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17126 68TH AVE W
APPLICATION
for
The City of Edmonds -er%EET FILE SIDE SEWER PERMT
Z03 NEW CONSTRUCTION 0 REPAIRS EASEMENT NO.
CONTRACTOR..... ...............................................................
OVVNER .... C:4z.l ..................................... --- .................... PERMT
............ ................................... LEGAL DESCRIPTION: LOT N
ADDRESS ...... 0 . .... .......................... -. BLOCK No . ............................................
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NAME OF ADDITION .... ............ 40-e .....
RECEIVED
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Approved:
MAY 2 9 1975
DATE................................................ By .....................
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SIDE -SEWER PERMIT
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CITY EDMONDS SIDE SEWER PERMIT
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WATER -SEWER DEPARTMENT
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STRUET FILE PERMIT
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Call 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.
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ADDRESS LOCATION OF CONSTRUCTION ------ 68th Avenue West
---------- ----------------------------------- ---------- - ----------------------- --------------------------------------- ---------------
Lot # Sfladowwood Division #5
PROPERTY LEGAL DESCRIPTION ................................. ........................
..............................................................................................................................
....................... . ........................... .......... . .......... . ......................................................................... . .............. . .................................. . ..................................................
................................................................ OWNER AND/OR BUILDER .... � DEAUX..00NSM.CT101'q ................ . .......................................................
CONTRACTOR'S NAME & ADDRESS ....... R F7 M COntraCtOTS
-------------------------------------------------------------------------------- - ------------------------------ - --- -------------------------------------------------------
Permission is granted ................... May ... 29..q ... .. ............ 119.75., for repair and/or connection of a side sewer to the city sanitary sewer
......... ----
In 11, Mance with City of Edmonds ordinances.'
ATTENTION IS CAM D 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 Contrdetor 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—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. &—Obtain full information regaxding 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
shaxper than 2A 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
'.f' 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 maJn sewer or its appurtenances except to in-
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Bert the pipe into the wye.
DISAPPROVED Date
41
. ...... ..................... By ................ Date ............. .. .........
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By -------------- Date ---------------- ------------------- - By -----_--------
APPROVED Date...-./,O ........
...... By --- - --- . .. ......... . .. . .. . .......................................................................................
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Remarks: ....... . ....... .......................... . .. . ................ ................... ................... . ....................................... ...................................................................
..................................................................... . ........................................................................................ . ................................... .......................................................
MUST nspection
—BOTH Permit Co S Be Signed By Owner of Firm Performing Construction PRIOR To Request For I
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...... ............................................ ... hereby certify that the side sewer installation constructed under this permit
--- ------------
(Owner of Contracti Firm Performing Construction)
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was installed in accordance wi all governing ordinances of the City of Edmonds.
Datedthis ---------------------------- day of ................................................................. 19 ........
Check BEFORE you dig for: Water C], Gas E], Telephone E], Power E], Sewer E], Other E]