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17004 67TH AVE W.PDF17004 67TH AVE W CITY OF EDMONDS pUg_ CVy0RKS - EWINEERING ACTION REPORT �o 1623 SUSPENSE DATE: / Time: ' - �f File N Date: QYes Attacbments: No i SUBJECT: : �Q�!l��l%/i �X" " / l s n n r i ,� ✓1 REQUESTOR: NAME. ADDRESS: PHONE: ( `7 Sid/� REQUEST RECEIVED BY: TELEPHONE _ CONTACT IN OFFICE r---1 nOTHER: ( . 1 r RECEIVED BY:'� All Concerned Notified Q' Action Completed/File APPLICATION I/ for The City of Edmonds SIDE SEWER PERMIT EASEMENT No ........................................... NEW CONSTRUCTION 0 REPAIRS C] OVVNER -----D!! ....... E .. � YES ............... CONTRACTOR 4;Ht�t-4 No. 4sa;E6 .............................. PERMIT ................ ADDRESS E 0 ul - I c .1 e-4 se", fort Cif T", & L . t J L. I V r"3 LEGAI, DESCRIPTION: LOT No.....---...4EB . .................................. BLOCK No.........:---....-................ NAME OF ADDITION ... C? .... 5-L-T . ........ P..n ...... F;kt .......................................... I 5AeM=-"M --7-'bEMEF=' N tip Approved: DATE 4 3 4 ��y� k ... By 'Tye , CITY O;F E'DNI'tOiND1S} — `Sivfi • SEA ERlv,0', MIT a k ' h : u, �.. WATEWSEWER DEPARTMENTI PE�RIVI►ITT` ;� w ' It 77828°B for -Wei sewer (Inspections 1EFORE ,covering any portion: of 'the construction ) (tInspecdom will: tie pro' yI _ed+:with(ni;-24-- hoursaafter requst.,- NOS Sat. ,Sun ,.or holiday,•,,inspectlons;� - - : `a 6 } ` 17004 �,7h Avenlae Wiest ADDRESS LOCATION OF CONSTRUCTION PROPERTY LEGAL4DE�SCRIPTION.' •' . - ,�+� Lo-t-- $, n_uubl_e DD •`Ranbh,.Add�t�on .... - _ .............. l ...... ....... ....... ......... kph t - .. -. .... 1 r QWN,ER',/A1VDyUR! BU'II:DER Al � en .. Eoyes .. ,. TR�ACTOR;S NE&ADDREss Chambers/DeHaven Const , T7545 First Avl� s�lF, Seattle, tJash �fovember �9.` 19......7 for•re it and%or.:connection of :a side sewer to thetcitiygsa.ni ary,sewer,.-; aPenliission isgranted, ° _. repair systerrt inl,�aaeordanceiwitlil<(City of :Edmonds; ordinances } t. Y ATTENTI.�ON!yIS�9CALLEDtTOhTHE'FOLLO.WING �N(`' ~To'T1 ` Tfiet{ownerspof.%the,,property: mayrobtain^a .permit ,to, construct sewer .insidi,properiy,' line ..',A licensed,'Side, Sewer Contractors must tie employed, to.conatruct aide sewerjin.�street.�area.. Do.:not�cover-•any, portion6f.,sewer before'�it• has,,been�inepected.:.. }' - Allwoikperformedtdm+cityrriBhibf-wa.y,�requiresG;ani:Invasion,lof:?Flight-_.of,way,Perrnit-obiainable�from the C[ly,E,ngineer's:offlce rf NOTE No 3, Otitairi fullQlnformatlom-regarding.)Ordinance;•1.1'.'1'6:•030; and(ReKulatlons+ ;governing�aide, sewera�'whem,you�. get. permit., i a.NO,TE'rNo 4 „Topofgsidesewer:Smuet;have-.at Ieast,30'dnches .co.verage',at property Ifne. andy.l2' inches irislde property.`41ne;, minimum ;Brads of 2 /,' No; bends in !grade ' fr., -' sharper,,thECfi, will,,be"permitted.. _.NOTE No..,S-Trencherslnistreethmust,be,•wafer settled and.�sur[ace of street restored Jo, origins' condition ',Contractors -'shall -,be responsible for.fatlure' due--*Eo improper. .work'which&maytdevelop,•within one, -Year of,completion•.. NOTEIiscunlawfuli.tof/alter;or !dol,any,,other .work 1th",,�Is provlded, for in ,the -.permit „or'to. do.�any work on the' main sewer''or'.its appurtenances';except to In �s��sert,lhey{piP?Pinto D. : yDateISATPROVED❑�Date -- By ,Date: ...... BY �." ... — :. B Fes. -�.iY ��... APPRUV/ED •. ISl ,Date..../•. y,..... ;ice; r ........................... ... .. .. .... .... .... I ,BOTH(Permit Co ass,IVLUST' BeSigned+:By'.Owner•,of Firm Performing Constructibn, PRIOR'; To .Request Forslnspectlon, -- s 1 ter. I �'S. , hereby certify that:the'sldesewer installation constructediaunder this+per-mit, v :. --dO.wner'.of,`Con c_t..g Ism; I?eifci ing �Constructlom)r - -q. - - l _ waehl'nstalledlirniaccord'an a+:with,a]ls:governing-ordinaiices,idf`the.iCity, of�Ednlonds:' ,.: �< Gj' . 11 Dated thfs......:J.... rr1 ter -5 heck BEFORE you, dig, for Water, © Gas :El - Telephone::0 Power Oh f❑ a APPLICATION The City of Edmopcl#. r T"" for SIDE SEWER PMN" NEW CONSTRUCTION- REPAIRS OWNER . .................... f j ---------- I ................... ADDRESS wpcl: Rin "'AMANIYOFACCURACy Tbeinformatien attBch>3d map wa,, CoMpij&,j fo, . 'ft,Yr, 0'n the an Us, by the Cif of consullants, The City of Ed ,Tlch�s doL,6�;nLi ot 8PP'1410 set fortl� or, the rnap warrZT: r- Any p-tsoiot entity rew-rdipc 604dW afi inner c,�, aunt inqui llfj th', 1. i M,:d, JZ`uding, but not limited to, f to, the location of a:-, - s snu'v"rj Suc"� se,-flcr stubs may or may not, exs th,' location shc'�Jn, Neither the C! tand may crnl'jrc� st ty of Edmonds no., its . - 1, j1 c__, rY shal'i be liable for the information given thi s map, nciicr cn"� o"" cr sent Oil Provided based UPOn said map EASEMENT No. Z CONTRACTOR .... f z PERMIT No ....................... LEGAL DESCRIPTION: LOT No ................01 ------------------_--- BLOCK No..._..- NAME OF ADDITION ......... ... ,-.-RECEIVED-, NOV 19 1973 Approved: DATE................................................ By ................................... .................................. { Permit Address' �� • . Legal Description - T Lir j j BUILDING PERMIT RFVIE1:I - PIGINFFRING, DFPARTNFNT CHECK. LIST Reviewer's Intials 1. Septic Tank System Design Approved 2. Sanitary Sewer Avai1ahi1ity�" t.� of Dwn. No.. 11554m Project: L Side Sewer Availability: 3.. Any Sanitary Sewer Connection Fees.' Q� 4. Site Drainage Checked _4P 1jA1 j P 5. Storm Sewer Availability: - Sht. of Dwg. Plo.I8 p54 Project:Roadside Ditch 6.. Grading & Final Contours 7. Sidewalks (Site Inspection shows condition of existinn walks as follows): 8. Curbs,„ 9. Curb Cuts NO 10. Underground 14iring '( Street Lighting. 11. Street.Right-of-wav & Bldg. Setbacks:KI W T i Sht. 3. of Dwg. No. _ of Official Street Map. 12. Existing Utility Easements 13. Access Easements n 14. Water Mains & Fire.lydrants (Indicate Size Yater Pain) 15. Bonds for Site Pork �� • 16.. Special Requirements liste'dA in memo to Rldg. Dept. �O 1Y1:�'11VYy 17. Commercial.A. Apt. Requirements form completed 18. Drawings stamped & nota 19. Site Inspection made on 20. All items filled in on 21. This Lot included in Subdivision (List any special requirements): Q 10. him 3/9/76 SOL_:_ w t�:•r; a ..�� -. .. �v^--�_ - ... _ � .. - ,.. ., � . � - ..