17524 76TH AVE W.PDFIIIIIIIIIIII
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17524 76TH AVE W
APPLICATION
'EASEMENT NOa
Theii City.? ac
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SJDE SEWER �POWT
NEW CONSTRUCTION REPAIRS E] LID NO. --- ASMT.'N*O...-Z5.:4
OWNER - CONTRACTOR PERMIT NO.
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JOB ADDRESS ------------------------- LEGAL DESCRIPTION: LOT NO. BLOCK No - --------------
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Call 775-2525 for side sewer inspections BEFOUX covering any portion of the construction.)
Inspection will be provided within 24 hours after requat. NO Sat., Sun., or holiday Inspections.
ADDRESS WCATION OF CONSTRUCTION .. Y I ;' 4
— C�11 ;'Vo. �..
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PROPERTY UMAL DESCRIPTION ........
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. ............ ............... ................. . .................. . .............. . ...... . .......................... . .. . ... . ...... . ............. .....
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...... O1VV'11q=AWD10R BU]ILDFJ&..14'!�..�'�..5..�'�',."i"�' -I' EQ-i"i
61TRACTORLIS NAME & ADDRESS .... M
.. . ....................... -..31st N
.......... ........... ... . ............
C Buthel I
7-
ftrinisslon Is granted . ............ ....... .... -�' ,
*#stem In accordance ... — . --L ............ 19 .... �-'4 ' for repair and/or e0M2MUon of a side sewer to 00 191W AMAUUMA7 80114W
with City of Edn2onds ordinance&
AT�— ON IS CALLED TO THE FOLLOWING:
I —The owners of the Property may obtain EL Permit to construct sewer Inside PrOPerty line. A licensed gift BMW
side sewer In street area. Do not cover any Portion of sewer before it has been inspected.
340TE NO� 2—All work Performed in city right-of-way requi
rea an Invasion of Right -of -Way Permit Obtainable, froM the, 0
NOTE NO. 3—Obtaln full Information regarding Ordinance 11.16.030 and Regulations governing side sewem -b- �Vsa #4 pwadk
-IMOTZ No. 4--TO-P of side sewer must have at least 30 inches coverage at property line and 12 Inches inside propeety ibis;
sharper than % will be permitted.
bends In
"VIOTE NO. 5--Trenches in street must be water settled and surfers Of street restored to original condition.
work which May develop within one year of completion. c9atratte" abon A* dw, in Improw
NO. 6—It Is unlawful to alter or do any other work than Is provided for in the Permit, or to do any *#oft on the Own jllr,�
Bert the pipe Into the wye. except to
DISAPPROVED [] Date ... ............. -BY ------------ Duf; ' B ...... . By—, --- - ---- MA, M
By..........
APPROVED Date .. ... 11"?,� -17 T",
. ... .................. . ...... . ..
-------- 4-e-,
It4unarks: ....... . ...... . ................
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--------------------------------------- ------------------- --- -------------------------------- L ---- lilf� .... . ..................... . ............... .............. . ............... .
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BOTH Permit Copies- NUST BL-Sipied �ay Owner, of Mkm Perfornling Construction PRIOR To R
e(juest For Inspection
.......... .... hereby certify that the side sewer installation constructed d t
(Owner of Contracting Firm Performing un er this pernd
V, -VII.Stalled in accordance with all governing 0 inances of the City of Ednionds.
- J,
iV V Check BEFORE you dig for:
Datedthis ...... . .. . .. . ........... day of ................................... . .. . .... I .......... .. . ...
0, Gas 0, Telephone 0, Power 0, Sewer D Otber 0 Aj-V
0.
VA(I
APPLICATION
The City of Edmonds for T NO. ................. . ..................
EASEMEN
SIDE SEWER PERMIT
NEW CONSTRUCTION El REPAIRS LID NO. ------ NO.
----------------------------------- CONTRAM IT NO.
OWNER .. .... ... ---- "OR --- ............ PERM
JOB ADDRESS ------------------ ................ LEGAL DESCRIPTION: LOT No BLOCK NO . ...... ..............................
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. . ............. ......... .........................................
NAMEOF ADDITION ........................... *., ............................ ............... ................................... ..........
4'ECEIVED
AUG 28 19,,�,
Approved:
DATE
Al
I
...................... By -------------------------------------------------------------
[O'MAAT140D ---------------------
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MW AM UWMG AGMMMMM
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4w **Ct% right to su 0 to pwmhose wt
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inqtoi� to wit All of that prigowty, �,sionqjWq
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