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17110 S EALAWN DR
ADDRESS
TAX ACC(
BUILDING PERMIT (NEW STRUCTURE):-4�aT- mumv
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: E] Conditional Waiver E] Study Required [-] Waiver
DISCRETIONARY PERMIT #'S
DRAINAGE PLAN DATED: I
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER).
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE LID #:
SHORT PLAT FILE: LOT: BLOCK --
SIDE SEWER AS BUILT DATED: 7,-Q -7D
SIDE SEWER PERMIT(S) #: 52�
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
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SEALAWN DR
CITY OF EDMONDS WATERLINE AS -BUILT
ADDRESS HOMEOWNER
17110 SEALAWN DR LFITZGERALD
CONTRACTOR SCALE
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DATE DRAM PERMJT
03/10/2005 BY SIBREL NO. 2005-0184
N J-01
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The City of Edmonds
APPLIC'. -.A..44
SIDE SEWER PERMIT
NEW CONSTRUCTION Ej REPAIRS
OW,-qER ......................
ADDRESS....... .....................
APPROyED
4UN 3 0 1970
EASEMENT No. � .........................................
4 IP14� (�0,3)
CONTRACTOR....... .................................................................. PERMIT No.
LEGAL DESCRIPTION: LOT No. ........ BLOCK No . ............................................
................................
NAME OF ADDITION . . ........ 4,w- ....... A ............... t ......................
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Approved:
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DATE......................... ...................... By .................................. ......................
CITY OF EDMONDS
CaJI PRospect 6-1107 when work
CIVIC CENTER — WATER -SEWER DEPARTMENT is ready for Inspection. (No inspee-
SIDE SEWER PERMIT tIOL Saturday, Sunday or hoUdays.) N2 37 6 9
ADDRESS----------------------------- 1,7110...S_e.a_.1_aw_n .. Drive --------------------------------------- - ----------------------------------------------------
OWNER ..... _ ... Deane..-W. --- Stewart ---------------------------------------- CONTRACTOR ---------------------
Permission is granted . June 30 ------- ........ 1 19 .... 70, for ............. ---- days to REPAIR or CONNECT a side sewer
- ------------------------- ----
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALL D 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 area. Do not cover any portion of sewer before it has been inspected.
NOTE 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 2%.
. __\ No bends in grade sharper than % will be permitted.
N( I To. 4-7renches In street must be water settled 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.
Cl-�IY OF EDMONDS .1w
P'bBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction
17110 Sealawn Dr Plat 11) 158-069,0(
Owner:�qashincjtan Haturn'i Gas C
Name.
805 156 Avenum N.R�
Mailing Address
Bellevue, WashiMton 98007
City, State, Zip Code
0 Contractor: Same As Above
. Name
Mailing Address
3
krmit No. 9 2 - 2 .") /,
Issue Date
0 PermitIssuedTo: / ),A),42
• Type of Work to be Done:
-Main Maintenance
• Work in Connection With:
El. Sub or Plat El Single Family
0 Comml. / Ind. 0 Apt. Condo.
9 Pavement Cut: 0 Yes 0 No
State License Number
Z
City- State, Zip Code Telephone Number
U
M,
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 including defense, costs, courtcosts, and attorney fees by reason of granting this permit.
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Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
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, al
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 permi1jpu&*-be availab
I
Signature:
for inspection purposes at all times.
te Aucr 3, 19 82
uwner or Agen
THISPERMIT' ML__ 7POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: /'. e k
. el
Time Authorized: Void after days
Special Conditions:
Ammendments:
Permit Fee: _1�1_
Security Deposit:
Receipt No.:
Fund III Fee:
Street Cut Dimensions
X
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
FIELD INSPECTIO\N N(O.-,S
I
(Fund 111 - RoITFe cony to StreOt T�ept.
Comments:
Diagram:
AS
Contractor called for inspection Yes No
T
Kork Disanproved By: Date: Bv: Date:
Work Approved By: Date:
Inspector: I/ /
EncT. Div. December -1978
bY TYPE
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158 069 NE 7- 27�4-A
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FILE
June 2, 1966
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Dear Sir:
The City has received complaints regarding effluent from your
septic tank disposal system. The Snohomish Health District has verified
that effluent is running on the surface and a potential health hazard
exists.
You are hereby requested to correct the above sited deficiency.
Excerpts from the City Ordinance are enclosed herewith for your information
and appropriate action.
Very truly yours,
CITY OF EDMONDS
LEIF R. LARSON
City Engineer
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Enclosure