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18029 70TH PL W.PDFIIIIIIIIIIII 5547 18029 70TH PL W 11 C. 1 PI-7 1E111 10: 9520 City of Edmonds PERMIT EXPIRES_&kg_�2W SIDE SEWER PERMIT U j Address of Construction: LED # Property Tax Account Parcel No. i�,5-041(r C)()() 0 Attach copies of all access and utility easements Verified and Approved b Owner and/or QCn!t!ra!l5t�,dr: ­kcc!*� Contractor License cc, P_tAP_ -k 0 Ik t4l ng Permit AyAlf 2 FZJ) Single. -Family Invasion into City *Right -of Way: Lj Yes [ZrNo F� Multi -Family (No. of Units Commercial (No. ofUnits *RW Construction Permit # Cross other "Private Property: � F-1 Yes No Public "Attach legal description and copy of recorded easem'e*nt. Owner/9-6-ritracDor 7- 2-5 Owner or contractor signature and acknowledgement statement: Date By signing for this permit I certify that I have read the City's public handout entitled ide Sewer_Specifications, and shall comply with all City requirements outlihed therein. 9 CALL. DIAL -A -DIG (1-800-42�+5555) BEFORE. ANY EXCAVATION 2 9 FOR' INSPECTION CALL 425-771-0220 extension 24 HOUR NOTICE REOUIRED FOR ALL INSPECTION REOUESTS ..................... ....... ... ....... ...... . . ..... . . ....... .... . . FOR OFFICE USE ONLY .. ... .... . .... ... . .. .. .. ...... .. . . Repair Fee $ Permit Fee $ Issued By: Trunk Charge $ Date Issued: As sessment Fee $ Rec eipt No: City Permit Surcharge Fee $5.00 Total Fees Paid $ NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN INSPECTOR ARRIVES A $45 RE. -INSPECTION FEE WILL BE CHARGED. Job Site Ready YES No Date: ,Initial: Partial Inspection: -Date: Initial: Partial Inspection: Date: Initial: Initial: _�As-built to Street File: rFINAL INSPECTION APPROVED: Date: 1,� PERMIT MUST BE POSTED ONJOB SITEn- White Copy: File. Green Copy: Inspector Buff Copy: Applicant L;temp;bldg;forms-,ssper-mitjlg4/00 NOTICE" MO WARRANRY OF ACCURAcy The Informatiop shown oq the aft8chad map VJ29 Compiled for arl', c use by the QY Of Edn, c7f c Isultaffis, The 's The i4f of Edmi0nds duas r1c, an Y,;` g set forth on thr; -nap. .. Warrant lh� Any person or entity C, C I,, Gondur"i an irdepcfident inquiry regUding the Intoral'--Jiv C;� th(t MCI, 1, including, but not lim;,tad t o, the location of any sk'-'-*� � - S" c� sewer s'103 may oi, M a loo� YflGie)dslandmayor m,!yrcjc,',�-iaj th " i;(jrf shown I Neither the City of Edmonds its nor e`Mp)y-,,,, G, Offluz; Sii4' bc- liabl'e fo, g.vl? Information g'Ven 0 reprwc, 4 bon provided 0, n this map, nor for grr, S914 Map 171 I ............ n CD 181ST PL, S,W, .CIT,Y OF EDMONDS SIDE SEWER AS -BUILT ADDRESS . 18029 70TH PL W PERMIT NUMBER 9520 HOMEOWNER xxxxxxxxxx CONTRACTOR ACORN DATE 08/06/01 DRAWN BY ISMAEL ABILA D-9 -75 �k Pl. w �-,u 0 0