18406 90TH AVE W.PDFlill lill lill
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18406 90TH AVE W
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City of Edmonds -
RIGHT -OF -WAY CONSTRUCTION
PERMIT Permit Number.
STREET FILE Issue Date: 3-.23
A. Address or Vicinity of Construction: — 18406 90 Av W (9412446)
B. Tvveof Work (besvecific): Install New Service
C. Contractor: -Washington Natural Gas Compa Contact: Frank Swan
MailingAddress: 885 Mercer St., fteattlep WAPhone: 224-2278
State License #: Liability Insurance: Bond:$
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. F-1 Commercial []Subdivision El City Project 13 Utility (PUD, GTE, WNG, CABLE, WATER)
F] Multi -Family 0 Single Family n Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut ElYes []No G. Size of Cut: -2 ( 2 x 4) H. Chargg�,$
1A 8" & 6" water @ 8 & 119E and 1 @ water @ 101W
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hd�l '�tke��tty` of Edmonds harmla;from injuries, dainages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense of any legal proceedings including d /
Vense costs,4dnd attorney fees by reason ofgraQtin thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR -A PERIOD OF ONE YEAR,�OELOWING THE FINAL
INSPECT . ION AND ACCEPTANCE OF THE WORK. ESTIMA TED RESTORA TION PeE S"WIL� BE HELD UNTIL Tflf;,Fl�N64 8 ETPATCH
IS COMPkETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSP-D FOR ISSUANCE TO THE APA U ANT.
Constru,ption,*awing of proposed work required with permit application.
A 24'1�oiir notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all'times.
7�raffic Control and Public Safety shall be in accordance with City regulations as required by the City'.'Efigineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the abouestatements and understand thepermit requirements and thepink copyof thepermit will be
available on site at all ti es"7brins ctio purposes.
Signature: Date: March 11, 1994
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: U�)'-. + RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER MAY 3 1 DAYS DISRUPTION FEE/FUND'111:
SPECIAL CONDITIONS: Aa RESTORATION FEE:
PERMIT FEE:
TOTAL FEE:
COMMENTS: RECEIPT FEE:
DATE:. ISSUED BY: 4d-'e
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Nv. 1991
FIELD INSPECTION NOTES
Comments:
Diagram.:
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
(Fund 111 - Route copy to Street Dept.)
El YES
Date:
Date:
El NO
rton
Addendum to Cit of Edmonds
:,Right of Way
ipermit Applicaiion''
8xibmitted 'j�y Pt�,TCHELL` S. -LANKFORD
En4ineering Aide
Washington Natural'Gas
1 -P # .'-521-'5246
V
C-P
'40-
I \13
(0
aMMM
NOTIC�:
'VAJ
;:.i -ra n
jgf- —a.. C-: U-U. -r-au
The -information on the attached
map(s) was com. piled for use by the City Of
Edmonds/ its Employees and Consultants.
Th,..e City of 'EcIrn.onds does. not. warrant the
n these
accuracy of anything set for.th o . '
map(�). An . y person or entity -requesting a
copy should conduct an independent
inq uiry regarding th*e info'rm'atl on shown- or
tFi�� -map(s), including, but not J*rnited to,
n of any sewer stub shown. Suc
the lotatio
sewer stubs may or may- not e.xist and may
or may not exist at the location shown.
Neither the city of Edmbnds nor its
tompl-o-yee-s o-r office-rs -sh-a-1.1 be Iia-b-'Fe for -the
this map(5), nor for
information g ven on
any one representation provided based
upon'said map(s).
APPLICATION
for
Ae City of Edmonds SIDE SEWER PERMIT EASEMENT NO - -------------------------------- -----------
NEW CONSTRUCTION REPAIRS F� LID NO. —� ........ ASMT. NO
OWNER - --------------- CONTRACTOR ...... ------ ------------- PERMIT NO.
........................
T ................. LEGAL DESCRIPTION: LOT NO - ----- S=—,-
JOB ADDRESS --- ................................. BLOCK NO - ------------------------------------
�j
F�tF;N'S- V-1<=, . �2-
---- ------------------------------------------------------ . ........................................................
pproved:
ATE.... . .. .. ................. By .. . ..... ...................... �
1
ZA" /A i7yg
7 W -T
-'PER ",]Uk��,::�,�,�;,
S,� ''SIDE;" SEWER: M
CITY''OF: , IDMONID
-WATEWSEWER.,I)EPAIRTMENT
PERMIT L -15 5 40 -
yCall, .175-2525 for' side zewer Inspections, ISEFORF! covering, any portion :of ,the 'construction
spectlons.,
A-l[nipection.:,wlil -be )pr'0`Yid6& milt'hin,','2�,hours�'.aft&r'�requi3t.� NO-,Sat.,:Sun., or,�h6llday,,i�.
n., ON, OF "GONST-Ru CT-110 ............... 8.406: 90th-Avonue'Vost.,
ADDRESS',,�!O,6A' ........ .................. : ........................................ ..................... ............................................... ... ........
Tal. irs
I -PI - - ,,
PROPERTY, 'LEGAL,DESCRIPTION: .................. ......................................................................................... . ................................... ......................................
Lot 2.
. ..................................... .............................................. ............. ........................................................................................ . ................................. ............................
....... :OV EN ............. ..................... .......... ....... .............................
. ........ ............................... ....... ....... i .......... *
tRACT M'Excavators
—CON, OR,&XAME &ADDRESS ...... C F,
................ ....... � .......... ................................... ........................ .......... ...............................
Auie Is. 1976 -fok-�repair�and/,6r:,donn�Betion.�of a side-�sewer-to:,ith,.Ibi�Y-118�Llilt
....................... I 1 0
...... ary',sewer
-ordinances.
-AITTENTIOM,1S, CAILLED'TO
7HE, FOLLOWING.:'
NOTEvN I o.�,i---:The owners of the -prop
qrl�y,,may obtaim. a,permlt to �construct. sewer jnside property,line. A licensed Side S6wer: Contractor must tb�construct
e�Afi street area�.' Do'not'cover,any,PoFflon,'of sewer before it, has,,been 4rispected., % m, � 1 1 .., �,
NOTE ;No,,2—!k-II1 , work�per�form e&in�,cify,right-of-way, requir esian, -Invasion of Right-of-W ayPermi t obtain -able, -from the-,Cit y- EngJneer1,s,offICe.;
VOTE,No'. �3—'Obtain:fiill�,information'�regELrding.�Ordinance 1-1.16.030and :Regulations, governin& side. -sewers when you get'permit..
NOTE�, No. 4 Topl� of side isewer,must �have,.a�-.Iea:s*t 30, inches coverage at -property .,line and 12 Inches Inside property line; minimum grade of 2f/� Vo ibends. In gradc�
:,Shar.l)er�,.than,��,'�,.NvilI be permitted'.
NOTE 149, 5�Trencfi�s in. sireet �Must`lbe, water 7settleds-and�fsurface oi4h'treet restored . to,:orlglnal conditiomQontractors shall 'be responsible for;-fa�11ure-7du6 to improper,�`.,
wo�k' which';may.,demelop- within one y6gro,,of,completlon.,
INOTR�146 'As unlawfW-Ao alter or do�any other, work Ahan ii,,provided- -for in :the, permit, or,,.to'do any work on Ahc-mainsewer�,or- its appurtenances except
"ser�t tbe-pibe into�th6lwkc.. %
7.7
ATPRQVED Y ......
DIS ...................... By .... D B ...... .. .... my ...............
JE]
ROV ......
.7 ...... .
Date:�' ............... .. ......
....................... . ............................... .......... ..................... ........
4-
.... ................................... ...................... ................................................................................ ......................... ....... .................
.................. ......... ........................................... ........ 7 ........................................................................................................... I ............................ M ............ ......
�,,]�o-TH,,,Per�m�it'C'o'p'ies, M.1-TST'.Be ignedt'By Dwrier. of Firni- Performing 'Construction PRIOR :To'�Rej u'est,.For 'Inspection.
n t
..... . . ... . 'hereby cer f that lhe.!side,zewer ins tallbtion,-.cons tructed� -under this,, per ii
�,,66nstruction)`
_VY
wner,---i
orltrsc. ng, rn
--- --------- .... .
�In K , V�ig
/da erf KniffiAg, ordinaiw6SJ�6f, Ci,t
was,,1nsta1ed!_inacc ancp1W,1th,701,gqV y-�of'Edmonds..
bated".this,... ...... ...... ..day of
. ... .......................
Sew
TowLer er,;E], i0ther[]:
-,�Cheek�,BEFORE�,y.ou!,dig.�pr,:,,,,WV ter.�[],. 1GOW To 6phone; iE3,,,
APPLICATION
The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION [D REPAIRS E] LID NO.
-----------------
OWNER --- --------- tr
.7 ---------- (e, ........... ....... CONTRACTOR ------ C -5... PERMIT NO.,-56AO
-----------------------
JOB ADDRESS ------------ - ------ LEGAL DESCRIPTION; LOT NO - -------- 2 — ----------------------- BLOCK NO - ------------------------------------
Z—
............ 7t ....... a es ............... -- --------- ...........
--- -------------------------------------------------
NAMEOF ADDITION ...................... t )42c& . . ..... .......................................
RECEIV7
AtIN 1%. 19T6'
a
46
0
M
/ 2- -5'-
/�n
Approved:
DATE ....
Public WOM 14A,
.............. BY -------------- ------------------------------------ i . iy.YK