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17005 67TH AVE W.PDFiiiii I 11111115233 17005 67TH AVE W The City of Edmonds APPLICATION for SIDE SEWER PERMIT NEW CONSTRUCTION 0 REPAIRS C] EASEMENT No .................. .......... OWNER................................................... ...............................................................4A........................ CONTRACTOR J, ...................... PERMIT No..4.."..7....2 ADDRESS .4......... LEGAL DESCRIPTION: LOT No.................................BLOCK No................................................... C:X=�4 Cnlc:) NAMEOF ADDITION ......................................................................................................................................... 0 0 0 0 ;n-AB(41 012r=P) WAP Uc:,Lr--- 4:�svxEaF!5 approved: OATE ..... . oglo-2gf-,�- By . . .......................... �IT Ili `rOi�t ,g1E N i v y ` I ) ' '^ MONID$ SI,D,E, S,E„WER �PER�M�IT ✓`a r v,` "'' / WATERrSEWiERI'DEP:hRTMEN•T,4•"• , FLE PiE+RM4IT`'` i s Call( I78' 1107/ for Islde, sewer Inspections :BEFORE covering, '.any,:. // 6 y. Portion ,of4 thei construction 1`tInepeetlon will hbe provided! within 24'lhours after request.' IYO 9at..„8un:�;or holiday„Inspections %)) ADDRESS�LOCATIUNLIOF"CONSTRU•CTION. ...7�Q5 G7 tt Avg td. ....................................... Lot 1, D b l DDRar+ch.; Addition 3 .......................................................... (PROPERTY `LEGA�Lt�DESCRhPTION ...........: ... ..............OWNERAND/OR'rBUII:DER.....PtlSSt'I T i�kti^Rld�1' {.- - ... .. (CONTRACTOR+SbN✓AMEi&,}ADDRESS Chambe�5_ �i ��i46V&� COnst, -1710 �- -67th W dmr�ndS Per"ssi`omMswranted., Se'piClibei^ 185 73 ......-••••••-•-•• ......., 19 ....... , for repair •and%or ,connections Of. a, side, sewer to: the city'sanitary,,sewer; s3^stomi,inr;accord'ancel;with Citiy� of Edmoredsxordinances: AT TIONJ-MCALLED! TOrTHE! FOLLOWING Io:,:1=The:(ownerartof,(thee.property, may,._obtaln?a.permif `[or,consQruct sewer' inslde;•propertyNline:,• A`�licebsedi,Side Sewer,Contractor,�muat•vbe em to •e �" side);sewer ltt?istreet.,area. Dofnoi icover,,an ; R p Y d ,toi constcuch, . y. portiont,of sewer':before,,it',hasilbeew inspected. " •NOTE,No..`2 A•lL work;iperformed(;fnl,city,right-of-way:requires;am Invasion,:of -Right-of-Way-•Permll<(oblaln'ablei;front•the� Clty,,Engineer ai,office - NOTEt No: 3=Obtain full+lnformation„regarding.:Ordinarice 1 P:18 030' and Regulritlons, governing, side,'sewersti,when� you, get ,permit.. . NpTEf Noi,'4` Topxoflside, sew,erlimusf,havelat least.3(1, ches.Icoverage;at„property ,llne a.ndl,-12','inches..lnsid'e,,-'property,dine; •minimum igradet�of 2 J,;'?Noi}tien$'sl,ln),grade� §harPerlithan,,I�i•,willl'bel,permittedt; -� - - ,NOTE No:; (S—Trencheai inustreet, must- lbe)•wate,,settled�•a.nd�,surface', of street, restored, toy originab,condition ..�Contradtors•,ahall'be�-rea risible .for<f" - r �' ` }v-orkt,whle$;;me,y,develop: within-;one-.'yearsof ,completion -;.:- Po. _. ) {- allu e,fdue Ito improper, NOTE, No.r'f�ItderiuNawful 20 alter;oridoi'any,other work fthank•is providedt for, 4nti 'fhe permit or,toi,do any ;work on'stfie, main sewer.or,ifs, appurtenanceai except Co, do-, serflthetipipe�into,the•,wye.� - u Date DIS`AkPP,ROVIED} ill -4 . By, : By: Date........;... By,!:. Date:.: By,:: A+PPRQMED? e 1:Oate.....` ,. .:::: l..1 BY".. Rein_ arks ? ... _ .. ......: . .. f . i .. — 'BOTH, 'Pe ;� i sL' ' U e, Signed+ By r©wriel'(of! Firm�'Perfo ming 1Con_struction� �P.RIOR Toy �Request_'Ror,�Inspect on} L{ _ :. r h Hereby ,certify,that theslde 5ewerymstallatloni constructedtunder'tfiisipermit -l•-�.y )( •wf7tContracting-'•Firm �Perfor Ingl:Conkruction)) - _ - wF ltalled4,invaccordanceiwltli, all) youernin ordlnancesrof);the� City, of Edmonds, - �.; Dated;',ti►is .:�. �:.........da %- F Y ✓19 �'d (CheckF 1BEURE you!cdi`g for :Wafer",�' :Gas 0, ..'Telephone (0;, Potver „ Sewer:10,; Other.,Ol( APPLICATION for The City of Edmonds SIDE SEWER PERMIT NEW CONSTRUCTION REPAIRS 0 EASEMENT No. ........................................... ;2 . ..........IOWNER tt... S ..... PERMIT No. Yq.7 / ---------------------------- ADDRESS ......... 4jt ..... — ----- LEGAL DESCRIPTION: LOT No. ............ BLOCK No ............................................. NAME OF ADDITION ... ........... p 0 Ift XGURAVIY Th- Informatic- show, bu the City ot Ed.- - ..... By ......................................................................