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17010 67TH AVE W.PDFiiiiiiii lill 5234 17010 67TH AVE W APPLICATION for The City of Edmonds SIDE SEWER PERMIT EASEMENTNo ........................................... NEW CONSTRUCTION 0 REPAIRS • L1� 1�1 13 OWNER ! L- - --•---Wt_.....M..NE ......................:.. CONTRACTOR ..._ WN............_.........._............................... PERMIT No. `-1�-1�I..t ADDRESS I'7 I l� Av E . W • .............. LEGAL DESCRIPTION: LOT No-------------------- BLACK No. ............................................ m��UOA-F—= 1=)D NAMEOF ADDITION.................•-•-------•---••---.......----••----.....__.................................----..._......................_.........._.. • • • /` I . �k-1 £:;.i3C~' 17i5:;. �.'; is v , .. _ .. -• -- a se, full: G:. u; sf: cwu , - �4. = .r tt��....,,.i �[: �.i �'.. ii i...ii`= f�' t�: - li„�,[„G'L'G!1 �y �'l:s , . ��:!''. �i. r, rr, f=i �•,y' v'^ prcv,dau b"u ;1 upu,, saiu map 3 Approved: DATE. 4.-� L .......... �,Tz v � � hCIITY` il;F iEDiMOiNi ,S,"- 'S;II ;E; S'EWA Ek:IRE R�M�I�Ti' c. *" 'WATER `SEWiER; 'DEPART-MEN•T•'. r ' fl 'P,Epmi, 1 4 4 4 iJ. f rcallt ,778r1•lOTr for .aide_ sewer.• inspections BEFORE covering,"any, portion: wf tthe; construction i �\�Inspectlon!,ivilli'�belprovldedt'wlthln ;24r�hourai:after �requeat.. N04Sat. Sun.,j:+or holfday/ inspections '�DRESSi1LOCATIUNi?tOF'(CONSTRUCTION........ I7��lO FiJ�th Al EP1U@ �1e aPRQP•ERTaY�LECi`ALr?DESCRI'PTION'.. .::...... �:©� g�:_L..ouf i•� DLI....tanch:-ir.c. s 7 .. ..............OWNER:- BUI'LDER Jkk tdJ Monet- � J ,-.. ....- ... CONTRACT,ORiS1,N/ ;Eli&,7�DRESS................. OtJiiCi; ... - Perinissionl�i's}jgianted,.:.: e►� �m�e►^ .1 ... ....... , 191 �:, for :repair' and/ori connections of a+side sewer Itor the, city rsanitaryp sewer dsystemtlhi iae6rdance);rNith�lCity46f?Edmond's�iordhiances.. . - /A 1TIONi ISJtCA�LLEDI'TOI THEtFOLLOw3NG - '. '.., - - , .. :. N�� No`, T—The!towneraltof'ithei,;propertiyf,may�obtain'ia, perml6;;toi.consfruct •sewer iinsidevropertyr-lln'e A+, licensed `Sid'exSewer Contractor ;must Ybe Femployedl',iol,conatruct side,!sewer�im�st{eet";areati..D,o'notccoXer•any,porflomiot�aewer,beforelit hast�beem•inspected_-r.- - - .: t:,•. •NOTE,,Noa/2—Alll�work�,performed4dn!city'rlglit-of-way,.requlreanamInvasloniof Right of=W,aY,>P,ermft.,obtainable,ifroms,thevGlty,,Englne6esrofflce, _ NOTEI,Not,.13=0tit`aim-fullleinforina6lon:;regardingv Ordinance''3•L16.030? andi;Regulations; ,governing,isid'elisewersrwhem,Y,ou,iget; permit... . NOTE{Noi;'4'=Topnof„side!'sewed+must'hadeatileasb30i7ncheaicoverage'.-at'property'linens:ndC1" !xriches;inside[;property.'llne;;minimuml;grad'e of 2;%;3-+Nolibendsiim`(gradei ' '--.. 'sharperithan, ,ys', �wllltibef;.permltted:; - - : s.' • :'• - - • NOTES No:. Z--=Trenchesidnlistreet •niust2tbe ,Water.�settled ,ands �surface•'of',street restoredl toy �oiigina i conilitfon . (Contractors.'shall.be,:'responaibiej fort failure, idue-Xq: improper work•whichkmaytdeveloplwithinl,one:;y ear, �o€completion:, •- - ,r- - - •- NOTEF•I?o.:fB—It;;isiiunlawful,to'alterlom of/any; other, work, ithanl:isicprovid'edi forjw-,the,lper t �or,totado.any,•;workron;lthe, matnt'sewer or,it`s+appurtenanoesi+except,ifolln- . .. •.:eer,"t.lfhe•ipfPeY;lntoijthe�wye;`_" -- - _- {--.- . i �DISAPPRO,ViED) .. �i ]C :'Date -._.:: y. ,�_ ..7'By :.. Date::.. ... .. ... By,- Date:. By A� ..PROViED �. Date_ .<. By .c�z�. ,r�? fA%!'. ,,,� ...... Relnarks//�Y sC-� -� �.? 911 BOTIh"I mit,. , o 'ies IMUST,' Be 'Signed':By.'Owinei;!iof' Fir-mi •Perfor-ming Construotion,PnjOR, Tot Request For Inspections = 1- ,I,1hereby,+icer,tlfy,".that,the, sidelsewer •installations+constructedi!under thlsti Iper-mit (Owner of i - tradtingi Firm'•.P.erforming, construction) - td •,,stalled`in';accor nceAvithlalP governing, ordinances,,of;tthe•1City, of Edmorift -..day'iof .... . ,•119!. ate tCheck IBEF,OREf you dtg for: Water', , , Gasi '�; Telephoner ,1; Power , Sewer Other p i L 1❑ i❑ �❑I �/ �� � i 1 Y APPLICATION for The city of Edmont smE..BEWER pET EASEMENT No. .......................................... NEW CONSTRUCTION ❑ REPAIRS ❑ � ID / if OWNERJ<xdk_...W .......`.(1Y.1 R i'- t.....................................••. ---- CONTRACTOR.............................................................. ................................... PERMIT No. ...................... / A LEGAL DESCRIPTION: LOT No. • J..--••••--•-•.................... BLOCK No............................................. ADDRESS U.... 42 7..........f !/ 4".........14........... c - ''j' NAME OF ADDITION ..: k 4?.6. f.'',....... . ...... 11Q.1n.e ...!.. Gr ��............................................ i CEP '. 8 1973 3�;- IOi7CE' NO WARRANTY OF ACCURACY The information shown on the ttached map was comoled for use by the City of Edrim!- no consultants. The sty of Edmonds dos nu %,.vrc: U., w; of ny'il,fi=�; se' forth on it a map. Any person or entity rcq: c y h�L coad ct v inder, mdent inquiry regarding the un ic� map, incbluding, bu not limited to, the location of Such sc.•j�r stub may or may not exist and may or r r o C: i st i location snovin, N ither the City of Edmonds nor its e:,�f;�;��v�. cr € .si .: i e inform ion given on this map, ncr for r ily we. r_, proMed based upon said map . Approved: DATE................................................ By