18118 ANDOVER ST.PDFIIIIIIIIIIIIII
10172
18118 ANDOVER ST
10 A
U G
City of Edmonds --- Water Department
TAP CARD
Meter I No27'39 .....
Size ........
Mfgrs. No2.41'162 " 4 , I
For............ . .. . . ..
Date ................ 0117
Tap I No.,7 �0.2��r
3/4
Size .......
....... Stvle.&�L.$k ................. .
LotNo ............ D ......................... Blk. No ..................................................
Add. ........ * ....... ....... *'*'* ..... " - - --------
ServiceLocation ........................................................................................ .
............................................................................................... . ................ . .....................
Meter Location .... 5PG
........... . ... ... . ..............
MakeTap .................................. : .................................. . .................. = ........ . ... . .
Send Bills to
Date of WoA.�Fk.-CY.-�
Foreman
Guar. Voucher No ......... . ................................ $ ................................... . .....
IQ��CVZVJ�v Kr--Tp,,z 5�� 'T - 19 -77 t!�
Remarks: ...... : ........................ . .. . ... . ................... /':: ......................... L ... - - -----
OUTGOING Index ......... Reg ....... Route Bk ...... . . StenciL ..... Card...__
INCOMING Index ......... Reg ....... Route Bk ... . ... StendL._...Card.._..
Material Chargeable to Installatio4aters
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SIZE
DESCRIPTION
RATE.
AMOUNT
—NO.
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Pipe, Galv. Screw ..................
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Material Chargeable to Taps Connected
NO. , SIZE, DESCRIPTION
RATE
AMO
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Lead Connec't'ions ..................
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Curb Cocks ............................
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Corp. Cocks ...........................
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Unions .............. - ....................
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Saddles .....................................
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NiPples ....................................
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Bushings ..................................
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Plain Ells ................................
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Street Ells .......................... ...
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Curb Boxes ................. . .........
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S. 0. Extensions ....................
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Gates .......................................
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Plugs . ........................................
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Couplings ...............................
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Superintendence ......................
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ROO TING SLIP '9 -4 T 4-ow"9XV'r
S El,',VTCE INSTALl,ATf0N - 6"'k
ADDRESS:
Z'
1) ATF:
DIAL A D.J(;#
P. U. 1).
TELEPHONE
CABLE, T.%'.
GAS
FoRE%%N
ST0*1 SEWER
OTHER
FUTURE SERVICE INSTL: YES NO
BORE: CUT:
SURCHARGE: NO
LOCK
CREN'
DATE: INITIAL: -------
UNLOCK
DATE.."?- IS -7 7 INITIALA_
ACCOUNT NUMBER: 130
METER.SHOP
SUPPLIER: �-)UD 94-�
CIVIL ENGR.
DRAFTS11AN
TREATMENT PLANT
B L T
SIDE -SEWER PERMI'
#
SUPERINTENDENT
INITIAL: DATE:
TAP CARD
METER SHEET
APPLICATIO,-.
UTILITY
DISPATCH
11 T LL I NG
CIT6 OF EDMONDS - SID40EWER PERMIT
WATER -SEWER DEPARTAMNT
PERMIT 5 4 0 8
Call 775-2525 for side sewer Inspections BEFORE covering any portion of the construction.)
Inspection will be provided within 24 hours after requot. NO Sat., Sun., or holiday inspections.
ADDRE LOCATION OF CONSTRUCTION ....... 1,811a.-Andmr ... Street .................................................. . .................................
... ..............
'ETY LEGAL DESCRIPTION ....................... Lot D. Jones Addition
............. . ..........................................................................................................................
* ----------- OWNER AND/OR BUILDER ..... RA ... $&ONST ...... ................................... .......................................................
ADDRESS...... Lymmad-Septic-lank .......................... . .............................. . ... .......................................................
March-2 19 ... 76
.... ....... oi.i�i�o .. .... 2 .. . ........... for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City nds ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before it has been Inspected.
NX)TE No. 2—All work performed In city right-of-way requires an Invasion of Rlght-of-Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade
sharper than % will be permitted.
NOTE No. 5--Trenches In street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
work which may develop within one year of completion.
NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the malin sewer or its appurtenances except to in -
Bert the pipe Into the wye.
DISAPPROVED [] Date .. . ................................... By ................ Date ...................
APPROVED ri Date ... . ...... . .. . .................. . .......................... By --- - ------ - ---------
Remarks: ........ ...... . ........................... .. . .........................................................
-------------------------- * .............. — ...... * ...... - ----- ** ----- *— ... * -------------------- --11111 -------- I ...........
....... By ................ Date ................ ................... . By ----------------
........ .. . ............................... .......................................................
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection —
....................................................................................... ... I hereby certify that the side sewer installation constructed under this permit
(Owner of Contracting Firm. PerfGrming Construction)
was installed in accordance with all -governing ordinances of the City of Edmonds.
Datedthis ............................ day of ................................................................ 1 :19 .........
Check BEFORE you dig for: Water E], Gas 0, Telephone 0, Power E], Sewer 0, Other C] V V
9,1TY'OF EDMONDS. SIDE SEWER PERMIT,
1( : _\ WATER -SEWER DEPARTMENT
1� TO -
PERMIT
01
Call 775-2525 for side sewer inspections BEFORE covering any portion of the construction.)
lie
(Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday Inspections.
ADDRESS LOCATION OF CONSTRUCTION ....... U118Andover street
............................................................................................................................................................
PROPERTY LEGAL DESCRIPTION ....................... Lot D. Jones Addition
...............................................................................................................................................................
...................... . .......................... . ...................... . ............................................................. h .......................................................................................... :1: .....................
.. ............................... OINWERelLND/OR BUILDER ..... ... S..CON.SF .......................................... . ....................... z
... ........ ..... ..............................
S NAME & ADDRESS ....... Sentic Tank
........................................................... . .................................. . .......................................................
March 2 76
Permission Is granted ......................................... 2 ................ 19 ........ I for repair and/or connection of a side sewer to the city sanitary sewer
in accordance with City of Edmonds ordinances.
A ITION IS CALLED TO THE FOLLOWING:
NOTE No. 1—The owners of the property may obtain a permit to construct sewer Inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before it has been inspected.
NOTE No. 2—All wor k performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE,jo. 4—Top of side sewer must have at least 30 inches coverage at property line axid 12 inches inside property line; minimum grade of 2%. No bends in grade
sharper than 1/f, will be permitted.
NOTE No. 5---Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
i work which may develop within one year of completion.
NOTE) No. 6—It is unlawfu.1 to alter. or do any other work than is provided for in the permit, or to do any work on the main sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED0 Date ... . ................................... By ................ Date .................... ....... B ................ Date ............... . ................... . By ................
APPROVED. 0 Date..._0 ............. By ... . ............ .. . ............................... .......................................................
Remarks: ........................................... . ................................................ .......
/ ............................................................. ....................................................
......................................................... . ...... ........ ------ ----- ---- ---- - -- ------------------ ------------------- --------
1W BOTH it Copies ST Be Signed Owrjer of Firm Performing Construction PRIOR To Request For Inspection
I, ...................... .... hereby certify that the side sewer installation constructed under this permit
f Contracting Fi
(Own;er, o rm. Performing Construction)
W1
Minstal ;ed �in—accordnce with all governing ordinances of the City of Edmonds.
Datedthis ............................ day of ................................................................. 19 ..........
Check BEFORE you dig for: Water [:), Gas E], Telephone [], Power E], Sewer C], Other 0
Ve
ADDRESS: IV/�/ kidnvov 3reel
TAX ACCOUNT/PARCEL NUMBER: 6�1 041 k 0� k 0-7q M
BUILDING PERMIT (NEW STRUCTURE): 191n O!nqg b �,R
COVENANTS (RECORDED) FOR:
CRITICAL AREASV DETERMINATION: Ej Conditional Waiver F� Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):_ tjj�)bDqIbEA� 1,qUOM(Wc�) Jcj9,-j b7,�rj�JLL,.� jgqj oqbdpjy.,,)
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED: -77,11 1-7v
SEWER LID FEE $:
LID #: t P,51
SHORT PLAT FILE: 'S-5-2Z - IS LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER WTER TAP CARD DATED:
LATEMP\DSTs\Fonns\Street File Checklist.doc
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Use PERMIT '1__ IRV,
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AUTHORIZES
NOTE. mit Limit One Year (Ese,pt DEMOLMO.1-3 �Ich ONLY THE signed by the 11-jUding Ofti &I or his 1)ep-
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SIGN
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G. I DATE Sl NED DEPARTMENT D s AT
CITY OF
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dATE
OTE: Applicant Subiect to Plan QN/eck
This Permit ca, an work to be dond, On pfilnol PrOp" ONLY. 775-2525
Any ennytrUctiorr on the public donsain (eurbs, &dIrWellut, drivewn", ORICINAL -File YELLOW - lnsspeC:o, 4
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WORK DESCRIBED BELOW HAS BEMNINSPECTED, AND IS APPROVED.
CONTAC'r INSPECTOR AND
ARRANGE FOR APPOINTMENT.
0 RECALL . FOR INSPE=ON.
-7
THE ACTIONS OR CORREM70NS INDIC)
WITIUN ......... . ......... DAYS OR PENALTIE�
APPUMD. FOR INSPECTIONS CALL:)ffl"
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Water Service Drawing
The City of Edmonds
EASE MENT NO . ............. ................... ..........
NEW CONS-14RUCTION E] REPAIRS L1r) NO . .................. . ASMT. NO . ..................
OWNER............................................................................................. ... CONTRACTOR ............ ............................................ ........................... PERMIT 1,40.
JOB ADDRESS ..... AN.;P�Ovak ................. LEGAL DESCRIPTION: LOT.. NO . ...................... ................ BLOCK NO . ........ ......... ................
................
.............
NAME OF ADDITION
NOTICE: NO WARRAtM.OF ACCURACY. The information shown on the
atlached map was compiled for use by the City of Edmonds, its employees
and consultants. The CXy of Edmonds does not warrant the accuracy of
anything set forth on the map. Any person or entity requesting a copy
should conduct an independent Inquiry regarding the information shown on
the map, including, but not limited to, the location of any sewer stub showrL.
Such sewer stubs may or may not e)dst and may or may not exist at the
location shown. Neither the City of Edmonds nor its employees or officers
shall be liable for the information given on this map, no; for any oral
fepresentdon provided based upon said map.
0
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Lit
PVA14-0001-11175 (REV.11 1178)
.................................. ................. A ...... ... I --- ............ ...................... ..............
/ / /,/,S I*
Approved:
DATE ............. B y A /A r-4L . ..................
0
STREET FILE
NOTICE: NO WARRANTY OF ACCURACY The Information shown on the
attached map was compiled for use by the City of Edmont-'3, il� cm.n.0cyees
and consultants. The City of Edmonds does. not warrant of
anything set forth on the map. Any person or enfity requ�z—':,j a COPY
should conduct an independent Inquiry regarding the Inforni.-licii ciiav,-n on
the ma - inrhi0o�ng. hig not if , Pd fn tho Inr%nflesn ^ -, 6 ; ;; --- ; ; ; M IS
. - -- - - -t ap,�,
shown, Such sevver stubs mayor may nd eyist and maggr :ynct6,d,.td
the location shown, Neither the City o ' Edmonds r�r�r.,-.;!cyzcs or
officers shall be liable for the information liven on )Kmap, orz�
representation provided based upon said i i
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APPLICATION
Thei City of Edmonds for
SIDE SEWER PERMff EASEMENT NO. -- ------------------- ------
NEW CONSTRUCTION E] REPAIRS 0 LID NO - ------------------ ASMT. NO - ------
OWNER ------
------------
JOB ADDRESS ---- / _cK -'Q/---
LU
F-
LU
LU
Cf)
CONTRACTOR
oil ----- ------ ---- - --- ---- PERMIT NO
LEGAL DESCRIPTI61 LOT NO.
--------------- BLOCK NO - ----------------------- ------------
----------------------------- --------------------- ; ----------------------------------------------------------------------------------- I --------------------------
NAME OF ADDITION ------- — ---------------------------------------------------
Approved:
DATE ....
RECF!Vr!�
AIAR 2 1976
Public works i;,,.
... I ................. By ----------------------------------------------
CITY OF EDMONDS BARBARA FAHEY
MAYOR
7110-210TH ST.S.W. 0 EDMONDS, WA 98026 * (206) 771-0235 - FAX (206) 744-6057
COMMUNITY SERVICES DEPARTMENT - PUBLIC WORKS DIVISION
t . 18 9 "3
April 4, 1997
Thomas Rutherford
18118 Andover Rd.
Edmonds, WA 98026
Subject: Water Leak Credit (#333075)
Dear Mr. Rutherford:
I have reviewed your account and will allow a credit for the billing period between January
13, 1997 through March 31, 1997 in accordance with our City policy. The policy states
that the customer will be billed at the retail rate based upon the average water consumption
for the same period during the previous year. In addition, the excess water lost from the
leak will be billed to customer at the City's wholesale rate with a 15% surcharge added for
administrative cost. Only one leak credit will be granted in any three year period.
Should you have any additional questions after you receive your new. billing, please
contact Ilene Larson, Utility Billing Clerk, at 771-0241.
Sincerel
,,c.# - a
Scott Highland
Acting Water/Sewer Supervisor
RH/Ik
cc: Ilene Larson
Utility Billing Clerk
wordata\water\credit96\##33075
* Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
APR-04-19? FRI 09:46 1 T SND TUMOR INST FAX NO:C206 440 #476 P02
I I W 1*
4-3-93
Scott Highland
City of Edmonds
Public Works Department
Water Division;
- I am writing this letter to request a credit for a water problem that we
experienced. We were informed by an employee of the water department that Our
meter was running at an unusual speed and that we were loosing water. We shut off
the main line to the house and realized that there was a leak somewhere between the
meter and the house. The water line runs a distance of over 300 feet. We
immediately ealled our homeowners insuwce company and proceeded to have a
leak detection company come to locate the leak. After locating the leak, a
cOnstruction company came to uncover the pipe. We experienced a delay in work
due to the heavy rains. When it was determined that it was safe to start work, the
construction company uncovered the line, purchased a permit to fix the leak and
repaired the line. After the line was repaired,'the repair was inspected by the water
division of the City of Edmonds
We really do not know when the leak occurred and we have no way of
pinpointing the time because of our previous reading was an estimate. The severe
weather made it difficult to read the meter for an accurate reading. We would like to
impress on you that we made every attempt to fix the problem as soon as we
became aware that there was a problem. After the repairs were done, we had made a
request to have the meter reread to have an accurate idea of the amount of water that
was lost.
621
11:� (,A3 P,-
-APR-04-197 FRI 08:45 ET SND TUMOR INST FAX NO:(20 440
#476 P01
PugetSound,
Tumor institute
at Stevens
Date: 2& /
Please deliver the folloWing pages to:
Name:
Firm:
FAX #-.
Depi:
#:
(206) 640-4440
Totol number of Pages (including cover)
Comments-
Phone #:
FAX is sent from;
Phone #:
CONFIDENTIALIFIFY NOTICE
Radiation Oucology
John E. SYNvoter, M.D., Directoi
Robert M. Meier, M.D.
Peter D. Grimm, D.O.
Sandra S. Vermeulen, M.D.
JaAet NeWeton, M.D.
P
Thl 'facaimile transmission is intended only for the addressee named above, it c9ritaini information that is privileged,
cou6ntlal or otherwise protected frorn' use and disclosure. If you are not the Intended recipient, vou are hereby notified that
ny review, disclosure, copying or dissemination of this tranornission, or the taking of any action In reliance on its contents, or
Mar use Is strictly prohibited. If you have received this transmi:sion In error, please notify us by telephone Immediately, so
that we can arrange for its return to us. Thank you for your cooperation.
21605 76th Avanue West, edmonds, WA 98026 ('2206) 64�0-4300
CAF0HM%FAXCV&n WW
This wrvice is provided through acooperat'lue q&4 of
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21605 76th Avenoe West, Rdmonds, WA 98026 ('2206) 640-4900
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CITY OF EDMONDS
STRIM FILE
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-0220 - FAX (206) 771-0221
COMMUNITY SERVICES DEPARTMENT
Public Works a Planni.ng * Parks and Recreation 9 Engineering
M
May 26, 1993
Thomas Rutherford
18118 Andover Street
Edmonds, WA 98026
Dear Mr. Rutherford:
LAURA M. HALL
MAYOR
I have reviewed your account and will allow a credit to your account
for the last two billings according to our City policy: the average
consumption for the same period during the previous year charged at
normal customer rates, plus the excess ' usage charged at the City's
cost, plus a surcharge of 15% applied to the excess only. Only one
leak credit will be granted in any three year period.
Should you have any additional questions after you receive your new
bil,li.ng, please contact Ilene Larson, Utility Billing Clerk-.
Sincerely,
Ron Holland
Water/Sewer Supervisor
RH/l k
cc: Ilene Larson
Utility Billing Clerk
#333075/TXTWATER
0 Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
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7
STREET FILE
CITY of EDMONDS --- PUBLIC WORKS DEPARTMENT
Routing of Building Permit Applications
Proposed Property Address of Application: 18118 Andover St.
DEPARTMENT
COMMENTS
DATE
W A T E R
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BUILDING
DEPARTMENT COMMENTS
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