18119 80TH AVE W.PDF111111111111
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18119 80TH AVE W
Tl� City of Edmonds
I
APPLICATION
for
SIDE SEWER PERMIT
W CONSTRUCTION
E REPAIRS D
-11�1
OWNER --- F�-A-'EE - ------
JOB ADDRESS -A .... 7 .. 4ek=rn-4 --- ----------
EASEMENT NO. -.— ----------------------------
LID NO. ....... ASMT. NO.
CONTRACTOR ---- L—'*"t4t4W.CX::�P
------------------------------------------ ...... PERMIT NO . ...... - ----- 1-4.
LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . .................. I
................................................................................................. ................................................................
NAME OF ADDITION ------- -------
...................................................
L4V-41M
Approved:
By
DATE ... .. .,. I
- - -- --------- ------- ------------ 1-1/;
I
APPUCATION
T6 City of Edmmds for
SIDE SEWER PERMIT EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION REPAIRS LID NO - -------------- .—ASMT. No. -------------
OWNER ---------- S ------------------ 4
.......................... CONTRACTOR PERMIT NO.
JOB ADDRESS ..... .... ..... .................. LEGAL DESCRIPTION: LOT NO - ----------------- -------------------- BLOCK NO . .....
...... 1-7 --- - - ----- . ..... -/
............................................................................... ........ I ................................................ ..........
NAME OF ADDITION .........
......... ............... ...........
41-e- �-- ------ -------------------------
gill'I �� ,5-
Approved:
DATE............................................ By ---------------------------
NOTICE:
No warranty of accuracy.
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of'Edmonds does not warrant the
accuracy of anything set forth on these
map(s). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
the -map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
empl-o-yee-s or offi-cers Shal. lbe I-Ja-b-l-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 775-2525 for side sewer inspections BEFORE covering any portion of the const�uction.
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.)
ADDRESS LOCATION OF CONSTRUCTION ......... ........... .............. go,
.................................................
PROPERTYLEGAL DESCRIPTION ------------ ................. ....... ................................................................................................................
.................................................. . ................................................................................................................. . ................................... ..................................................
........................ 01�MERAND/OR BUILDER.'A P-1-.4 ..... :f3 ------------ Al-1.1 c Al nn ...
............... ........... ...... . ...................................................
........................................
',NTRACTOWS NAME & ADDRESS ......... ...................................................
-- -------------------------------------------------------- - ------- ----------------------
P, ��Yssion is grant�d ........... -------- ............. 1CT�, for repair and/or connection of a side sewer to the city sanitary sewer
s� ..m In accordance with City of Edmonds ordinances.
A—AINTION IS CALT D TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct sewer in.side 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 work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtain -able 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 1/8 will be permitted.
NOTE No. 5--Trenebes in street must be water settled and surface of street restored to original condition. Contractors sball 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 main sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED D ...... -------------------------- BY ----------------
APPROVEDD .................................................
-1 -- -----------------------------------------
Remarks:
BOTH Permit Copies MUST Be Si" By Owner of Firm Performing Construction PRIOR To Request For Inspection
-r-"c _.n.).... hereby cert ify that the side sewer installation constructed under this permit
ns
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%--installed in accordance with all governing ordinances of the City of Edmonds.
Datedthis ............................ day of ----------------------------------------------------------------- 19 .........
V V Check BEFORE you dig for: Water E], Gas E], Telephone E], Power E], Sewer 0, Other E] -%/ -�
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