18106 72ND AVE W.PDF5668
18106 72ND AVE W
0
ADDRESS: 2W
TAX ACCOUNTIPARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRJTICAL AREAS:
DISCR,ETIONARY PERMIT
DRAINAGE PLAN DA
PARKING AGREEMENTS DA
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DA
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
DETERMINATION: 0 Conditional Waiver E] Study Required E] Waiver
LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
LATEMP\DSrs\Fonns\Street File Checklist-doc
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-PERMIT NO: 9588
City of Edmond,s -
PERMIT EXPIRES_,,,?-/,,Pq / kc;
SIDE -SEWER PERMIT
Address of Construction: I Rb & :1 'Z ICA A\)Q- Uj 'LID
Property Tax Account Parcel No. !Q'7 -7 5- 600 0() vo,
Attach copies of all access and utility easements' k)A— Verified 'and Approved b
Owner and/40MEZZ !L X.04mv'.
Contractor License ar)(n I L F_ 6(d 61AU, Building Permit #: jNk
Y Single Family Invasion into City *Right -of Way: El Yes KNo
Multi -Family (No. of Units *RW Construction Permit
Commercial (No. of Units Cross other **Private Property: E] Yes $�No
Public "Attach legal description and copy of recorded easement.
'0,�vqer or contractor signature and acknowledgement statement:
By signing fdr this permit I certify that I have,read the. City's public handout entitled
ide Sewer Specifications, and shall complywith�all City requirements outlined therein.
CALL DIAL -A -DIG (1-800-424�5555) BEFORE ANY EXCAVATION 2
.9 FOR INSPECTION CALL 425-771-0220 extension
24 HOUR NOTICE REOUIRED FOR ALL INSPECTION REQUESTS.
A C, )O_L�
'Datj I
NOTE: IF JOB SITE ISAOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE.WILL BE CHARGED.
,NO Initial:
Job Site'Ready YES Date:
Partial Inspection: --Date: Initial:
Partial Inspection:, Date: Initial:
FINAL INSPECTION APPROVED: Date: Initial: As,-builtto Street File:
PERMIT MUST BE POSTED ON JOB SITE
White Copy'�,�ii6" Copy: Inspector Buff Copy: Ap�licant
L;temp;bldg,forms;sspermitjlg4/00
1,7 —C
. I g9Z
-PERMIT NO: 9588
City of Edmond,s -
PERMIT EXPIRES_,,,?-/,,Pq / kc;
SIDE -SEWER PERMIT
Address of Construction: I Rb & :1 'Z ICA A\)Q- Uj 'LID
Property Tax Account Parcel No. !Q'7 -7 5- 600 0() vo,
Attach copies of all access and utility easements' k)A— Verified 'and Approved b
Owner and/40MEZZ !L X.04mv'.
Contractor License ar)(n I L F_ 6(d 61AU, Building Permit #: jNk
Y Single Family Invasion into City *Right -of Way: El Yes KNo
Multi -Family (No. of Units *RW Construction Permit
Commercial (No. of Units Cross other **Private Property: E] Yes $�No
Public "Attach legal description and copy of recorded easement.
'0,�vqer or contractor signature and acknowledgement statement:
By signing fdr this permit I certify that I have,read the. City's public handout entitled
ide Sewer Specifications, and shall complywith�all City requirements outlined therein.
CALL DIAL -A -DIG (1-800-424�5555) BEFORE ANY EXCAVATION 2
.9 FOR INSPECTION CALL 425-771-0220 extension
24 HOUR NOTICE REOUIRED FOR ALL INSPECTION REQUESTS.
A C, )O_L�
'Datj I
NOTE: IF JOB SITE ISAOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE.WILL BE CHARGED.
,NO Initial:
Job Site'Ready YES Date:
Partial Inspection: --Date: Initial:
Partial Inspection:, Date: Initial:
FINAL INSPECTION APPROVED: Date: Initial: As,-builtto Street File:
PERMIT MUST BE POSTED ON JOB SITE
White Copy'�,�ii6" Copy: Inspector Buff Copy: Ap�licant
L;temp;bldg,forms;sspermitjlg4/00
NVICE: NO WARRANTY OF ACCURACY lr�je infotmdi&7 -m on the
aftac;hzi map vja� compiied ft, use by tit City of Edmc7.,_',,, il, =,!:ye3s
C01sullaritr, The City of Edwiofjd� doas not vjurz:� V,�' �_1111-ol
aw�,hjr.,j seit forth or, th map. ky pc.;3-,:,i or ently
s!:' jll'.: Zonduct an in' ',ni-i Inqu-m� u;gz- -'!;;g Vic hr", C
th� Incluling, but Pol limit,co to, tile locl'�'1011 �f .b
Such v, 'J"'i stu.'!s may cr mw.�) n,.,,. cxlst and mw� cy m:,) iict Ll
th, lo,.,atlon Ncither th,, City o(i Edn, oids w its cT""'*':c'y"l'-,�',', or
ot.,z,, sha!) b;) ljobie for tho iriii;,,tfiz�ion giver, on fiiis map, nor fol. ally 01—J
re-presentlion provided ba3ed upw said m&p
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181ST ST. SW
CITY OF EDMONDS SIDE SEWER AS -BUILT
ADDRESS
18106 72ND
AVE W
PERMIT
NUMBER 9588
HOMEOWNER xxxxxxxxxx
CDNTRACTOR JD NEWTON
DATE
0'3/25/02
DRAWN
ISMAEL ABILA
BY