1610 9TH AVE N.PDF111111111111
9865
1610 9TH AVE N
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City of Edmonds
RIGHT -OF -WAS CONSTRUCTION
PERMIT Permit Number. -
Issue Date: — =p
A. Address or Vicinity of Construction: 1610 0 Av N (9611654)
B. Type of Work (be specific): Install Service
C. Contractor: Washington Natural Can
Mailing Address: 1122 75 St SW Everett
State License #: 98203
Contact: Marianna Kingnhnry
Phone: 3S6-7500 X7596
Liability Insurance: Bond: $
D. Building Permit ll (if applicable): Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City Project [i Utility (PUD, GTE, WNG, CABLE, WATER)
❑ Multi -Family ❑ Single Family ❑ Other
INSPECTOR: INSPECTOR: j A 4;
F. Pavement or Concrete Cut: fl Yes []No G. Size of Cut: x H. Charge
APPLICANT TO READ AI4111 SIGN
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 4efen4;e 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.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be
available on site at aillimes for inspecti n purposes.
Signature: Date: 6-19-96
ontra , or or Age t)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: l�A. -k
TIME AUTHORIZED: VOID AFTER__�L4
DAYS
SPECIAL CONDITIONS:
G vz I
COMMENTS:
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND 111:
RESTORATION FEE:
PERMIT FEE: . v-fit 1 t O 0
TOTAL FEE: �( ( 0 0
RECEIPT FEE:
DATE: ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. 1994
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:
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Watermain depth N/A--
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Addendum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
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Key:
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-SS- Sewer
.e. Water hydrant
Q Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
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Watermain depth
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Addendum to: 'City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
0356-7500 X7596
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Key:
-W- Water
-G- Gas
-SS- Sewer
-& Water hydrant
p Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
APPLICATION
The City of Edmonds for
SIDE SEWER PERMIT
NEW CONSTRUCTION 0 NEW No ............................... ............
REPAIRS 0
/ 73
OWNER .......... c .... ............
ADDRESS ....1. k!ZQ� ....... AlL- C-
....................
V,
CONTRACTOR .....
..... PERMIT
LEGAL DESCRIPTION: LOT No ............................................... BLOCK No . ......................................
ro
S C 0 7-3 -/4,- 5 ke e_33 /t,(_[
NAME OF ADDITION ... ....... /7 -
..........
-7 7, -7:F 6 J-2c
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APPROVED
MAY 16
DATE ....... �� .,/�?/ �.� 1�
I By ... 1�1�2 ............................................................
E®fV1ONDS cal► PRos,,t 0-1101 when work �q
CITY OF WER DEPARTMENT is ready for ►nspectron. (No ►nspeo- No
6
CIVIC CENTER —WATER -SE ttons saturdaY. Sunday or holidays.)
SIDE SEWER PERMIT
North......................
1610 N ins th...Avenue.................. owner ........................................ .......
....-...
ADDRESS ............... ............ --• CONTRACTOR .............
.---
.
-•-••-•••--•- aside sewer
pf Mallory---------------•-••............. s REPAIR or CONNECT
OWNER ............. 69 ...... day
6 , 19.....---, for .............. •- ordinances.
ranted ..------.may---�...... governing
Permission is g lication on file and g
with City
Sewers in accordance with app
line• A licensed Bide Sewer Contractor must
ATTENTION I8 CALLED TO THE FOLLOWING: permit to construct sewer inside property ou get permit
obtain a P side n of sewer before 1t has been inspects •
overning side sewers when Y minimum grade of 2%•
NOTE No. 1—The owners oY the ProPeTty may line;
Ordinance 11.16.030 and Regulatio s and 12 inches inside property
be employed to construct side sewer in street area• Do not cover
ro ertyresponsible for
NOTE No. 2—Obtain full information rave t l permitted. will be p
r1nmE No. 3—Top of side sewer must have at least 30 inches coverage at p
No bends in grade sharper than '�a within one year of completion.
develop or to do any
work on the main sewer or its aPpur-
N.r, No. 4—Trenches in street must be water settled and surface of street restored to original condition- Contractors shall be
failure due to improper work which may
NOTE No. 5—It is unlawful to alter or do any other work than is provided for to the perm
tt is unlawful
except to in the pipe into the wye•