17109 68TH AVE W.PDFIIIIIIIIIIII
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17109 68TH AVE W
APPLICATION
The City of Edmonds for EASEMENT NO. .— ........................................
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS F-1 LID NO. ..... ASMT. NO
OWNER ----- . ....... ER
--------------------------------- CONTRACTOR -------- — ----- -- P MIT NO.
JOB ADDRESS .... LEGAL DESCRIPTION: LOT NO . ..................... 4 --------------- BLOCK NO - -------------------------------------
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NAME OF ADDITION . ......... lc-)
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Approved:
DATE.J
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PPLICA
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NEW CONSTRUCTION Ej REPAIRS LID NO. NO.-,
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'tR: ACTOR ---
QW& ........... PERMIT NO.
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RDktSS� .............. - ----------------------------- - ----_------------ LEGAL DESCRIPTION: LOT NO - ------ -------------------------- BLOCK No - ------------
JOB A�
............................................. ...................................................... ...... .... ................ ----- -
NAME OF ADD
-------------------- ----
ITION -------- /1 e,.h_ ...
RECEIVED
JUL 3 1 1974
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Approved:
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DAT........... , ..........................
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CITY OF EDMONDS SIDE SEWER PERMIT
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WATER -SEWER DEPARTMENT
a PERMIT
Call 775-252.5 for side sewer inspections BEFORE covering any portion of the construction.)
..... .... ..
(Inspection will be provided within 24 hours after requst. NO Sat., Sun., Or holiday inspections.
ADDRESS LOCATION OF CONSTRUCTION ................ Avcnn Uest
...............
....................................................... . ...................... . ........... ...........................................
PROPERTY LEGAL DESCRIPTION ........................ L.o-t N.q ...... 4 --- DpRbl.e ... DD ... RaAch ... Ae.djll.on .... No ....... 2.
...................................................
................................................... .......................................... ----
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--------------_-------- O1VNERP1ND/OR BUILDER ......... Hofras
.. . . ..... ................................... ...........................
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CONTRACTOWS NAME ADDRESS ... Ufn_mcpod Septic Tank Co., - 81 S t P . E.
15317 TS
........... J ...............
...................... --- - --
......................... . ............ 19 . .....
Permission is granted ........... f 74 for repair and/or connection of a side seweVo the -city
sanitary sewer
system in a4wOrdancO wit City of Edmonds ordinances.
h
AT TION IS CALLED TO THE FOLLOWING:
N
Zo. 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 area. Do not cover any portion of sewer before it has been inspected. j
T
NO E No. 2—All work performed in city right-of-way requires an Invasion of RJght-of-Way Permit obtairrablc from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulati6ns governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 in.ches coverage at Property line and 12 inches inside property line; minimum grade of 2%. No bends in grade
sharper than % will be permitted.
NOTE No. 5--Trenebes in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to im
proper
work which may develop within one year of completion. �r.
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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 appurtenances except to i
sert the pipe into the wye.
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DISAPPROVED E] Date.--- x .................. By ................ Date. By ................ Date ............... . ................... By ................
7ED By . ............. . .. . .. .........................................................................
APPROI Date-..-. - ---- ------- - ...... ...
..............
Remarksy ............
......................... . ....................................... ..........
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..................................................................... . ........................................................................................ . ................................... ...................................
BOTH Pe it Copies M-"T Be Signed B Owner of Firm Performing Construction PRIOR To Request For Inspection
(Ow . ne . r of .. Con - tr hereby certify that the side sewer installation constructed under this permit
fruc i*.
1�eric, ;i., n.!l
7 w _�talled in accordance with all governing ordinances of the City of Edmonds.
Datedthis ............... . ........... day of ................................................................. 19:_--
Check BEFORE you dig for: Water 0, Gas Telephone 0, Power 0, Sewer Other 0
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(1,�ner i ontr
Check BI
-77—
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