17506 69TH PL W.PDFiiiiii Iiiiii
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17506 69TH PL W
APPLICATION
ST P"'WE E T F i L E for
The City of Edmonds SIDE SEWER PERMT
NEW CONSTRUCTION REPAIRS 0 EASEMENT No . ........................................
OWNER . ........................... -.— .............................................................................. CONTRACTOR ..................................................................................................
PERMIT No . ......................
ADDRESS ... 4 =4 NC -a -�\.t..-.�FSTLEGAL DESCRIPTION: LOT No . ............................................... BLOCK No . ............................................ -
NAME OF ADDITION ......
........................................................................................................... .......................
DA
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DATE........... ....................... By ....... .6 . ........ em�.
... .. ........ /14� ........ ---
ME -SEWMER,
M N PE VT,'.
R) MY
CITY Q,
DEPWATMENT'
WATEWSEW
'T
PERMIT., _T'
Y, �b6r�J6.n� of, 'the, �eonstructlor�.
.,-j,75,j525',,for' :sIdd- sewer 4IFFORK covering, any.
�g 44011SM n,.,,,or !holiday inspeetlons�
tlon,,wiht,�e; provi'ac it I ��24.'*hourii.,ifter* requst..'" )SU
cl,�w h nl*
I!ispe�
........ ...
........................................ * ........... . ............... ......................
V,
PIGM45 RV- ......
"DRESS��L&Y& 6kf�O T
...............................
ot 1 ..Cherry ... �rp�� t ............ ............... .................. ............ .............................
ESO ..71- .... ..
OM' ...... .
.ZRT,,YjiL'EGAffi,'oD RU�Tl .........
. ........... ........... ................................ .........
...........................................
.......................... ................ . .................................................................
Y., GOGERT SON ............ ........ .......................... ...............
AND/ BUILDEW ................................... .............
ik OR
...................................
14223' 1 Y 9.9..".
tithtkberqer�Const.-, Mg ...... a
.i014-MR6, T.,()R',St.,NMI,Eie&i�.AMD,RESS� ......................... ......... !7 ... .......... """".7 ................. ... .....
'-dfty,sani ar
:1? seweri.�toi,06-j Y�46,w I
IV . ..... * ......... Q ..... 0,
;kWVW%A= I Mi 9 ... 7A, ior.r�palr.and/or con,
'4,e;ni!j�1bni1s�granted',..
jSrsf�Mjr6'- oanc�B�with,-Cl�3�i�of:'Edthonds�ord'Ln�Lne��S4
accoi
A". lb',,empki�, -Ci�sfkid
y�T
1:�—'_The�.' �jsj of the. -property* mky,,obta1n-,a. permit't' eo�str 'ct *sewer', Inside property,llne7,. A M�ensed Side'Sewer, Contrdctor,�must?. e
0 U
ton of sewer., �13efore'tt has�beerilnsoected'.,
lown� r�invstreet` mrew: Dos not �cover.-any,'.port from. the IC t-, 'e r"
side!,sewe e I Y, ftgIn e s 0
"14PT�Ei';�6.�'i2—Allit,,*6rk;iii6fformed!,Inl,city,'�right.Of-way,-.require�lan� Invasion, of.R.I.9�t-of-'.W,ay,,permit,-.c�6taJ.na.bI
301�and',Regulatidiis:�igov�rnin . g�,slde sewerq� )vhen, you get, Pe W,
NOT�j'ON�','4. 'bbt,al�,�fuili�irif'ormE�.tibn,,r�gELrding:iOrdinance,1.11.16�O 1 1 1. - .. d, ne:'mintmuim,grade�,of 2%-., "',No bends,lllinl�grad
ve 3`Wjnehew'xo�erag'c�&C property line -an .12� tnciiis,�nstde! �ioperty,-ll 7
w6TE0,'No;,*j4 --.Top, i�wfsewei'muft ha,
,'..�she�r'poeft�sth��,1/8',,�-will"bc'permitted). &I rwAue,Ao,'4mprop1
watei settlid`,and1.surf&cCof itrect.restored to; originali conditftm.� Cdntractors,, shall, be! responsible':for,f lu
�N6,TE*No chesj,in� street, must ibei
Ithi w, one, year of,,completiow. an�es,.exeept
.-,work, whichimay!,develop, -the malm sewer or, its*,,appurten
I 'i�,,uhia,�fult�t6-alter�6r',do,!any other work :than'is: Provided, for, In the; permit., or tto.-do;an�;'work on
,N0TV,No.,'16L— V�
wye..
.........
-Date ... .......... t . ...........
"DMO! Date
D s
I
......................... ......
B . . ................. .........
. ..............
......... ..... ....................
..................................................... ....... ..............
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............... ............ ...................
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................................. 7 ..................... ......
........... .......... ......
n r: of' Firm) Terforniihg,�,C&iiti Udibri, -PR1O.R,'T6,,,Roquest0Fko
THt - er
C ST,Bi3 Signedi By,_� W,
rnit biji
Ins tallation, -constructe& u nddr ithisi.pprrn;
hereby -certify �tha:t.Ah�,,,sidiai,sewer
. .... .... ....
ate.,
By,
............. ......
n g, �Constructlon
e Co t�acting Irm Perfo
cbrdbin6e� withkali,,gov ing, ordinances;,of'�the;Cit -,of.Edm.onds.
.............................. . 191..
...........
Mated, .. ........ ...... i..:Aky 'OC-.�� ... ...........
Otherl3bCV/ Vi
9-: �VoNver
Tel" hon
'Rheck BEFORE.- �ou! dig, for:' Water'[],, :Gas. PP er
0
APPLICATION
for
The City of Edmonds SEDE SEWER PERMIT EASEMENT No . ..........................................
NEW CONSTRUCTION 0 REPAIRS
OWNER --- ------
... . .................................. CONTRACTOR Lt<,—I�... 41Z,-'. .. ........... C,3! ..... PERMIT No.
�7 -' - I -:;'-l---4
ADDRESS L4 .... �2A-� ........... .............. .. P 4 ------ ................ LEGAL DESCRIPTION: LOT No . .......... �/ ............................... BLOCK No . ............................................
NAME OF ADDITION .... L/...
Ll
m -- mi,
RECEIVED
m AY 1 19-74
Approved:
DATE................................................ By ......................................................................