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16209 70TH PL W
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TAX ACCOUNT/PARCEL NUMBER: O' s DOD 00 7' 000 5-
BUILDING PERMIT (NEW STRUCTURE):/ ( s�� J C1/
COVENANTS (RECORDED) FOR: �/11 702 `i a ��p / SS E,dQlI�M t,e5s
CRITICAL AREAS: "/ 7� DETERMINATION: ❑ Conditional Waiver ❑ Study Required Waiver
DISCRETIONARY PERMIT #'S.
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DA
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: Q LOT:
—I
SIDE SEWER AS BUILT DATED: / / O o
SIDE SEWER PERMIT(S) #:r
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:�' / l q IV
1
OTHER:
BLOCK:
L:\TEMP\DSTs\Fonns\Sueet File Checklistdoc
s J I
If yes; how isitedevelo' developed? n-
5. Describe the general
site topography- apply
Check all that 2 N .�,
Flat: less than 5-fe4 o change over entire site !
'Rolling: slopes on site generally mess titan 15% (a vertical rise of 0-feet
ormontal'diitan66of 66-&a)
1;:y W
Hilly: slopes present on site of more than 15% and less than 30% (A vertical rise
of I 0-feet over a.6orizontal distance of 33 toL 66-feet)-
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of Iess than 33-feet).
Other (please describe):
6. Site contains areas Year-round standing water. NO Approx.- De
7. Site coritains'areasof seasonal standin; w•ater. No Approx. Dept4:
What season(s) of the year?..,.
8. Site is.in the flood'
floodplain Of 'a' water course.
9.- Siti Contain' water flows across the grounds surftmi,flows.ar6year-,*j�
s a creek or an area wfiere
round? tol Flows are seasonal? (What time of year?
10: Site is primarily: -forested meadow ;shrubs mixed vol,
urban landscaped (lawn,shrubs etc)
Obvious wetland is present on site:
For City StaITUsc Only
1. Site is Zoned?, I-L
2. ks mapped soil
3. Wetland inventory or C.A. imp indicates wetland present on site?
Al 6
4;�. -.-,Critical Areas inventory or C.A. map indicates Critical Area on site?
5.. Site within designated earth ;,�bsidieiic'e'landslide hi . itard area?
410
6. Site designated on the Environmentally Sensitive Areas Map? -*
sfec,o
.DETiRMTNATION
'" 'STUDY REQUIRED CONDITIONAL WAIVER
WAIVER,'i
Revi6wed by:
PlayEr,,
Date
..A
PeyGIAMM
A,
. . . . . . . . . . . . . . . . . . .
.
............•.���.,.,.,a►{ , vn ana suormt it to the City: -".The City will :
this form. is to be filled out by any person review the checklist, make a precursory Jsiie
preparing a Development Permit visit, arad make a determination of the '
Application for the City of Edmonds prior subsequent steps necessary to complete a
to his/her submittal of a development development permit application.
permit to the City.
With a.signed copy of this form; the r
The purpose of the Checklist is to enable . _ applicant should also submit a vicinity map
City staff to determine whether any or plot plan for individual lots of the parcel .. .!
Potential Critical Areas are o'r. ~ -
may be'.. _. with enough detail that City staff can find - - .:.
present on.the .sub jecx property. The -.. --- - -- •- - and
information needed tofy the subject parcel(s)_ In
complete the addition; the applicant shall inctude
Checidist should be -
easily available from.into} ..� u
.. , ... � , , . , , .. � other per#inent nnation'.(e:gsite ,.�.�; t=; ,>,.,.- 'z :.• :-
observations of the site or data"` v fable at plan, topography map, etc.) or6studies in
City Mall (Critical Areas imveht&ies r ` s,w con unction'w "
P ] ith this Checklist to assist
or soil surveys). _
staff In completing their preliminary,
assessment of the t si e:
An applicant, or his/her representative, .
must fill out the checklist, sign and date it, t
I have completed the attached Critical Area Checklist and attest that the answers provided are
factual, to the best of my knowledge (fill out the appropriate column below).
Owner / Applicant:
Name
No yrr1V awv - ac�o� -ray
149210q _ 70114 M . w
Street Address
Applicant Representative:
Name
11vZo2 — •74W �J� • uJ. .
Street Address
G
8YYY
City, State, ZIP '" YL.Phone City, State, ZIPS
Phone,•.
Signature. Dale
Signatur Date' s ,
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j MAR 1 7 1997
j I 10' UTILITY ./
EASEMENT PERMIT COUNTER
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N°
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10' UTILITY
EASEMENTS �^
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The City Edmonds Side Sewer Drng I , •
EASEMENT NO . ............................
MEAD. co1vN •...............
NEW CONSTRUCTION ❑ REPAIRS
..,: ❑ LID NO. -2,10......ASMT. NO. •----•-------••--�
OWNER ... TU.i ERER. _.. CONTRACTOR ..:...:......................... PERMIT:'NO. 33.5
JOB ADDRESS .. �-- �,1........:........•.Q-T~-.PL;wk............ LEGAL DESCRIPTION: LOT NO. .........
................
............. BLOCK NO. ..... .t,XNN.W.QQ� 4INE
-------- ............................................. ......................................
-----
NAME OF ADDITION ...-•--
................................................................................ ............
a-5 2.S
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' P.V•C.BENOs 34
21' PuTURt 1.5�pP +�i 3.5'
wbE . 4^TEST 'PEE
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PWW-0001-11/75 (AEV.11/78)
1G2.09- 70 T" PL.w.
n
CITY OF EDMONDS SIDE SEWER ,AS -BUILT
IDOS PERMIT
NUMBER
IOMEOWNER
CONTRACTOR
ATE IDRAWN
BY
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APPLICATION
f
The City of Edmonds„ I for
EASEMENT NO. ------- .---------------------------------- ._
~<° SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS ❑ LID NO_ __________________ ASMT. NO. ------ -----------
OWNER ------ -------------------------- CONTRACTOR .--------,.ti15ti---------------------- PERMIT NO.
JOB ADDRESS ------ ------------- LEGAL DESCRIPTION: LOT NO-------------�_..-------.------------ BLOCK NO. ----------------------------------
e
0
0
NAME OF ADDITION ----- WF=ST--- tMGlUNT-- - 1/_1-l�-\kV-------------------------------------
Approved:
DATE 4527 , �lz---- BY --- --- - . -- ------ �j
1 /75
The City of Edmonds for EASEMENT NO- ----------- --------------------------------
STREET F1k3--r`4,t`- SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS E] LID NO___________________ - ASMT. NO. -----------------
OWNER CONTRACTOR ---------
--------- 6---------------------- ... PERMIT NO.
J . ------------------
JOB ADDRESS --- --------------- GAL DESCRIPTION: LOT NO. ------- S --------------------- BLOCK NO. - ----------------------------------
0
0
0
....................................... I ........... ....................... -------------------------------------------------- -----------------------------------
NAME OF ADDITION t - -----
Approved:
DATE-------------------------------------------- By --------------------------------------------------- Yi7fg
v
co
0
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CITY of EDMONSS MA�s�,�,��$� SID�SEWER PERMIT
For Inspection Call 771-3202 �L�C �R PERMIT NO. 07333
§dTr59PTonFtUon: 16 zo 7Z) I \.0 L LYNNWOOD LINE
Property Legal Description (Include all easements):
Owner and/or Builder: M1 AR I LY D (= R Ll-
Contractor & License. No: hl 5
Single Family Residence
Multi -Family (No. of Units )
Commercial (No. of fixture Units )
Invasion into City Right -of -Way: No Yes (If'Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
I.certify that I have read and shall comply
with the items listed on the back.
Permit Fee: ,..30.V0
Trunk Charge:
Assessment Fee: -
Partial Inspection:
Comments
Final Inspection Approved.: %
Date
Rejected:
eason
� J
Date
Issued By:
Date Issued:
Receipt No.: seS-y
F
Initial
** PERMIT MUST BE POSTED ON JOB SITE **
Wh.ite Copy File Green Copy - Inspector
Date Initial
Date . Initial
Buff Copy - Applicant
The City of Edmonds Side Sewer Drawing ;
EASEMENT NO.
mp-ND. GO NVA - n/�
NEW CONSTRUCTION El REPAIRS ❑ LID NO. Z1.0---- ..ASMT. NO- ------------------
OWNER MA'-xP 1..-V4-A-%xx-- To -SERER------------------- CONTRACTOR .------.-------------------------------------------------------------------------- PERMIT NO.-733-3
r p 7-7JOB ADDRESS ..�SO _%__.__--_---.!_Q_T~-_PL,-- ---------..------ LEGAL DESCRIPTION: LOT NO- -------------------------------------- BLOCK NO.----.EE��E
---------------------------------------------------------------------------------------------------------------------------------------------------
-�— 1'1' —.. f45 j.3'*j 22
4.. RV.c
I rw9ERc 1.5 DP
4 TM ISE
PWW-0001-11/75 (REV.11/78)
NAME OF ADDITION ------------
4' Rv.t
3.S' 45' —►
-----------------------------------
1.5'DP.
414c.o.w!�E
K62.09 70 T" PL. W.
Approved:
DATE .------------08(------- BY Lt-f ------- -
� � .O 7�itX, d) SrF; 'S`a�X '.'�,'. +`: 1 .. yy�G•' � t b..`. h' .• .: - � - t,l'• t�Sia , , -_ '- �3 '.� ,
ti g
'IF
,�OfND`Sf ,S�li �y,E F,SdEWER' P�ER�,�
k
`WATEWSEW.ER -DEPAARTMENT'
era t
FERMI
fS
"I - 't (//Call .�.7i5-2625• for -•sides sewer inspect ns: 11FFORE .covering; any portion - of the 'construction.-- -
�'. ,\AInapect�ion', will' -be' provided: within' 24- �houra�•after`.requst NOi�Sat., .Sun.,,•or holiday, inspections
ADDRESSiALOCATIONItOF (CONSTRUCTION ... „. ,,+ ,,,
PROP..ERTvY :I:EGALaDESCRIPTIUN .....:..! ! :... ::�7�`" +
............... :....... ....... ......................... .............. .
9 ..........OWNERA`ND/OR. BUILDER... .."mot �;�}� c��!^ ... C•,1`.:��.i<`"lr✓i:
>: ICON, SAOT,OR;S� N'AMEp& ADDRESS .,... Y�~ ! ,. c _ 1r-tiIn h 1 1 -. ..
`y n
iPAririi`ssionuisGgranted; a. )��-.....,.. ' .::... , 19.... ,for, repair, and%or ?connection .of a side •sewer to the�city sanitary',sewer
t �anlFin"acoordancecwith City, of Edmonds ordinances :
^- ATTE1v:T4.
IONIISaCALL•EDiVTO THEI'FOLLOWING:. - - i
' vNOTEC,No 1' The•.ownersirof'athe'pi'opertyp,may, obtain'.& -Permit to..construct.-sewer Anside property
llne .;A, licensed] Side SewerrContractor 'must-ibepemployed to{construct
' Jsid'et aewen;inotreet;area , - Do not.cover;any,; portion •of, sewer•,before it has been.inspected.;
-•r: NOTEF+No,2'=A�lh.workyperformed>°in elty�right-of-way.requireaJahr Inviislonrof.•Right-of-Way^Perni.lt'pobtalnable from"the-Clty,•Ehglneer'.e-;office'.
T =_No i 3 06talnjfulli'informatlon ;regarding; Ordinance 1.1.16 030:rand: Regulations; goyerningjalde, sewers -when- you,?get permit
No,4 Top✓of sideoewer mustthavezat least` 30 inches':coverage':at Property line 'and'1S.dnches lnside property Ifne 'inlnlmur A grade of 2'% No, Bends ilnligrade)
sharperFthan '%i,wi1P'bespermitted..••,. . _ • _ ,- - r ..
NOTE: No r5=Trenchesi lnustreet'•'must be .water+settled and;.surface ofAstrdet restored; toi-originaDrcondltlon..:Contractors..shall be responslble for.failure,•idne !to tlmproper,
-
`workwhich`may-deyeloP w_ itliln one ,year-of.:completion, - - - - - -, -
TDI;No .6-It:jlsitunl`awful fo ,alter or I'doi',a`ny:other work -•than ,ts, vided: for,7n .the ;permit or�.fo do• any, work'•on they main sewer or its appurtenanceai exoepf fto �Irr- -
asertAtheirpipe;fntonthe:.wye..
bJ !r
s DISAPPROVED+ I❑I ',Date --...By t ..:, Date ......... BY Date By
°LAPPROVER �s Date By,-==
Reba :f: -' ---' ............
ar. .....
' = B TH?'Pe ;iCopi s(`DiU, e''Signed?By•Owner of F rm:Perforrning,.,Construction PRIQR''To•Request For'Inspection -=� f
hereby certify t.hat,�th6, sldb: sewer' ns Nation constructed ,under ,thlstpermit.
D.wner.b['. ntracti g icm.';P,erfcr g Oonstruction�),-
was Ins t le Fintaccor ance; Wit all; goye ning,ordinances iGf the iCity, 'Of Edmo s sue;
rN;' 3Dated ,this:..1 ........ ..day, of...77
19� �i
:.}.
FO;Sewe RE ydiforWaer Ga: ! . phonei.;❑ P,i :Other ❑ �Jl��ll
r CITY of EDMONOID4SEWER PERMIT
For Inspection Call 771-3202 TREET FIL PERMIT NO. 07333
Address of Construction:
Property,Legal, Description (Include all easements):
,,Owner and/or Builder: M1AIR IL_Y 0 WOLF TD j3 r=RL-
Contractor & License No:
Single Family Residence
Multi -Family (No. of Units )
Commercial„ (No..of fixture Units )
Invasion into City Right -of -Way: No X Yes (If Yes, Right -of -Way
Construction,Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No Yes _ l� (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
I certify that I have read and shall comply Date
with, the. items...l.isted on the back.
Permit Fee: so__V6> Issued By:
Trunk' Charge: Date Issued:
Assessment Fee: Receipt No.:
Partial Inspection:
Comments Date Initial
Final Inspection Approved:
Date Initial
Rejected:
Reason Date Initial
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy - File Green Copy - Inspector Buff Copy - Applicant
0
A.L.WILLIAMS°
4En�
is X?S
A.L. WILLIAMS IS A CO-OP OF INDEPENDENT BUSINESSMEN AND WOMEN MARKETING LIFE INSURANCE AND OTHER FINANCIAL PRODUCTS.
Representing: Massachusetts Indemnity & Life Insurance Company / Regional Office: Atlanta, Georgia
Representing: First American National Securities, Incorporated
rL'A o vr- buKvt Y
FOR
TROND ULVEN
LOTS 4 AND 59 VI/ESTMONT VIEW DIVISION 2
EDMONDS, WASHINGTON
208
N 99056158,E
25' I fo9.00'
uj
N IlO' UTILIT7'�
EASEMENT
N
W.
W � I N O
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CP
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lo' UTILITbo Y
o �j
Ea*EMENT D
ez ' 43
- --- 164.00' i
17
5 /.n�
/2,0431
tt
\
d�49"l0'S�"
® -SET MON PIN WIN PLASTIG CAP No'a W9/
® • SET NUB AND TAUC ON LWE
L®�oll•Be®®alan�d & ®0000latoo. Inc.
rKAM GWLr
t0-�9 182�58 /' • 4D' 8 3 — 0 5
L�n+.c.aa-�.,� _
/ � Win^ � �z�r� -2 - __
*tj MONI NJ I- L--v-N-tVf--
J6
!TT !,.,OpjS D..
u
Sti-cot Right-of-lll,'ay Existin� UnD
Acccss Fascinents Existing EnD
0 TnD
Lot Pcr Subdivision Flat Asscssor "OT)
Site Plan Checked for Accuraq\
Ye
Pevicil loy togn T\ j Pa t C, .7
Ne
1--,Xistinn Eater Maill Sin -T-
I.
'.;t.r 7%lin Pocilired, A-1104.
Sp %Icc
llv(lrant I I
zo
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Ilotector (Heck 'Otor Reouirod
v
it
Date
'F;,,nl,: Approved
I II Soptic Tanl.- Por—mit P(-rv,0- -red !)e -nTj i t To.
sallitar.- Availabi.1JI.ty 1p
HIC ,10..
li
Side F,)(,I,,ur
Iil
u-,
Sajiitaiy "lei or Connoction Fee PoquIJ ml
N---L
I Pevicir bv
(Pon T) ; td i I:x :tins Pr(mi yn(l
IIculvert I,C(;uircd ze
C"Itch Re(!uired II1li.Cate On Cite I lall
Wamaqc-- mo.L n
opt-Ln ron
;!,r;il;olc roouirod Indicate op Site 111m)
SJi.l. C011(lit101IS cl GI-0111ILI FiCM (J.,'
IzCv-i c, ., by
" BUILDING DEPARTMENT
PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
COI�jvIJ(= %Z
W MAILING ADDRESS-
Z
USE PERMIT
Applicant Fill ZONE NUMBER
Inside Heavy Lines
JOB
ADDRESS
VARIANCE OR COND. USE NO. ADB NO. IHEI
3
o qs c,ls 7,1y PL -
, l
FRONT i7 SIDE REAR
; '
CITY
ELEPHONE NUMBER
VI l
-7 7�_ `-( �^3
Z
Z
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{{1
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SIGN AREA
ALLOWED PROPOSED
ENVIRONMENTAL REVIEW
El COMPLETE ❑ EXEMPT
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NAME
REMARKS
ADDRESS
PLANNING DEPT. APPROVAL DATE
I
II
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CITY
TELEPHONE NUMBER
LEGAL LOT
IrYES ❑NO
LOT AREA
SUBDIVISION NO.
Q
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NAME
STREET R/W
EXISTING STREET R/W � FT. DEFICIENCY THIS PROPERTY
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COMP. PLAN ST. R/W �,J FT. O FT
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ADDRESS
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CITY -
L �11(,L) p o L) -
TELEPHONE NUMBER
-7-7 - `f 3 3indiCntpri
REMARKS
Driveway slope not to exceed those
on Standard Drawing
STATE LICENSE NUMBER
2Z3-0 0-N - ,2C - 23,6 J
CITY LICENSE NUMBER
ti:jECKED
BY
_ -
Legal Description of Property (Show Below or Attach Four Copies)
- � — Uj r7
STREET AND/OR UTILITY WORK
REQ'D. ❑ YES I�NO
R/W PERMIT REQUIRED
6[1 YES ❑ NO
UNDERGROUND
Z
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WIRING RE'Q'O. %YES ONO
!
I
TYPE CONNECTION YES
SANITARY SEWER ❑ NO
VERIF ED BY
VI
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SEPTIC SYSTEM ❑ YES PERMIT NUMBER
APPVD BY CITY ENG.
aNO
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REMARKS
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METER SIZE
SERVICE SIZE
CLEARANCE
CHECKED BY
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REMARKS
I\/' NEW RRESIDENTIAL ❑GAS
LINE
FIRE ZONE
TYPE OF CONSTRUCTION
CODE
LQk
ElNON-RESIDENTIAL❑
❑ SIGN
ADD
ElWALLINING
ElDEMOLISH
ALTER EXCAVATE FENCE
❑ OR FILL El I X_FT)
REPAIR � INSP. POOL
❑ PRE -MOVE El
F
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to
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SPECIAL INSPECTOR
REQUIRED
❑ YES El
JAREA
OCCUPANCY
GROUP
OCCUPANT
LOAD
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 1
REMARKS
NUMBER OF STORIES
Z tJ0 -
NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
K.I
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SED USE I VALUATION I FEE
PLAN CHECK
NO,
HDICAT.E BUILDING SETBACKS,
ABUTTING STREETS)
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
•
,RECORDED
0006.900 STREET FILE
WSS : ctk :SS JUL 24 q10: S3
7/22/86 it :,+1 i�!! ! I �M;$, AUOITG,
COVENANT TO �NOHONISr; COUN (Y, N(ASNr
HOLD HARMLESS AND INDEMNIFY DFPUT Y
The undersigned GRANTOR, in consideration of the approval of
Na side sewer connection by the City of Edmonds, GRANTEE, and
N
O other good and. valuable considerations hereby stipulates and
�G
qp covenants as follows:
1. Statement of Intent. The GRANTOR has applied for a
permit to connect a side sewer to the main trunk sewer line of
the GRANTEE. The GRANTOR has proposed a connection at a location
which has a susceptibility for erosion and other detrimental
effects if not properly installed, landscaped, maintained and/or
reconstructed. GRANTOR believes that such line may be installed,
maintained and operated without detriment to the public or to any
private party':and therefore has made this covenant to hold
harmless and indemnify.
2. Hold Harmless and Indemnify. The GRANTOR promises to
hold harmless and indemnify the City of Edmonds, its officers,
agents and employees from any and all claim, loss or liability
arising from or out of the design, location, installation,
landscaping, maintenance and reconstruction of a side sewer line
over, under and across the subject tract, hereinafter described,
saving only claims loss or liability arising from the sole
negligence of the City.
3. Subject Tract. This Agreement relates to a subj.ect
tract located at 16209-70th Place West, Edmonds, Washington and
legally described as:
-1-
Lot 4 of the Plat of Westmont View, Plat
Number 6303 of the records of Snohomish County
Washington, located in the Southwest Quarter
of Section 5; 25 North 4 East.
LAA
4. Covenant to Run with the 4taitd. The GRANTOR stipulates
that this Covenant to Hold Harmless and Indemnify touches and
concerns the subject tract and shall run with the land, binding
the GRANTOR as well at its grantees, devisees, heirs and assigns.
DATED this day of , 1986.
Attest: GRANTOR:
Secretary
STATE OF WASHINGTON)
&VOHVrx/&X s s .
County of Imo-)
I certify that I know or have satisfactory evidence
that KP'EJL:a S . Of3Fi2 �- signed this instrument and
acknowledged it to be j�6Lt�Z_free and voluntary act for the uses and
purposes mentioned in the instrument.
DATED this o`�— day of 199L._
NOTARY PUB IC and for
the State f Washi gto
residing at
My appointment xg
/'01
STATE OF WASHINGTON)
. ss.
County of King)
I certify that I know or have satisfactory evidence
that signed this instrument, on
oath stated that was authorized to execute the instrument and
-2-
acknowledged it as the
of to be the free and
voluntary act of such party for the uses and purposes mentioned
in the instrument.
DATED this day of
(seal)
19
NOTARY PUBLIC in and for
the State of Washington
residing at
My appointment expires:
-3-
rY� • CITY OF EDMONDS •
a, ENGINEERING DEPARTMENT
STREET APPLICATION FOR RIGHT-OF-WAY CONSTRUCTION PERMIT
FILE(Applicant to Cc-rplete A & B and Submit in Duplicate)
A. Permit to be issued to: t� M &,a C 0 sT/t •
For work at: (address or vicinity)
Type of work to be done: 12e CQ
(Attach Drawing When Applicabl6
Time Required -- Start: 013117 r% Finish:
Owner: t..-
Name
i?O.
Mailing Address
City State
Contractor:
Name '
Mailing Address
Telephone Number
2 2.3 —o/ - 80 - I-IR- R c
State License ;;umber
X z36 gQ
City State Telephone Number
B. IN'DE*NITY: 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 applicant or the City of Edmonds, or any of its departments or employees,
including but 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 Department.
Work subject to inspection and restoration in accordance with City Code. A
24-hour notice is required for inspection by the Engineering Department.
Call 775-2525. )( a.?,O
Signature: '
Ovder or Age Date Signed
C. DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
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