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17632 69TH PL W
The City of Edmonds
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APPLICATION
for
STRIct I FILE SIDDE SEWER PERMT
NEW CONSTRUCTION C] REPAIRS
OWNER ........ .......
.................................................
ADDRESS ...... L.76-3.? ..... ...... AP/ te
.... ..... .... ... ...................................
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EN!!ty"WOW LINE
EASEMENT No. ......................................
CONTRACTOR --- 6-44 ------ J40-'4---,c ........ ............................. PERMIT
LEGAL DESCRIPTION: LOT No . ............... ;;� ......................... BIA)CK No . ............................................
NAME OF ADDITION ......... Chl�rO..y .............. �01.1 ........... W'400.49.41 . ........................................
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Approved:
DA ......... By ....
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,lTYY.'!DF: EDIM, it .,(,4tSVW.AEWlPERM,, I
M ',�'SIDE"'- Ck
)IN S",
z '-SEWER,,DEP*RTNl1-ENT,
40.6 6 -
01T
TIRM
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on
C�lll 7.764�07. for, side :sewer. ins -BEFORE' covering,' ahy'-,pc;rtiom joU thel".constructi
Tra ection wjjj�.bo`"� - rovided withim. 2.1 �:hour s!�a , f . ter request N& Sat_ -sun. inspectiqns.,!�
t J,4
"DAESSNN 4,CONSTRY ........................................................................................................................................ ...... ....... ........ . .
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.-ILLTS
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w 0/0R, -JILDER .......................................... ............................................
')MEIMADDRESS' rv-, t
(0 QXTRW OR' % -:� �49 -
S�-,N* ---- ............. ... .......... -- --------------------------- ...... ------------ --------------------------------------- .......................................
.77
connectibif,�,of.,wi Mdb.seiv6rAdAho!,c
..................... .. ................ ;19� ... �.`.i;;lbr,rep4iraAdVor
d - an es.
S Y*S'tem- A th nce�with. Ityl-of.-Edrin6n �:ordin C �7
H'�iFOLILOWING.
;E�4xibNf 1§�6A-LL913� TO,
',1,-2 m ay-,obta'W a-��Cr insldc�*Pr6pertyllnc� -.-,V lic'en'sed')Sid%PSewer- contractor, mu st,,,be, emplo��dl ftdx�ofistruct,
has,been inspected'
�,NOTEj,No,., -of-Way Permitjob al� '�i'e: f* :4� .1 t
t m-,th -C ng!ncer:s.;offlce.,
NOTEf,No�, govei*nln�:.*si�e,:se%�'e*rs"'whe'n,'yDui,.ge 'perm
no;, . mlnlmum�,grad
lne;an&J2,Jh on
7.
WOTF _lo,,orJgmLl cionditiom -Contractors�-shall%!be, responslble-,'f EL
,I�No!, rc�
pr�f llur�e;,q��,,jkortrnp per,,�:,,-
i6��4v its, amlawiuP Ato,,alt'er,:or!jd6r any,.-oth ev work An n� 'js,.p' ii&d,,' -fir�,,�the permit. �orjlo id ouan y;-,�woik-4on,,t he:, m aW, sewer,, or' tts'�&Pp4rtenanc
1�0 for
:s��t_lheyipelin_ %
to . ............................ -B
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POmnarks:,* .......... ........................................................................................... ..................... ...... ...... ........................................ . ... .........
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................................................. . ...... ...........
.0.wn . er of' "Firm 1�'erfon� iii 1�'?'lbo o:-,R e q u e 6P,'6r,,4, n s p e
MOM Permit,,, opiesrMUST e,;Sighedl By:' ristruction'?PRIOR'T 1
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'i_T.p1lo f aid m�
,.h a per t, w
r
'no.
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or, 0 e
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ide�.Ahisi$'6rrnl
................ .......... ..........
. . ...... ... ... ...
L.6n-)
(Owner -of ontracting -Firm- -Perfcrmlng,Construcl
6 �.)of,Edrn6nd&.*
nstalled�.inidceordan ��,,A�j CC6ST
...................
""(�)Ddtedl)th ..... xi-v
lot. .. ..... 19
fi�ck BgFbAE Allg: f�ry Water. P6ver :S��&. 'Other� jE3L
C '.'Tblephon6i in;' ,
November �, 1971
city of tdWMds
Public Works Department
200 Dayton Street
Edmonds, WeshLogton 98020
GeAtlemen:
The undersIgned certifies herewith that the aid* nower installa-
time serving Lots 2 sn4 3, Plat of Cherry 11111 Manor (comonly kn'-AM an
17702 - 69th Pl. W- 444 17632 - Oth Pl. W., L4*m4s), were installed in
accordance with all City of Umands requirements related to side sower
Installations. It to further understood that the undersigned *hall Lo
responsible for matorUls and workmanship provided for those installo-
tions for a porLod of not loss than Otte (1) year frao the date of occupomey
of the houses theroon.
&'Incolvly,
HILLIS HORLSO INC.
LARRY 0. HILLIS, rresidont
826 South Broa&way
Lvorett, Washington 94204
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LEGAL DE6C
LOT 2
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