17510 69TH PL W.PDFiiiiii iiiiii
5328
17510 69TH PL W
PermitNo: Adoq_�30
City of Edmon&,
RIGHT-OF-WAY CONSTRUCTIONI ERMIT Issue Date:
J
A. Address or V;cmity of Construction:
e
B. Type of Work (b speci ic): loelrm 1 0/1 -/V 04be!,
_90\A-1 0�04rvA e?2/ I 14ti -6 YJ r-&- or 6 g +
C. -Ce0bn6!:c'tor: Im 4L--
---I r I #6_ (;-- (t_
Mailing Address:.1"5 Z 'e— 95--ij, :!��U)
State License #: Zo o
City Business License #:
4-
Phone: 4.,/-o?— 4�
'eJOIAMI ALVMEL-_dAW� =WMR._.
1 11
Liability Insurance: Bond:$
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. F� Commercial El Subdivision El City Project X EUC (PUD, VERIZON, PSE, COMCAST, OVWSD)
Multi -Family E] Single Family F-1 Other
INSPECTOR:
F" ,
F. PAVEMENT CUT: El YES El NO
CONCRETE CUT: El YES F-1 NO
G. Mail Apprd`ve�'d Permit 6 Call for Pickup
G. SIZE OF CUT
,&-A, ..
I-ITY
x
INDEMNITY. Applicant understands by his/her signature to this application helshe, holds the City of Edmonds harmless from
iiijuri damages or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of
qsl
Edmonds or any of its departments or employees, including but not limited to the defense:bf any legal proceedings including defense
costs and attorne�fees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP �ND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION,FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS
COMPLETED BY CITY FORCES,A T WHICH TIME A DEBIT OR CREDIT WILL BE P�OCESSED 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 r6quired by (WAC) 296-155-305 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 HAVE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THA T I MUST MAKE THE PINK COPY OF THE PERMIT A VAILABLE ON SITE A TALL TIMES FOR INSPECTIONS
Date: e, ZOO
Signatfire:
'CITY'
-S
Aporoved-by: kiihi7of*a 'Fee, f"04
y
Time Authorized: Void,After
Special Conditions: ?C-S—feve;, nsp,ec-ion
pp't Ai To t a I F ee'
11MIMIEZ dg�� 4 �r-wl* Re t N
ceT
ft'ReS W-27" 1129MAffE -0: 699 0— Issued-:bY—
AAA AL IC 014v.4� rflld� A. I - A= Y/ j,
i�Pll Ir */ I - 1A IAO�V�'
REQUIRED INSPECTIONS: M fWft
Call 425- 771-0220, Ext. 1326for a 24-hour
FINAL APPROVAL OF PERMITTED WORK:
;re n request line
DATE LQ -5
clor's Sit -nature
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
C:\Documents and Settings\CurtisNy Documents\Fomis\Engnrng\ROWpemit_.doc Re�ised 10/01/03
0
U")
37'
37'
M
Open trench in shoulder
of ROW for approx 41',
bore 2 sidewa lk
surfaces for Vea,,�'bore
I "
roadway surface for 37'
and set carson
pole
4'e
Kmi
N
rl� -
W .4 T 0- E
S
NORTH NOT TO
SCALE
Comcast of Washington, LLC
1525 75th Street SW
Suite 200
Everett, WA 98203
Contact: Kermit Benson 425-263-6362
North Drop
Node: EM 04A
17510 69th Pl. W. - City of Edmonds
Work Details
Open trench in shoulder of ROW for approx 41 feet, bore 2 sidewalk surfaces approx. 5 feet each, bore roadway
(m/1) and set carson to extend and bury CATV service drop to 17510 69th pI W. Install cable at 36" depth.
All disturbed areas will be restored to existing or better conditions.
approx 37 feet
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.
ccomcast
PROJECT'S TIMELINE AND PROPOSED HOURS OF OPERATION:
0 Timeline — Up to 30-days past the issue date.
0 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 plans 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 traffic 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.
LErbs"lo'd.Contio I-A�Ies -w;`#
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 sandbaa will placed within the
.s
.gutter upstream of the catchbasin.
Traffic control sef-up for minor encroachment
100;
Traffic control set-up for lane closure
W
. �Mmtoptionall
A A6.
6 NiV5
fLAGGER STATION
001.
Truck Mounted
Attenuator
foptional)
113 L
200'
A
fill
�
Buffei space
T
Depth =
36-inch minimum
-Compatible w/
other utilities
Shoring required
Pavement Cuts
T-cut 1 -ft wider
than trench
Neat -line saw -cut
or jack hammered
edge
9
�%R
S-D
N T �A
Depth, Cleaning, Containment,
Compaction, and Restoration
'C 0 M-P Y�
All trench backfill shall be mechanically
compacted to 95 percent of maximum density
using I -ft loose lifts with whacker or 2-ft loose
lift with a hoe pack.
1f,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 used in a design
mixture approved by the Engineer.
Ccomcast
ri
ffim'e
np
CLEANING: All Streets and roads are required to
be cleaned and swept both during and after the.
installation work
0 -Mechanical Vacuum is preferred method -
CONTAINMENT: All un-restore'd shoulders or
material storage areas are required to be contained
with reflective barricades.
'gffi -tot a:
All disturbed areas shall be restored to
existing or better conditions ! I I I I I I
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 (inunediate cold mix patch):
Asphalt - Permanent hot mix patch at same thickness
or 2-inches and sealed within 30 days.
Concrete - saw cut and pored with mastic joints, eight -
sack rrdx, either type II of III cement, within 30 days.
S
City of Edmon ;'d' s ','Permit No:
RIGHT-OF-WAY CONSTRUCTION PERMIT Issue Date:
to 9 PJ 1A
A. Address or Vicinity of Construction: 1257e)
B. Type of Work (be specific) -Zna n- -/-Yv rk,"I a '5h t) u Idt r ol� e0t.0 e2e)nn' 15
t)6 /1 r / ve �1 'A' :410- bDKC P-4 adIA30 14
k Fpr'�5"' rn) L annl
*� 1 -�-5
r V I C.'L C1 rz�p A (A.3
C. Contractor: - 426 mr-O C
#2nn P
Mailing Address: 1'72,5 VIA _S U-) #=
State.License C- yCre (AA I !&ZO-5 L
City Business License #:
D. Building Permit # (if applicable):
E. F� Commercial
Fj Multi -Family
INSPECTOR:
ET SubdMsion
E] Single -Family Fi'�
Side
1.6, \ec t
e
Insurance
�(ddp�licabl'e):
"INIP, VERIZON, PS4
I
F. PAVEMENT CUT: El YES [-I NO SIZ OF CUT
CONCRETE CUT: El YES El NO
G. I XMail Approved Permit 0 Call for Pi\cku
INDEMNITY. Applicant unde ds by hislher sign/ure th is ap \ication
4,hats r
injuries, �amages or claims of any ki or descripti �/' I d ver, " 0 r� n or
Edmonds or any of its departments or emp es, in)itding b�t t limite�\t�e
costs and attorneyfees by reason ofgranting thi mi . t.
x
MWE
COMCAST, OVWSD)
holds the City of Edmonds harmless from
een, that may be made against the City of
of any legal proceedings including defense
THE �CONTRACTOR IS RESPONSIBLE FOR AN LS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK. TIMA T FEES WILL BE HELD UNTIL THE FINAL STREET PATCH IS
COMPLETED BY CITY FORCES, AT WHICH TIME IT OR L E PROCESSED FOR ISSUANCE TO THE APPLICANT.
# Traffic control and public safety sh be in accordance wit regulations as required by the City Engineer. Every
flagger must be trained as requir by (WAC) 296-155-305 an must have certification verifying completion of the
required training in their possessi
# Restoration is to be in accorda e with City codes. All streef-cut trench work shall be patched with asphalt or City -
approved material prior to the nd of the workday - NO EXCEPTIONS.
# Three sets of construction dr ings of proposed work are required with the permit application.
CALL DI L-A-DIG (1-800-424-5555) PRIOR -TO BEGINNING WORK
0
I HAVE READ THE AB OVE TATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THATI MUST MAKE THE COPY OF THE PERMIT AVAILABLE ON SITE A TALL TIMES FOR INSPECTIONS
Signature- Date:
(Contractor,dr)Agent)
FOR CITYUSE ONLY:
Rigb(-6f-;-'*a Fe e::�,
Oprovedby:
DisruiptiOnFee/Fd6d.
Time Authorized:. Void'After
Special Conditions- I0smcti6nTee:,)
lioceipt, 0.�'
Is,su�#'Iby..
REQUIRED INSPECTIONS:
Call 425-771-0220, E�yh,1326for a 24-hour voice -recorded ihspection request line.
FINAJL APPROVAL OF PERMITTED WORK: DATE:
Inspector's Signature
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
C:\Docurnents and SettingsTurtisNy DocumentsNFomis\Engnmg\ROWpemit_.doc Revised 10/01/03
Open trench in
shoulder of ROW
for approx 45'
and bore d/w
approx 19'
Comcast of CA/COrTX/WA, Inc.
1525 75th Street SW
Suite 200
Everett, WA 98203
Contact: Gary Clawson 425-263-5412
North Drop
Node: WK10
14109 113th Ave NE - City of Kirkland
6'�,X'
N
W + E
S
NORTH NOT TO
SCALE
Work Details
Open trench in shoulder of ROW for approx 45 feet and bore driveway for approx 19 feet m/I to extend and bury CATV service
drop to 14109 113th Ave NE.
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 Kirkland. 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.
Ccomcast
PROJECT'S TIMELINE AND PROPOSED HOURS OF OPERATION:
a Timeline - Up to 30-days past the issue date.
0 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. Xcopy of the Permit and Traffic Control Plan shall be on -site with all
contractors during the project.
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 plans 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 traffic 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.
E rosi C J-6 ER"
I' low � ohtt6 ules'�*
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
.utter upstream of the catchbasin.
w
Traffic control set-up for minor encroachment
.00;
Truck Mounted
Attenuator
toptionall
6 . . .
Traffic* control set-up for lane closure
100,
)ace
FLAGGERSTAnON
D,
A
Depth, Cleaning, Containment,
Compaction, and Restoration
Yend
Depth =
*
36-inch minimum
1*
-Compatible w/
other utilities
Shori-ng required
at 4-ft +
Pavement Cuts
T-cut 1-ft wider
than.trench
Neat -line saw -cut
or j ac k hammered
edge
:7comp�c'
All trench backfill shall be mechanically
compacted to 95 percent of maximum density
using I -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 used in a design
mixture approved by the Engineer.
Ccomcast.
-a
6 A, -inrylent-
`8
-48 egnin
'M'Z.'! " _ g._, ..., n
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.
�'_f 00.
6
K
I . V'vi
W ,
All disturbed areas shall be restored to
existing or better conditions
Trench parallel to road:
* Shoulder - Match existing surface conditions
4 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):
1* Asphalt - Permanent hot mix patch at same thickness
or 2-inches and sealed within 30 days.
Concrete - saw cut and pored with mastic joints, eight -
sack mix, either type II of III cement, within 30 days.
PROJECT REVIEW CHECKLIST
ZFS-/O 6p I;v
ADDRESS:
I MEET
APPLICATION RECEIPT DATE:
Reviewed by: (initial/date).,,�
CaMMENTS
PLANNING
wrwsm STREET ENGNRNG",�"
FIE
-
EuILDING
/////////
77777777
1IT177UI
Snnz PAMILY/mMTrPLE/CofaRCTAL - (Circle One)
SETBACKS C1MCKED - Plannimg
7 T7TR77
////////
11TFfl7777
VARLkMCE/SETMkK AW.
77///////
1111111M
7
CONDITIONAL USE PERMIT
2
ADS MQUIREMENTS CHECKED
3
11117T
111111TR7
OTHER ZONTNG REQUTRDMM
4
ENVIRONMENTAL FEATURES
5
ACCESS SMPE VEHICLE ACCESS _57
-777T
6
777777
111111117
11117TIT
DRhmAGE PLAN (On Site)
7
STREET FILE
TITfTF17771111111
8
LEGAL DESCRTMON VFAIFICATION
11IT1777717711
TT7=
9
7777=
7777TRII
QUIT CLAIM/DEDICATIONS ,Y7
.10
111177777
7T/77777
FASEMERr - PUBLIC/PRTVATE
/////////
////////
11
7/77/7
7M77777
77777717
CALCULATE SrYER CONNECTION IF NO LID#
12
PLAT/SUBDIVISTON REQUIREMENTS
13
RIGHT-OF-WAY CONSTRUCTION PERMIT RFADD
777TIT
//////
=77
/////////
1111111111'51ISlf7
14
77////
77777777
BOND RE(P FOR PUBLIC IMPROVEKMS
//////
////////
15
SOILS CONDITIONS & GROUND
14ATER FIEID C31ECKED -
777P7
//////
TITRTTff
/////////
11111L11
16
1777777//
77779111
MEET PAVING REX)UTRED'
17
77R7
CURB AND GUTTER REQUIRED
//////
is
717-11
711111111
srDEwAix RpxIRED
/////////
/////////
-7777/77//
19
777TR77
CURB CUT FOR DRIVEWAY REQD
20
11111175
STREET NAME SIGN REQD
21
7TTFT
7777/7T/7
kX
111177777
OTHER SIGNING RE(P
22
77TI77
77IT11117
7TITRT17'
SIDE SEWER AVAILABILITY
MMMUMML
23
-
EXISTI-)G WATER MAIN SIZE
111711
D, A
7TIT=
24
7T/W////
WATER TETER SIZE
25
SERVICE LINE SIZE
26
11111111T
777777777
77777777
HMRJ*" REQUIRED
///////// -
/////////
////////
27
111111117
7111111
HYDRANT SIZE EXISTING
28
777Tff
77Tf=
CF40SS CONNECTION INSPEMON REOD
-7=
29
VATM MIrEm CHARGE REQD
11111111T
11111171
-1111111117177
7"F77777777
30
7 TI"I /Iff
FIRE M �M CHARGE REOD - SPRINKLER
3
d"p,
uyv, yy
STREET CUT
11/11117t
;1
3
OP"N DITM EXISTING
Ai
CITY OF EDMONDS
U USE PERMIT
SF
ZONEAS_4� NUMBER
CONSTRUCTION PERMIT APPLICATION
joB
S
SS
AUUHrSS
FAODRIE
0
cc
LU
z
0
NAME (OR NAME OF BUSINESS)
14
- e5kiee-t C.— 6 UC T/ 07/1)
L AL 6DESCRIPTION CHECK
07
LEO L
C
7
SUBDIVISION NO.
LIU NU.
MAILING ADDRESS
0
W
t:
PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP.
EXISTING REQUIRED DEDICATION
z
Fr
Uj
LU
z
CITY TELEPHONE NUM13ER
177LI30!9_—:�
NAME
0C
RIGHT OF WAY CONSTRUCTION PERMIT REQUIRED
5 T HLE I USE PERMIT REQUIRED 0
ADDRESS
SEE ENGINEERING MEMO OAT
CITY
TELEPHONE NUMBER
I
REMARKS
111A
NAME
ADr6SS
6014
Ir
0
2
z
0
__'1M=UPPLY
METER SIZE
SIZE
FIXTURE UNITS
CITY
TELEPHONE NUMBER
177eY 3�S_`�
REMARKS
STATE LICENSE NUMBER
S—F'54-0 94f 4
SIGN AREA
ENV. REVIEW
ADB NO.
ALLOWED PROPOSED
COMPLETE I EXEMPT
I
z
Legal Description of Property - Include all easements
h w below ttach pfurigoles, _"F
SHORELINEO
79A CT_ 147 G �2 -bA
VARIANCE OR CU
PLANNING REVIEW BY
DAT
PA 6,!!f
z
z
YARDS z�
__E�7
FRONT SIDE-7 REAR
HEIGHT
LOT COVE
-
tJ 0, C 0 L E -34 6�, I�C)4�_
REMARKS
Fy(1W_:k6_1 E;Ot�_�7
NEW RESIDENTIAL PLUMBING
ADDIALTER 0 COMMERCIAL F] MECHANICAL
0V P �__7
REPAIR RETAINI'NG WALL SIGN
CHECKED BY
j—tlm
T PE OF CONSTRUCTION
Z�:&
CODE
D-7ej�,s—
HEIGHT
2-5—
EXCAVATE FENCE
DEMOLISH OR FILL ( x _FT)
PRE-MOVE INSPJ swim
REMODEL COMPLIANCE INSP. POOL
z
5
SPECIAL INSPECTOR
REQUIRED
0 YES
AREA
OCCUPANCY
GROUP C7 -2
OCCUPANT
LOAD
_E1
WOOD STOVE/
INSERT APT.BLDG RENEWAL
REMARKS
ill -All ffk-w4 Pezil'W- 1r19 ZX_46Y
a:
U
0)
W
aro
.0
77&VK
NUMBER OF STORIES
7W 0
NL ER OF
VMB
TO ELLING
W
US
NATURE OF WORK TO BE DONE (ATTACH PLOT PLAN)
AJ 09�_- If �J &LIF L
ji�eA-ic'eE
PLAN CHECK FEE
BUILDING
PLUMBING
MECHANICAL
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks,
""--marquees, etc.) will require separate permission.
P1 A S
is and
A ,-*Y-
d hold
licials,
GRADING/FILL
STATE SURCHARGE
ENERGY CODE
-11.
MEMO TO: Building Division
FROM: Engineering Division
SUBJECT: 5 1
After review of the subject building permit application, we have the
following comments:
1) Connection to City water system required.
2) Connection to City sanitary sewer system required.
3) Right-of-way permit required for any work.on City property.'
4) Driveway slope not to exceed 14%.
5) Back water valve required if downstairs plumbing is below
elevation of upstream manhole.
6) Water and sewer lines to be separated by 10 foot minimum.
7) Builder/owner responsible for containing all temporary runoff And
erosion on site and may not impact neighboring properties in any
way.
8)
Of
/P.
Construction hours from 7:00 a.m. to 10:00 p.m. on weekdays and
10:00 a.m. to 6:00 p.m. on weekends and holidays.
STANDARD DRAINAGE PLAN
C AT04 11 A,5 I N:
.� - — I
IMUAL I Q Qk TPKf4CW LSrNr-rH
_rRICNCH CDVWR
............................. ....... . .......... T!
- " ft
,,�PEF.7:
-rE E Vv/ 4'LoNG L-F-as
LCVM-L TXWNCj4
CAP
I
SYSTEM CROSS-SECTION
T(O f5f�=- LA"/,ED �
T9,E?,CW COVER
3/4 * _ I I/ I I
GPAVEL
4 OiAm FERF P
� — �_c I
TRENCH CROSS-ScCTION
go
INFILTRATION SYSTEM
PAGE I OF 2
for ��_,9Y&VE 5�7_15N8Ee(_
location—L7Sx)t .,'2:2 FL , v/
&; r", M L) /� :,
plan by ±07,2,A �:� tN
phone __ 77 4 30 4—:3
DESIGN DATA
Trench Perc LF per Imperm Trench
Number Rate 1000 sq.ft. Area Rio.
NOTES
I Call Engineering' Diyis ion (771-3202)
Jor prebackfill and final inspections.
2. Responsibility for operation and
maintenance of drainage systems on
private property is the responsibility
of the property owner(s). Preventive
maintenance consists of preventing
soil and other materials from entering
trench during construction as well as
after construction. Catch basins should
be cleaned of floatinq material and
sediment at regular intervals (at least
twice per y ar)
VV.
CITY OF EDrylorJOS
t
>e
T�5-r 14OLE H(zkF:h
��' OP 4" PEt�. w
IS' GRAqCL AU-01ZD I '.) Z
Tb f>?cQF1cA-r1oNs
C-ATC-;J &A51N
43
co
FT16W-L/mc
'�V'� Pwj5pboT5
- 2t>
V1-
-70 /
SITE PLAN, SCALE:
NOTE: DO NOT USE INFILTRATION SYSTEM
ON SLOPES'OVER 15 PERCENT (15
F�OCT RISE pc*- 100 FEET HORIZONTAL)
I
'% z5kos /od aNtm, �d 4-
1qt_0,4)Cr-
720
Z.—mb.
STANDARD DRAINAGE PLAN
INFILTRATION SYSTEM
PAGE 2 OF 2
C IT Y 0 f EDMONDS S I D E S E W E R P E R M I T
'<r
00
C)
V)
For Inspection Call S7-,,mET FILE PERMIT NO. 07724
0 Address of Construction: 17-67
Property Legal Descri ption (Incl ude al 1 easements):
Owner and/or
Builder:
Contractor &
License No:
T-cE A)
A
B
2', 0
Singl:e Family Residence
Mu 1 t i - Fam i 1 y (No. of Units L - YNNWOOD LINE
Commercial
(No. of fixture Units
Invasion into Ciiy Right -of -Way: No X/ . Yes (If Yes, Right -of -Way
Construction Permit -r-,,Tquired. Call One -Call -Center (1-800 . -424-5555) before any
excavation.)
Cross other Private Property: No Yes (If Ye s, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
I eert that ave rea and shall comply Date
with Z tems listed on he back.
Permit Fee: W-00
Trunk Charge: Z-5- 00
Assessment Fee:
9
Issued By: sT 1
k
Date Issued: ;E
Receipt No.: -71-7-L
Partial Inspection:
Comments Date Initial
Final Inspection Approved:
'Dat6 Initial
Rejected:
son
** PERMIT MUST BE POSTED ON JOB SITE **c
Date Initial
Wh.ite Copy - File Green Copy - Inspector
Buff Copy - Applicant 4
The City of Edmonds Side Sewer Drawing EASEMENT NO - ------------------------------------------- !11 -
NEW CONSTRUCTION REPAIRS n LID NO. .— -------------- - ASMT. NO - ---------- -------
OWNER ------ --------------------------- CONTRACTOR ..%A!:M-P — ---------------------------------------------------------------- PERMIT NO.0-771A��
JOB ADDRESS l—t5-lq ------- ------- VLI -------------------- LEGAL DESCRIPTION: LOT NO - --------- ---------------------------- BLOCK NO - -------------------- ---------------
--- ---- ---- - ------ -
--------------------------------------------------------------------------------------------------------- --------------------------------------------------------
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
LYNNWOOD UNE]
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Fli�- VjVf.7—,—.: 1"i"
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Approved:
PWW-0001-1 1/75 (REVA 1/78)
DATE. ............. By ..................................
CITY OF EDMONDS
-,7--
ASSET INFORMATION SHEET
IeNEW
ADDITION
RETIREMENT
ASSET NO.
ADDITION TO ASSET NO. -
I DESCRIPTION �, 6 i I
SERIAL NO.
LOCATION DEV. NO.
I / Z'o, �, 11, ) 1 9: �v I
PURCHASE ORDER NO.
PURCHASE ORDER DATE
COST
B.A.R.S. ACCOUNT NO.
ESTIMATED LIFE
PROJECT NUMBEA -71
PROJECT COMPLETION DATE -IL59 �lJi
COST �V, 57/
INITIATED BY DATE APPROVED BY
**SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
Z�DEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
G.L. ENTRY
REFERENCE DATE
ttnp INITIAL
DEPARTMENT FILE
A,� -.
VERIFIED BY
PROCESSED
BATCH NO.-