17122 68TH AVE W.PDFIIIIIIIIIIII
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17122 68TH AVE W
PLANNING DATA
SINGLE FAMILY RESIDENTIAL
=FILE I
Name: 4 Rnaf==n�
Date:
Site Address: -�a - GRAL Ave- - W
Tax Parcel (DOG yaGC>CC)CC)a0C)
Project Description: Re)ioa, Id -and e-w p-Act
Plan Check #: OZ70
Reduced Site Plan Provided: (YES Z)A1 -4tzoning:
Map Page:
Corner Lot: (YES
Flag Lot: (YES
Critical Areas Determination #: CAkA�DLOX
E] Study Required
19 Waiver
SEPA Determination:
HEE
J9 Exempt
Fit E
0 Needed (for over 500 cubic yards of grading)
0 Fee 0 Checklist 0 APO List with notarized form
Required Setbacks
Street:
Side:
/A
Side:
Rear:
�k's o
62� /I o'
(W� as"
Otbacks --To TN�-�
Street:
Side: (N A"
Side:
Rear: (W)
Detached Structures: �S�cxzrN o,--,
C1 Rockeries:
0 Fences/Trellises: Alo,-,e- e:illnowr\.
El Bay Windows/Projecting Modulation:)
Stairs/Deck: Pce5posed cleAr, eAnoan\
I SaiNin Height
Datum Point: NIA
Datum Elevation: At/.6
I
Maximum Height Allowed:-
#-
Actual Height: 4 A-o
as
4,,. a,
Other
Parking Required:
Parking Provided:
No C�
Lot Area
Maximum Lot Coverage: 35% roposed: C?
Lot Coverage Calculations: 1/9 a pr-of'�� bee
S ed 2, qY 20 2 0, GOO 4fr 1 9 7e,
ADU Created: (YES 1(9�
Subdivision: Woc:& &I L
Legal Nonconforming Land Use Determination Issued: (YES
Comments
Cp
oQ t4 0, !E1 OW'de--a, = D`;Z
Plan Review By:
Planning Data Form 07-14-09
0
APPLICATION
The City of Edmonds for
SIDE SEWER PERMIT
NEW CONSTRUCTION N REPAIRS E
EASEMENT NO - --------------------------------------------
LID NO. ASMT. Wo. -------------
OWNER
CONTRACTOR :P�?t.* ...... PERMIT NO.
................................................. I ................................... ....... I ------------------------------- ..........................
T" . \,t-4M-cS,.7 *b 2
JOB ADDRESS ---- k—D ----------------------- -------------------- LEGAL DESCRIPTION: LOT NO. ..— ................................. BLOCK NO . ....................................
........................... ---------------------------------------------------------------------------------------------------------------------------------
NAME OF ADDITION ..... ................. ..............................
Approved : I I .
DATE ........ 14 . . ..... ... By ................
---------------
NOTIM NO WARRANTY OF ACCURACY The Information shnwn ri t�
--fm use by the City of Edmonds, i' 3
aftzrll-�d m,-,, was cornplibu
aw, r; 7- 7--ts. The City of Edimonds does not warram th�-
an.v— - r forth oii the map. Any person or entity requc:..
c. an imk, uii Inqui, y regarding the informl1ic'.
.'jdlng, bm n(f,� limitod to, the location of an
y
rawei stu)t� mdy oi may nol e)dst and may or m:j r.�! c:. Li
t: �,owa, NcMi�� tho City of Edmonds nor Its cntp!s�! cf
'�,a kab',4ft Infuiiaeftlon glv&4- on this map, not tot uy c,-:�
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CITY OF ED
MONDS SIDE SEWER PERMIT
WATER -SEWER, DEPARTMENT
7a
z(RTMET FLE
T ......
6 C,
PERMI 6))
�_j
caii 775-2525 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 ....
................... . ...................... . .......................................................
PROPERTY LEGAL DESCRIPTION .............
........... ... 95
....................... . .......................... . ........... .......... . .................................................... . .................. . .............. . ................
------------------------------- ------------------- -------------
................................................................ OWNER AND/OR BUILDER---
.............. . .......................................................
CON'TRACrOWS NAME & ADDRESS ..... B & M Contractors
...................................................... ............................ ............................... ... .......................................................
Permission Is granted ........... . .................. Y,%V 2 -9
-------- * -- - --- -------- 191�_, for repair and/or connection of a side sewer to the
SYSteM in accordance with City of Edmonds ordinances.
city sanitary sewer
All;iNTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—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 arty portion of sewer before it has been inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invasion Of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3--Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—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.
NOTE No. 5--Trenches 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 maln sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVEDDate ... . ......... ...................... By ................ Date ............... . ................... BY ---------------- Date ..............
. . ................... By ................
By
APPROVED Date..
...........
................... . .. . .. . .............................. . .......................................................
AR /�
Remarks: ....... . ...... . ......................
.... . .. . ....... . ..... .....
.. . . ................................
.... . ...................................................... ....................................................
. . ..................................
................................... . ................................................................................
........ . .................................. .............................................. .........
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
0:1
........... hereby certify that the side sewer installation constructed under this permit
. ..... ... .... . .
er of Contract -In. Con . str . uctio . n
installed in accordance with all governing ordinances of the City of Edmonds.
Dated this ........................
.... day of ...............................
............... .......
.......... 19 ---------
V NI Check BEFORE you dig for: Water Gas Telephone Power Sewer Other E3 V N/
.. .... . .. .... ... ... .. .. ..... UTA!1
Open trench in shoulder of ROW for approx 75 ft, bore roadway 20 ft, and set
carson to extend and bury CATV service drop
60'
9.
16— —
CATV
Comcast of WA LLC.
1525 75th Street SW
Suite 200
Everett, WA 98203
Contact: Kermit Benson 425-263-5362
North Drop
Node: EM 05A
17122 68th Ave W. - City of Edmonds
20'
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-4
-4
APP NOTED
EERIN
24 HR. NOVICE REQ.
FOR INSPECTION
S
E W
N
NORTH NOT TO
SCALE
Work Details
Open trench in shoulder of ROW for approx 75 feet (m/1) bore roadway apprbx 20 feet and set carson to extend and bury
CATV service drop to 17122 68th Ave W. Install cable at 36" depth.
All disturbed areas will be restored to existing or better conditions.
Backfill material will be mechanically compacted to 95% of maximum density as specified by the City of Edmonds. In tight:
corridors hand trenching will be utilized to ensure protection of other utilities. Contractor must locate all existing utilities
impacted by this project.
Please see attached plans for restoration, erosion control and traffic control. Erosion control will consist of placing filter
fabric fence and/or sandbags along curbs and catch basins where necessary. Keep drainage system clean and functioning.
Remove all debris from the work site. Streets and roads will be cleaned both during and after installation of work.
City of Edmonds Permit No: '01"
t
RIGHT.-�OF-WAY CONSTRUCTION PERMIT Issue Date: 9-06�
A
A. Address or Vicinity of Construction:
B. Type of Work (be specific): 06 RQedA .0- 0'007 ;,17) "x,
A
OIL) I -Ir-
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C. Contractor:
U-4
L'(— �o, Contact: o—'r E7�
Mailing Address:
I .
—
Phone:
State License
Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. M Commercial
El Subdivision
Ej '�City Project, (&UC (PUD, VERIZON, PSE, A+&'T, OVWD)
'Other
F1' Multi -Family.
El Single Family
INSPECTOR:
F. PAVEMENTCUT: E]YES NO G. SUtE OF CUT x
CONCRETE CUT: YES NO
INDEMNITY. App . licant understands by hislher signature to this application helshe -holds the City of Edmonds harmless from
i . nj . uri . 6, * damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City
1 3
Edmonds or any of its departments or employees, including but not limited to the defense of any legal proceedings including defense
costs and attorneyfees by reason ofgranting this permit.
THE CONTRACTOR IS, RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLORING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS
,COMPLETED BY CITY -FORCES, AT WHICH TIME A DEBIT OR CREDIT 97LL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Traffic control'and public safety shall be in accordance with City regulations as required by the City Engineer. Every
flagger must be trained as required by (WAC) 296-15�-305 and must have. certification verifying completion of the
required training in their possession.,
Restoration'is- to be in accordance with City 'codes. . All street -cut. trench work shall be patched with asphalt or City -
approved material prior to the end of the, workday — NO, EXCEPTIONS.
Three sets of construction drawings of proposed work are required with the, permit application.
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
I HA VE READ THE ABO VE STA TEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND A.CKNO WLEDGE
THA T I MUST MAKE THE PINK COPY OF THEWERMITA VAILABLE ON SITE A TALL TIMES FOR INSPECTIONS
Date:
Signature:
FOR CITY USE ONLY
Appyoved by: Kll'�LF-c Right-of-way Fee:
Time Authorized,: Void After '0 (41 Disruption Fee/Fund 111:
Special Conditions: ,R6gtoFatimrFee': /-00�
Totaffee,
_57LA
L04Z At di;"� ''l, Receipt No: 4
�i '"e
A&45" *4 /7' li4e�K' olfal-m Issued by,.--�7z"
W4
4& 0 Ad
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UPON COMPLETION OF PERMITTED WORK,ANENGINEERING FINAL
INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT C DE (P opp.-4,25-771-'0220, Ext. 1326)
'C
ADE (P �ig4 '
FINAL APPROVAL OF PERMITTED WORK. DATEka�__
olr's'rigna
S ture
Insp tor's
For inspection requirement!-se.e. Engineering Inspection Informati,o,n,.,,,,h,a,n,,d,,o,u.t.
DAMy Documents\Forms\Engnrng\ROWpermit-.doe
cc 0 M. c' a' s' t
PROJECT'S TIMELINE AND PROPOSED HOURS OF OPERATION:
Timeline - Up to 30-days past the issue date.
Work Hours -The entire project area will be conducted from 7:00 AM to 7:00 PM or
as specified by -the Inspector.
Traffic Control Plans
1. The standards and guides of the latest version of the MUTCD or as set-up per
Code shall be followed at all times.
2.. A copy of the Permit and Traffic Control Plan shall be on -site with all
contractors during the project.
3. All contractors will avoid parking on sidewalks.and shoulders and will take the
lane and follow the proper traff ic control set-up for the given situation.
4. Pedestrian access shall be maintained through or detoured around all work
sites.
5. Please find attached the traffic control plan� for the various types of work
sites that will be encountered during our project.
6. Flaggers will be used only when all other methods of traff ic control are
inadequate to warn and direct drivers. Only licensed flaggers will be used on
the project.
7. If situations occur when questions arise about proper traffic control set-up the
solution will be determined in the field with the Comcast Construction Rep.
and the Inspector.
974-
Er6's1'6`ff"_*C,6"'_
If curb and gutters in project area:
. Filter bags will be placed in catchbasins downstream of work site, and
. Small check dams of pea gravel filled sandbags will placed within the
gutter upstream of the catchbasin.
Traffic control set-up for minor encroachment
100i
Ileuo!1dol
M
Traffic control set-up for lane closure
FLAGGER STATION , 01
100,
Mce
FLAGGER STABON
Depth, Cleaning, Containment,
Compaction, and Restoration
Depth =
36-inch minimum
Compatible w/
other utilities
Shoring required
at 4-ft +
Pavement Cuts =
T-cut 1 -ft wider
than trench
Neat -line saw -cut
or jack harnmered
edge
All trench backfill shall be mechanically
compacted to 95 percent of maximum density
using 1-ft loose lifts with whacker or 2-ft loose
lift with a hoe pack.
If proper compaction cannot be achieved with the
native material, new import material is required at
the 95 percent rate.
As an alternative, CDF can be usedin a design
mixture approved by the Engineer.
Ccomcast
CLEANING: All Streets and roads are required to
be cleaned and swept both during and after the
installation work.
* Mechanical Vacuum is preferred method
CONTAINMENT: All un-restored shoulders or
material storage areas are required to be contained
with reflective barricades.
All disturbed areas shall be restored to
existing or better conditions
Trench parallel to road:
• Shoulder - Match existing surface conditions
• Pavement - 6.1/2 inches of crushed surfacing material
and asphalt concrete Class B at 2- inches minimum or
same thickness if greater..
Trench across road (immediate cold mix patch):
• Asphalt - Permanent hot mix patch at same thickness
or 2-inches and sealedwithin 30 days.
• Concrete - saw cut and pored with mastic joints, eight -
sack mix, either type II of III cement, within 30 days.
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PLOT PLAN
I" EQUALS 201
�CEL NO.. 00642600000200
':')AL DESCRIPTION. LOT 2 SHADOW WOOD #5
ZEET ADDRESS. 17122 68TH AVE W. EDMONDS. WA.
51,91
Cornei��Jlag&Q
Setbacks
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Front �u)
Sides
Rear �w)
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Other
68TH AVE
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MAY 04 2010
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MAY 04 2010