AGENT) � A DATE cjIGNE DEPARTMENT CITY OF OFFICI 'S SIGNATURE DATE �• Z�r EDMONDS A TENTION CALL FOR INSPECTION ELEASED eY: ATE b> % IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE 771-3202 UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR ORIGINAL — File YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. PINK — Owner GOLD — Assessor 102.er n.. D TBEET. F1 I OF EDMON n COMMUNITY SERVICES DEPARTMENT RIGHT-OF-WAY CONSTRUCTION PERMIT p.� RECg%y p \Permit No. ��=a J!!� Iste Date,+`-025 _ 1 UL 2 5�J191 ?'AmES MCCfoyERIJ IbUIQ�Mflk*ttractor: A. *Owner: S1VII6H C4uN1A PV 0 Name. Name '2-53Z E MCC,.RAW ZI01g Amy Mailing Address Mailing Address S6--WrrLE. (wlA cis 17- a z.DMoNDS W-A <6 0Z6 City State `- Zip City State Zip �a-T MAR -TIN 6v-3zc�'7 State License Number Telephone Number C. • Address or Vicinity of Construction: 14Z1 9-VA AV t\I 911 DQ►FTWO�]i LN Type of Work to be Done: I WS-riR%-.- vwDER•`RoUND FiM it-ITIf_�-S onI fg_xtSTttJ& Pat-E-S.TRAiX 1N Rlw � goR� uNDEA. S�,R�TS -ry S�Rub IJEw NomES D. • Work in Connection With: ❑ Sub or Plat C ngle Family ❑ City. Projects ❑ Commercial ❑ Multifamily ❑ Utility E. • Pavement Cut: ❑ Y W'< F. 0 Size of Cut: X 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//_'I • 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. I understand the above and that this permit must be available at the job site for inspection purposes at all times. Signature: 64.'^." Date: Owner or Contractor This Permit Must be Posted at the Job Site For Inspection Purposes f Call DIAL -A -DIG Prior to Beginning Work APPROVED BY: 3 PERMIT FEE: c29 A h &e. a ���, OTime Authorized: Void after 1d�s,� days. Restoration Fee: w Special Conditions: Receipt No.: Fund III Fee: Ems- Street Cut Dimensions: X $ U RELEASED BY: Date 1' INSPECTED BY �!�" Date a 0 w NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. March 1989 ,i? FIELD INSPECTION NOTES (Fund ..l I I Route copy to Street'D 'P.1' Comments: Diagram: CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO Partial Work Inspection by P. W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: Eng. Div. July 198 Z ZOAP )OQ(ZS l 1476 i PUBLIC UTILITY DISTRICT NO.1 OF SNOHOMISH COUNTY REV. 7/a7 LOCATION 14-ZI 9TN AV IJ 1-7 DQ%FTWooD LW SO CO AREA j POLE NO. SW 1/4 S 1 3 T Z, R 3 DATE 7- I S- 9 1 W.O. N0. 3Z MART I N DWG. NO. REASON FOR WORK FC IACr S V(- S 4j:�a ENGINEER 7:Y-t M M c-( C> v Q tJ DRAFTER U.G. N0. SCALE I'l = 100' APPROVED DATE PRINTED c-AS -- DATE WORK COMPLETED FOREMAN ENVIRONMENTAL ANALYSIS ® EXEMPT ❑ NOT EXEMPT FEES REQ D SUBSTATION NtAPt_(= W 00 D ® YES ❑ No PARA. 18 ITEM C j CIRCUIT N0. \Z-345 PHASE # Z 1 PRIMARY OVERHEA O.H. U.G. COND. KV ❑ RESIDENTIAL ADD CKT. FT. PH ❑ COMMERCIAL REM CKT. FT. PH LEO# NET CKT. FT. O.H. U.G. COND. KV SECONDARY OVER EAD BASIC E $ ADD CKT. FT. PH REM CKT. FT. PH t Z 3 NET CKT. FT. ------. METER CONY. ­ POL ... $ PERMITS (DATE GRANTED) t. PRIMARY UNDERGROLND ❑ TREE TRIM ❑ RESIDENTIAL ❑ STATE ❑ COMMERCIAL ❑ COUNTY L BASIC E LEU# A CITY EDr OQOS -- - -. . O A .t� SORE ...:.... _...:. - .. EASEMENTS SECONDARY UNDERGROUND REQUIRED Cl NOT REQUIRED -Z_ . :BASIC FEE $....- - P-sso-s UNDERGROUND PLAT: _...._ ......-.-- _ BASIC FEE $ DATE RELEASED - I... FOREIGN*_CONTACTS ♦ tFT. ❑ GTNW JPN# STREET. LIGHTING o CATV JPN# 6 27 q 0%9-1 FT. ®$ / _ $ *JOINT TRENCH GTNW & CATV ��az INSPHk4-1 ¢ns5 I WORK.:.iN.' RIGHT 0 WA W.JOINT BORE GTNW & CATV ....._......... ❑ PRIMARY ❑ ® SECONADARY oo POLE STENCILING eov_ . B i 4-0 t FT. ® $ �-oA / _ $ Z �d0 - FROM TO MISCELLANEOUS FEES TAKE OFF POLE- PRE-CONSTR. REQUIREMENTS VAULT $ �e' CDMoN0S PERMIT $ -2)Q ❑ TREE TRIM ❑ PUD LOCATOR ' �rw $ IN BACKHOE ❑ <-y- 4 c N D,QT `"' $ W ONE CALL DATE ' 2 $ # INDEX POLES PLAT TOTAL DUE $ 1 S�tO �o LOGS U-MAP DATE PAID XFMR C-MAP RECEIPT# LOCATION MAP PAGE Se D- NEW SVCE APPLICATION# W 1NSTAl-L 3" SEC R\S�� 0�1 %�1STiNG PO%.E ->�ENCN WEST,"'T� ASP�iR�.-f , BORE UNDc-2 gT" 1FW ►J 2-7' ANO A 11JS7 all _,PJC.;. TQ�NLFi 15 WOQ-TH INJ tJ tiNSTALL StG P�DES�L AZ PROP ( 0P_WCt- O 10C)a DC Wtj RISER , A L Q.oSs 11 Av NJ Tv �v r✓t 10I P6cD�STAI- %QSTA0-%- -s gRtt CoNN4_Lc-r0RS Itj Pao W-O- #' 32- ilJST(tLL S" Sic. 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