17111 66TH PL W.PDFiiiiiiiiiiii,
5227
17111 66TH PL W
PIO APPLICATION
The City of Edmonds for EASEMENT NO . ...........................................
SIDE SEWER PERMIT
NEW CONSTRUCTION N REPAIRS 0 LID NO. J.'N ....... ASMT. NO. .......
OWNER ..... ....... ................................ CONTRACTOR ---- ------ C) --------
..................... PERMIT NO.ni>l_.\E!>
JOB ADDRESS ---- 1 --- 7 ... ....... ...................................................... LEGAL DESCRIPTION: LOT NO . .......... ..
------------------------ BLOCK NO.
"-I
0
---------------------------------------------------------------------------------------------------------
,q ......... "(_IN L__j = "t=l=t_� kk=>
............................................................................
own on
Approved:
DATE.. By
,4';- --------------------
SE E
aim
ENT
..�,DEP
!��V�EWER �,DEP
Z
-nsY-ltEF0R porti6n.,'of Ahe constTuqtlon!V,
�,-'W*5".`f�n 91d6,sewer�,:16spectic
1. orhollila�'inspections.lj
ter req.s't r'; No�* Sat.' - iU n J; -
kInspection�,wlllileelprovided'�*.within, iCjh.
C V 0 7 11 66th R1 Ace:, .......... ....... . .......................................
06. ALMOT ..... ....
W�OFVC ONSTRU, -_ ......................... ........
.......................
7 ....
.......... ..................... .........
31,
7, . ....
M. ....................
............................................................ ............
............ ......
............ .............. ............ . ...... ............. ....... 7- 7 ...
�D` . ........... ........
U1 E ............................................. ............ .............
.. ... ER AND/0 B
BoX ......... .......
9""
K -IJ b.-_5ewer Qo6st-'. P, 0. ...... 7---�777
W&AMDRESS ................. .................................. : .............
3, n
it ry
nectfim of a sW -gewer to, thel-city,; a sewer,
9_75, for r
effiiission is gran ....... .. 3, epair and/4-con
acc if ity.,of';Edmond ordinances.
A;fibe Wittivc
A2 -
p
,NTIONK,k
-F SWALLEI)i,_ ..F6LL10WING,: -construct -
Side Sewer Contractor must; be�,empioyedl�to,
a pe wer lnsldi!�prop6rt
ow yilln6; A"licensed
1A — rty may, obtain rmit to. construct. se
TE M The own*ersoofi,the,prope jt�L has�;bee ins ected�,.,,:
Maiti'd� rtihNtieee,,�area,.:;- Dom ot- covW any port low ou sewer before: 11,
p
ce.
fit
%of -way requires. an- Invasion of FUght-of-Way, Permit, obt aJ nsbl e; from the, City Engineer.'s o
C
1, wo*r pei &A�edl i you, geti,permit.
TE �42 A' ln,�:�It�, right 1.
ns go whe
N. �3-01itatn full inF��mati6n,,re+g'a��ding)'Ordinance..1-11.16.030�.and Regulatio v6,rn.ing�stde-'sewers
and; 12,,Inches� inside.property HnO*minlmum, grade. of Noi bends� in gea4e..
coverage roperty, line
OTE 1 �4 p side wer4musf:have:ht least W-Inches' p
fI!i _t,.�jllt;be%permjtfed:
harper t &rjj Ad, improper'
risible for fktlur6, aue
'Trench'esfln,street,must be..w
No".*6 ater-gettled' and, surf ace+ of: stre6tr restored, to -original: con, dition. - ontra . ctors sb a 11, be res�6
Z -ork",,�ht6h IthIn-,6ne,-year,of completion. t.
I ffiayAevelop w &m ls,,'rovided Yor In the permit,, or,to. do,any.work on the, main+ sewer� or"it's.eppur enances�.except Ao; in-
N 0AT E work th P-,
peA h6,-wye
s6it-ithiiIii t
n,o �t
'By .......... Date ...... . ......... ................ Date ..... ......
'01S"IM ...... .... .. .........
.................. ...................... ........................................
... . ............ By*
................... .......................... ; .......................... ------
....... .. ..... ...... ... ............................
r s,:, ..................... . ........... ............ ............. ..........
.......... .................................. ......
...... ..... ............. M ...... .....................
........... ..... .......... .........
_777-r7777�
C WTo Req est. F-6r._'Ifispecti6n, ----7—..
U'Perm
IF BOTI Be, Sign6d'-'By,k!wner�ofoaFirm Perfomfing, onstruction- PRIO 4
Ilb6ti6n. c6nstrucfe'd: u'iider lhis_permit�
berieby': certifythat,,the,zid6; sewer insta %
7777*1�
"Firm-* PerfGrming Construction),
of:Edmonds.
66o
Ll t; IU rdanc'e;,�Ot4� all�,gov.�erning.,pr.din.a.i,ic-e,s: of,t.he
.............. .............................. ............
.7day Pf
Dated� thls..� .......
Other
iEiFop + for: -Water;,C],, :-.Gas El T leph?np;,O',� TIOWpr 01. Sewer "E]?
Et yo
APPLICATION
-the City of Edmonds for EASEMENT NO. _ -----------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION r-1 REPAIRS LID NO. _j_&7_1 ........ . ASMT. NO. 115Z)
Z,
OWNER ------------ 4? . ..... C_h� ................................ CONTRACTOR ......................... PERMIT NO.
JOB ADDRESS ...... Lll --- U -------------- ----------------------- LEGAL DESCRIPTION: LOT NO. ------------------------------ BLOCK NO.
NAME OF ADDITION ------ 2 � Y!; � - V, 0..-,: ........ H.. 4-1. � - j a P. T __5 .................................................
"-A � ............................................ -,v _ ..........................................................