17102 TALBOT RD.PDF11111111111111
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17102 TALBOT RD
APPLICATION LUGoD -Ltoe�
for
The City of Edmonds SEDE SEWER PERNaT EASEMENT No . .. . ................. ..............
NEW CONSTRUCTION REPAIRS
�440 If. 5,3
-d6 M 2E�5 —70,eA/ex
OWNER... P� .................................................................................................... CONTRACTOR ..... .......... ......................... PERMIT No.
ADDRESS ..�7/OZ —I,4LH0'7- 9,D
..................................................................................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAMEOF ADDITION ............................................................................................................ ............................
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APPROVED
—rA MAY 15 1970
Approved:
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CITY-.VF EbMONDS
Caj I FR4�spect 6-1107 when work
CIVIC CENTER— WATER -SEWER DEPARTMENT
Is ready for inspect -ion. (No!nspec.
SIDESEWER PERMIT tions . Saturday, Sunday or holidays.) N2 U720
ADDRESS ................................ IXXRK ....... 17.102 ... Talbot -Road ............................................
OWNER ....................... J a.m.e s .... K ...... T.um��Y ............................... CONTRACTOR ..... & ... Son's, Inc.
.... .. .... ....................................................
Permission -is granted M&Y ... 15 ............................ 19.70— for ........................ days to REPArR or CONNECT a side sewer
%vith City Sewers In accordance with application oil file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct Sewer inside property line. A licensed Side Sewer Contractor must
be employed to construct side sewer in street axea. Do not cover any portion of sewer before it has been Inspected.
NTOTE No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
.—,--,NOTE No. 3—Top of side sewer must have at least 30 inches coverage at property line and 12 Inches Inside property line; minimum grade of 27o.
No bends In grade sharper than % will be permitted.
NOTE No. 4—Trenches In street must be water settl , ed and surface of street restored to original condition. Contractors shall be responsible for
failure due to improper work which may develop within one year of completion.
NOTE No. 6—It is unlawful to alter or do any other work than Is provided for in the permit, or to do any work on the main sewer or its appur-
tenances except to Insert the pipe Into the wye.
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. oAddress or vicinity of Construction
:0j".02 Talbot ,Rd Plat � 139-7.Lo.'
0 Owner: ��jaohim,.,t'-_on i4atural Ges Co
Name
03 156 AY All
Mailing Address
Bellevue, ",7-ash"Ungbbn 98007�
city, State, Zip Code
9 Contractor: !' .r�-,ncz A,,i-
Name
Permit No. A'�
Issue Date
0 Permit Issued To: I
e Type of Work to be Done:
Tr-, c—. 4- ?) I I
Work in Connection With:
El Sub or Plat �E] Single Family
0 Comml. / Ind. �E .Ap!. Condo.
�y El No
e Pavement Cut:
Mailing Address State License Number
14
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City, State, Zip Code Telephone Number
U
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NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
B. APPLICANT TO READ AND SIGN
INDEMITY: 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 City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal
proceedings defense, costs, court costs, and attorney fees by reason of granting this permit.
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W Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
go following the final inspection and acceptance of the restoration by the Engineering Division.
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Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this permit must be availTH �at the job nm-tnT "MnspectALurposes at all times.
Oct 2'.1,
Signature: Date
Owner or Agent
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. issued By:
Time Authorized: Vold after 1,,312 —days
Special Conditions:
Ammendments:
- � __2
PermitFee:
Security Deposit:
Receipt No.:
Fund Ill Fee:
Street Cut Dimensions
X
NO"WORK-TO BEGIN PRIOR TO PERMIT ISSUANCE
Eng. Div. December 1978
FIELD INSPECTION NOTES
(.Fund 111 Route cony to Street DeT)t
Comments:
Diagram:
Contractor called for inspection Yes NO
Work Disapproved By: -Date: Bv: Date:
Work Approved Bv: Date: 7
Inspector:
Eng. Div. December 1978