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Portion
of Tract
143., 14eadowlale Be-,ch,,'according to plat tliereof
recorcied in
7
v ol.
5 of
Plats.,
page 38p records of 3noho.Lish Count'y,, Washingt�xi.
Fred
0.
&"ey
Loan
No.
4315
Defember-9,
1955
_NW COR.
(VRAC-T 14-3
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Mob
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120 '20
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41 15011
'4'Ty ROAD)
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SETBACKS:
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Scale: 11, r 301
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7,77j
K t A
OTHER
HEIGHT of WA
JAMES H. REID & ASSOCIATES
CONSULTING INOINvang
420 Bell Stroo 11h. GR. 1151 TER
EDMONDS, WASHINGTON I Ault%
J ob 641
fb 19/53
IF
APPLICATION
0
for
ne City of Edmonds
SIDE SEWER PERMIT EASEMENT NO . ......................................
NEW CONSTRUCTION REPAIRS LID NO - ---- 1.6�4 .... ASMT. NO.
................................................................................... PERMIT NO - --------------------
OWNER ----- L -------- PPIF—:N ...
------------------------------------- CONTRACTOR L I (f H Te=
JOB ADDRESS J.f ........ ........... -- ....... = ........ t 7 .................................. LEGAL DESCRIPTION: LOT NO.
---- ----------------------------- I BLOCK NO - ------------------------------------
..................................................................................................................................................................
NAME OF ADDITION ............. . ............ ---- J-4
- --------------------------
DATE.. ZZIc'! ............ By "I ----------------
7AW-11 --- ---- CA ---
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'PERMIT
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IS
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5 Jor
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F';CONSTRUCTION ......... .. . .. .....
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RD PER TEGW','�] itj�yp ', , , * v4dale.
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.,,PRENTICE
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/OR -BUILDER:..
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rank:: '1'
& ADDRESS ........ i ........... �9, Al d` .. ......... .
Fki Ific iteb e
ONTRA'OTOR'SNIAMEk . ril,�
'v� . ........................ .: ................... H ��h. P. N 0o d Ma�
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ance.-with
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r an or, coInn. W of 'W -Sid6'
��),rsystbm.�Jh.,accord -CiCk '6P,Ed6i6hds. ordifiance-s-.' sewe
.N,T] TO�THE'�OLLOA�][Nd_ K
'.The,owner�,
No;, ;1'-7 Y obtain'a'.�e�rmit'.t�,*'c'�nstruct;�ewe* -'I
r , nsIde.prop6rtk,,l ne., 'A:11cerised ;SId6,S�wer,.,Contr ct r.'
.;side - �sew6r 1H.4treet. hLrea,".Do.not'�cover.-an�.-k*rtion Of S�wer, before -,'has st� e�e loy.(;d-�t* t
It -'been Atispicted. r
YI,iOTk� N�;"2�AIII�-.%7vork',,�p.'erfprmed�:tn.-.ci*ty, rj*g.h't.ij*f..w�y,r�q6'1.�L,�:�n�',i fit -ofivity., F;��mjt�
'RJ F - City, Engineer's' fft e.
."`YM'O�I�Of.', . - . ,_ 6bta1I�abI.`,1frbm t he Y,
�i4bTF fulli7inforr�nail�n�.*�ei.�&dl�'9',Oidil��n��,il.."l�!o
Obt:ain i
u get pe I -
',,4'" 'ast w en, R
NOTFt7Nb! O�fj!lsi�161 Mr 1, �36 I nches::Cove rage' �t --pr��er`jy_'1Ijz;e,, d' prope Y--�116e:: minimum.%gr�$ �11*1#1 *1z
11 'I'shaiperihbL�i,,"A'�:,,;ill; be.perniate'dr an 12 Inch es Insl&-., rt*
de ;Of,:;2%�'-PN e-1.
r
renf ps, lm.,st�cet�.must,: c. water
','settled and,,surfacez,of-'st�6et rsto�'a to ..rJ`ji',i�I"J�6n'd'itI6n:. Conti
Mhlch�,mdy. dev.i :,respons
aI6P!.wIthIn1.onc. yea . 7r. of com'ipletion�, actori ishall' �e
r;OT . — . . .. . . . !: I '.
-�Itcr * '. .
0 , e—It llsi-unlw�ftt] Or.do-any other work:lthati� I s',P 'd ;.'0
h I rovI ed for In �the permit:. 6r'to':do,,a.riy!%�b�� �Od.thc math �sew�r'-Orjts appur
fiLet-P!pe: Into t c�wyc� ;, -,�
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WPROVED"
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77� BOTWPermi&�C'
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y-.uw en)o
o jes,�5 ST Be. Sigpe "B* ir" `�Per�formingj;Uonstriuqtio
eques
t. FbrV4inspedt! 2'
7"
of
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c P el�y._cer i Y that ithe�,sid6i'sew6nihs a*
Z , , er or it llation'donitiudt4.tf�d
ling Mr
i(Owner,.of'C Perto ri Cons ct,
ctl mthis;.permi
n
lustaAledi iiitAccorda th all. g nan' 'o th'e"CitY: of-Edn�6n&." e
ove i 6rdi
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1.19!
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F�!Ej, k N4
APPLICATION
for
The City of Edmonds SIDE SEWER PERYaT EASEMENT No . ..........................................
NEW CONSTRUCTION 0 REPAIRS 0 ll�-
4 zp �&�6 46;J
.,A /V 13 F-1? & -E R 4:.r PERMIT No..4
OWNER TA-A-46-5-1 - ----- ................................. CONTRACTOR .. .... ...................................... .... 4
ADDRESS ... Y---7-1 ..... w ....................................................... LEGAL DESCRIPTION: LOT No. -11A ..... 12
._/3
.. . ........... BLOCK No . ............................................
NAME OF ADDITION IN --- EA ... 12 ... O..Se�l .. � P. A.. 4 - 46 ........... at -A ..................................
--7
is
0
T,
7
e - -
1974
(--0
Approved:
DATE................................................ By ......................................................................
"'_�TTPINPET FILE
REGARDING: 17404 71st Avenue West 303-09000
Ta—dTr—e —ssT
R E C 0 R D 0 F. C 0 N T A C T S
DATE NAME, PHONE NO. & COMMENTS ACTION TAKEN INITIALS
ADDRESS of CALLER
5/1/74 James Prentice Certified Letter No. 406211 sent Letter received. TE
requiring hook-up within 60 days.
6/18/74 Frank Lichtenberger came into office TE
and obtained permit #4866.
6/18/74 TE
RECEIPT FOR CERTIFIED MAIL-30� ( lus pstage)
STMA
AT
303-08000 C91
PRENTICEt JAMES Q�'
71ST-AVE W -�� �!
17404 0
C\11 EDMONDS, WASHINGTON
9802,0
CD _01TIONAL SERVICES �F:011 �ADBI�10��A�F�ES
RIEURN 1. Shows to whom and date deliverea
With delivery to.addressee only 650.
R CE'PT�
ECEIPT� 2, Shows to whom, date and where delivered 350
SERVICES With delivery.to addressee only 850
NLY ove
red) . ... .... . .. ..
PS Form NO INSURANCE COVERAGE PROVIDED— (See other side)
Ap 1971 3800 NOT FOR INTERNATIONAL MAIL GPO: 1970 0-307-450
d 9 0 . I q '3 -
City of Edmonds
R IGHT-OF-WAY CONSTRUCTION
PERMIT PermitNumber: 4a-3/o
STREET FILE Issue, Date: /0
A. Address or Vicinity of Construction: 17404 71 Avenue West
B. Type of Work (be specific): Install New Service
C. Contractor: -Washington Natural Gas iBompany Contact: Frank Swan'
Mailing Address: 815 Mercer STreet, Phone: 224-2278
State License #: Seattle, WA 981,11 Liabili ty Insurance: -
D. Building Permit # (if applicable):
Bond: $
Side Sewer Permit # (if applicable): i
�c
E. Commercial n Subdivision El City Project J1 Utility (PUD, GTE, WNG, CABLE, WATER)
Multi-Fatnily E] Single Family Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut W1 Yes nNo G. Size of Cut: x A 14. Charge
APPLICANT TO READ AAIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees xv the Chy of Edmonds harmQiAL%),?es, damages, or
claims of any kind or description whatsoever, foreseen or unforeen, that may be made against the City of Edmonds, or -any of its departmems or employ-
ees, including, gr not limited to the defense of any legal proceedings including defense �o )add attorney fees by reason of granting this permit.
THE CONTRA CTOR IS RESP 0 NSI BLE FOR WORKMA NSHIP A AD MA TERIA LS FOR A -PER[jqq OF 0 NE YEA R FOLL 0 Rfi)Z 17fiFIk4l. INSPE C7 70 N
I
AND ACCEPTANCE OF THE WORK ES77MA TED RESTORAHON FEES WILL BE HELD UN77L THE FINAL S77ZEET PATCH IS COMPLETED BY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with pennit application.
A 24 hour notice is required for inspection; Please call the Engineering Departmenq�
Work is to be inspected during progress and at completion.
,.'Restoration is to be in accordance with City Codes. 771-0220
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required bi-tM-Cilty Engineer.
All strei't cut ditches shall be patched with asphalt or City approved material prior to the end of theworking day;
NO EXCEPTIONS.
I have read the above statements ��ulerstal t1, e permit requirements and the pink copy of the permit will be available
V
on site at all timesfior inspe * 3� purpose
Signature: Date: October 7, 1992
(Contractor or' Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK.
'SE ONLY
-AIGHTOF
ZIZEDfVOIDAFrER Dec-0 1.5 DAYS D ISRUPTION FEE/FUND I 11:
DITIONS: . I � - N) A, RESTORATION FEE:::
....... ........... ........................... ......... ....
PERMIT. FEE:.
.... COMMENTS:., ........... RECEIPT., NO:..
.DATE:
... .. ... .. �q_
......... ISSUED BY. .ky
.0
P
4
ip
Engrg. Div. 1991
ell
FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July
i*
iton
AV*9Vigbn&MWCa,V,V
I-Mo-A -71 AV W
gas main
Addendum to City of Edmonds
Right of Way
Permit Application
Submitted by: Mjc�-kA,9,0 lit" k2o
Engineering Aide
Washington Natural Gas
622-6767 x2761
pager qC-9 - I(c%
water hydrant
0 water valve
815 Merca St. (p.O. BOx 1869). Seattle, WA 98111 (206) 622-6767