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17117 68TH AVE W
APPLICATION
for
The City of Edmonds SEDE SEWER PERAHT
NEW CONSTRUCTION REPAIRS 0 EASEMENT No . ....... ..................................
........... '" CONTRACTOR 4Ht!g`"...EF= ................ . .............................................
O'V,`NER, FM C . .............................................................................................. PERMIT No
ADDRESS ....... P�h"Nqlr—= ------------ W ..... ...... LEGAL DESCRIPTION: LOT No . ....... 7 ........................... BLOCK No . ...................................
,015f NAME OF ADDITION ....... ....... Pf> ----- gRb"4C" .....
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KIOTICF' NO WARRAMY OF ACCURACY
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CITY OF EDMONDS SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
... ....... ..
.7
7,76-1107 for side sewer inspections BEFORE covering any portion of the construction.)
(Call
Inspection will be provided within 24 hours after request. No Sat., Sun., or holiday inspections.]
17117 68t h A yen Ue Wes t . .......................................................
ADDRESS LOCATION OF CONSTRUCTION ............. ... _ --- --- ................................
' ' '
Lot Number 7, Double DD Ranch Addition #2 ....................................................
..............
PROPERTY LEGAL DESCRIPTION ................................................................... I ..................................................
. ..................................................
.
.................................................. . ...................... ....................................................................................... . ............... ...................
Richard McFadden
011)MER11ND/OR BU ILDm ...... ............................... . ............... ................... . .......................................................
.................................................................
t. 11ash.
E nds.._. ...........
& ADDRESS_�h
CONTRACTOWS NAME .4m�grVku �98020
sew i sani wer
194a, for repair and/or connection of a side er to the c ty tary se
Permission is grantd� ........... ------ - ------------
in accord ance with City of Edmonds ordinances.
system
J nstruct
AT jION IS CAT D TO THE FOLLOWING: inside property line. A licensed Side Sewer Contractor must be employed to co
to construct sewer
__
Nd-_,40. I —The owners of the property may obtain a permit
side sewer in street area. Do not cover any portion of sewer before it has been inspected.
Permit obtainable from the City Engineer's office.
NOTE No. 2—All work performed in city, right-of-way requires an Invasion of Right-of-WXY
NOTE No. 3--Obtain full information regarding Ordinance 11.16.030 and Regulations gov erning side sewers when you get permit.
of 2 No bends in grade
I and -12 inches inside property line; minimum grade
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property I ne
sharper than % will be permitted.
in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
NOTE No. 5—Trenches
work which may develop within one year of completion. -to in -
to 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
NOTE No. 6—It is unlawful alter
sert the pipe into the wye.
---------------- -- .............
By .......... >Dste ----------- g;-;.. ------------ B .... .... Date ................. 'BY ...
DISAPPROVED E] Date 4
Z9 By... ... ..........................................................................
APPROVED --- -----------
..................................... ...................................................................
Remarks: .......... ...................... . ................ ............... ............... ........... . ...................................... .
................. ......... . ...... ................................................................... ............... . .................................. . ....... ........................... ......... .........
.................. ....
ed Owner of Firm Performing Construction PRIOR To Request For Inspection
BO
hereby certify that the side sewer installation constructed under this permit
.... ... ..... ......
0 uc
o cling Firm Perfcr ing C n r tion)
(Owner of Co
lstalleO in accordance wit . h all governing or inances of the City of Edmonds.
day ...................
Dated thl .............. 0
Check BEFORE you dig for: Water Gas E], Telephone Power Sewer E], Other
.......... .