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1450 OLYMPIC
VIEW DR
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RECEIVED CIt
. of Edmonds y :TRE Y •
F-WAY CONSTRUCTIO
FILE
ENGINEERING 1 EluriiT Permit Number: /
. r.
890 19�v
Issue Date:
A. Address or Vicinity of Construction:. 1450 Olympic View Drive
B. Type of Work (be specific): Install New Service
C. Contractor: Washington Natural Gas Company Contact: Frank Swan -
Mailing Address: 815 Mercer. Street, . Phone: 224-2278
State License #: Seattle, WA98111 Liability Insurance: Bond: $
D. Building Permit #. (if applicable):
Side' Sewer Permit,# -(if applicable):
E. . ❑ Commercial . ❑ Subdivision ❑ City Project � Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR: NO-Y L_ J ,
F. Pavement or Concrete Cut :. ❑'Yes ®No G.. Size of Cut: x H. Charge $
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the Cityiof Edmonds. harmless from injuries; damages, or
claims of any kind or description whatsoever, foreseen or unforeen, thai%wTbew.made agbinst th? City of Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal proceedings including defe a costs, and attorney fees by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATF1 OR PPERIJD O�,0 YEAR FOLLOWING THE FINAL INSPEC77ON
AND ACCEPTANCE OF THE WORK. ES77MA7ED RESTORA77ON FEES WILL, BE HELDJUN77L THE,FINAL S77ZEET PATCH IS COMPLETED BY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED -FOR ISSU,4NCE TO, THE APPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the. Engineering Department- 771-3202.. x
Work 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 regulationsas 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.
I have read the above statements a{nd understand the permit requirements and the pink copy of the permit will be available
on site at all times for inspection purposes.
Signature: Date: January .15, 1992.
o ra or"A ent) ,
T,::;;2.
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
n
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund 111 -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
i L ?
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Washington
Natural Gas
AwaSVXjta, Energy car,parry
Addendum to :
Submitted by:
lq�50 0L-4 vw Dr�
City of Edmonds
Right of Way
Permit Application
Kerry Walsh
Engineering Aide
Washington Natural Gas
622-6767 x2761
n-a9.5-'6.9-YA
Y
-w- water
-g- gas
-ss- sewer
water hydrant
815 Mercer St. (P.O. Box 1869), Seattle, WA 98111 (206) 622-6767
STREET FILE
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City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Pe .
rmit Number.
Issue Date:
A. Address or Vicinity of Construction: 1450 Olympic Dr
GTE top ace, operate, and ma ntain.a burieg service
18 B. Type of Work (be specific): wi re from exi sti ng pedestal VB286 1 ocated at Forest
9 0 1 9 Dell Or & Olympic r then ea t to a reside c at 1450 Olym i ppr. GTE to plow
58 feet, an3 push one roan 12 feet. R!8A 25 feet
Mary A Bower, Permit Coord.
C. Contractor: GTE Northwest Incorporated Contact:'Dennis Alexander 771-9036 or mobile 388-1358
Mailing Address: Everett, WA 98204-1400 Phone: Mary 206/488-1628
State License fi: Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit tt (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project )M Utility (PUD GTE; WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other 2100-90242310
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut. ® Yes ❑No G. Size of Cut: 2ft ax 5ft H. Charge_$
° To expose existing water line.
}
APPLICANT TO READ AND SI N
INDEMNITY: Applicant understands and by his signature to this application, agrees.to hold i � ity of Edmonds harmle� from'njunesldamages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made agaiXpVlthe 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 ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALSFOR AA �ERIOD OF ONE YEAR FOL�OWINGITHE 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.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be
available on site at all, timesApasicn purposes.
Signature: .
`;:: ��, JH. Stewart Date: May 10, 1996
(Contractor or Agent) Oprns Supv-OSP Engrg.
CALL DIAL -A -DIG PRIORTO BEGINNING WORK'
a
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
FIELD INSPECTION NOTES
Comments
Diagram;
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P.W.:
.Work Disapproved By: Dater
FINAL APPROVAL BY: Date:
05/07/96 15:09
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CAI T Y
S E P T I C
TO WHMM IT MAY CONCERN:
STREET
FILE
O F EDMONDS
'TANK APPROVAL -
This is to certify that the septic tank: for
has been inspected and are according to City of Edmonds standards
DATE:
Insp e
•
CITY OF ED't� ONDS
•
LOT APPROVAL STREET
NAME ADDRESS.
ADDRESS OF PROPOSED BUILDING I-i✓r0 O,G 1c
LEGAL DESCRIPTION: LOT_/BLOCK 4 ADDITION
TYPE OF USE NO. OF BEDROOMS_ SIZE OF LOT Y
SOURCE,OF DRINKING WATER: Public Supply )C. Private Well
Ar URFACE DRAINAGE
1, Is disposals. field site well drained? t-
2. Any water course (stream, drainage ditch, et o) through site? N6.
B,. TOPOGRAPHY
31.. Any heavy slopes in field area? //6
2. Will present topsoil in field area be removed or graded before field tiles:
are installed? /l/n
3. Will any fill material be used in the disposal field site? Ve s-
If yes, how much?
Co SOIL CONDITIONS'
le Has a hole at least 4 feet deep been dug in the disposal field area to
determine the type of soil present? Ilex
2. After hole is dug record the soil__ conditions at the following depths.
(Record as sand, gravel, clay, packed sand., loan, etc.)
12 inches ,I o fffri 30 inches f�;,h (,91eeell lv/ Ye/
18 inches 7 e, ou�n 36 inches a /IFbc--,—
24 inches 527,7-' o,�48 inches o &, F' snH el e7he "/
3. Any ground water encountered before reaching a depth of 4 feet. k' j
If so at what, depth?
D., WATER TEST
A simple water test will show how well this soil will drain or percolate water.
To perform this tests
1. Dig hole at.least 36 inches deep,, Use a shovel or post hole digger --
size of hole makes: no difference —only depth.
2.. Fill hole with water,. Now let all water run out of hole. This soaks
the ground and will give a more accurate reading.
.3. Again pour water in hole to a.height of 12 inches from the bottom.
Let water run out until there is just 6 inches from bottom let in'hole.
'4. Note how many minutes it takes for this ]last 6 inches to seep awayo
record this"time below;
0011@11 df- motes for fast 6 inches- to seep away 3
Divide this time by 6, to obtain the rate:per inch Z.
6: Date water test was performed
I hereby certify the above information to be correct and the above tests were
performed by me as prescribed,
Signed l
Address j O 2 D S -- / S.S' �'` i�iC:
NOTE: A septic tank permit is issued on the bass of ,t i�Fe above information. If
there are any changes or alterations in the above soil conditions it may result
iri the installation being rejected at the time of inspection.
Percolation Rate and Required Absorption Area.: For single Family Dwellings.
Percolation Rate (Time in Lineal feet of 4 inch tile
minutes for water to fall using trench with width of
one inch) two feet
3 li50 minimum
4 L75 11.
5 190 "
7 225 /
10 250 L
12 265 n
15 285
30 3.75 "
.over 30 Soil Unsuitable