17900 73RD AVE W.PDFlill 11111111
5744
17900 73RD AVE W
CITY OF EDMONDS
PUBLIC WORKS DEPAOENT
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En
SIDE SEWER PERMIT
FOR INSPECTION CAL
775-2525 Ext. 220
Permit N? _A264
Issue Date
PERMIT MUST BE POSTED ON JOB �q
Alwj� 11 -T
SS 0 MAE77 -7yal - . LIM F
1. Addre f 7onstructionmw��w'mwmlwmw'mw'mw'm7.5r-d
2. Property Legal Description (include all, easements) Z&1 Z
_j�-zZZ6e,ovi dda2�0-" .
3. Single Family Residence 0L Multi -Family No. of Units
Commercial
4. Owner and/or Builder
5. Contractor & License No.
6. Invasion into City Right -of -Way: No Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
7. Cross other private property: Yes No . Easement required -
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
a. Property owners must obtain a permit to install side*sewers on
their property. A licensed side sewer contractor must be employed to
construct side sewers in the public' right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year.
c. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
d. Side sewers may not be installed closer than thirty inches (30")
to any structure. 0
e. Side sewer lines must be laid at a minimum grade of 2% (1.15
and maximum grade of 100% (450).
f.. No turn in side s8wer greater than 450 (1/8;bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. Nd down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer 'line run.
j. Trenches within City right-of-way must be'restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k., Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required.
DATE:
7- 0
I c6rtify that I have read
and shall comply with the above
PERMIT FEE:
CONNECTION FEE:
DISAPPROVED BY: 'Date:
By: Date:
APPROVED By: Date:
* PERMIT MUST BE POSTED ON JOB SITE *
PUBLIC WORKS DEPAR� CHECKLIST
TREET
BUILDING PM1IT 1�4
(address),
(date)
Street Right -of -Way Existing����
�-eD �REQD
Z
Access Easements Existing
IN
p4
Utility Easement Existing
REQD
W
Lot Per Subdivision
Plat Assessor Map
Site Plan Checked for Accuracy_
-2-
Underground 14iring Reqd.
lZint
Check Accura of Legal Descripti
CY io�
.Z
Review by
Date
Existing Water Main Size
Water Main Required
.Service Line Required
Hydrant Size Existing
P4-
Hydrant Reqd Per Fire Code
Size
Detector Check Meter Reqd.
Cross Connection Inspection 4V.P,5E
Rlkcs,
Fire DeparUnent Comnents
Water Meter Charge Reqd.
Review by,
Date 2.6
Septic Tank Design Approved"-,,
'Date
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer Availability
Pro
Drm�7ing No.
'--�File No.
de Sewer Availability
ZZ.
�3:
Review by
Date 2
Open Ditch Existing
Culvert Reqd.
Size
P4
Catch Basin Reqd.
Indicate -on Site Plan
0
Shoulder drainage ma /Co�l�,
c �onoh" swale open runoff
W
Manhole reqd.
Indicate an Site Plan
Soil Conditions and Gar Field Checked
":7d4ater
Review by 77
Date
"115
Revised: 1v10-1977
Page 2
Stieet, Paving Reqd.
Curb and -Gutter Reqd..
Sidewa�k Reqd.
Curb.Cut,for,Driveway Reqd.
p4 Right -of Way Construction Permit-Req
E-1 Ipprovemen
Bond Reqd. for Public ts
Street'Nam Sign Reqd. Z
Other Signing Pgqd.---
Pre Permit Site Inspection. made on
0,
�_A BY: SEWER
WATER
PA
F-I
S =IT
ENGMEERIN G
Special Requirements listed in mem to Conmmity Development Department,
Building Division
.54
> . "BY Date
o All' items fille d in on, Building Permit Application
P� BY Date
Drawings Stanped and Notations Made
BY Date
Approved by Public Works Department
Revised: Iv 10-1977