18410 90TH AVE W.PDFlill lill lill
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18410 90TH AVE W
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CITY'OF EDMONDS
(4 CAMUNITY SERVICES DEPARTMENT
RIGHT-OF-WAY CONSTRUCTION PERMIT'
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Date:
A. * Owner: Washington Natural Gas Company
Name
815 Mercer Street'
VeaailinhAddress
t e WA 98111
City State Zip
STREET F1 E
Permit No. ?0-
mov 7—
Issue Date
B. 9 Contractor:
Name
Mailing Address
City State Zip
State License Number Telephone Number
C. e Address or Vicinity of Construction: . 18410 90 Avenue West
Type of Work to be Done: Ins ta 11 New Servi ce
D. 0 Work in Connection With: 11 Sub or Plat 0 Single Family 0 City Projects
0 Commercial 0 Multifamily KKUtility
E. 0 Pavement Cut: M Y [I N F. 0 Size of Cut: 2 X 4 (1) @ H 2 0
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application,* agrees to hold the City of Edmonds
harmless from any injur . ies, damages, or claims of any kind'or description- whatsoever, forseen or unforseen, that may
be made against the City of Edmonds, or any of its depa7rtent -o employq�s, including'or not limited to the defense
y�
of any legal proceedings including defense costs, court c( and 6 re s'-5y/reR9on !�f (granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP ;kNb`NiA1T.ERIALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Estimated restoration fees will be held until the final street, patch is completed by City forces, at which time a debit or credit will be
processed for issuance to the applicant.
• A 24 hour notice is required for inspection; Please call Engineering: 771-3202
0 Work is to be inspected during progress and at cortipletion.
• Restoration to be in accordance with City Code.
• Street to be kept clean at all times.
• Traffic Control to be in accordance with City regulations.
• All street -cut ditches must be patched with asphalt or City approved material prior to end of working day;
NO EXCEPTIONS.
I understand the above and that this permit must be available at the job site for inspection purposes at all times.
Signature:
Owner or Contractor
October 11, 1990
This Permit Must be Posted at the Job Site For Inspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
APPROVED BY: R
Time Authorized: Void after DEC— 3D days.
Special Conditions: NA
RELEASED BY:
Date 40_4"10
PERMIT FEE: -W )0
Restoration Fee:
Receipt No.:
Fund I It Fee:
Streei Cut Dimensions:
INSPECTED BY
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
x
Date
Eng. Div. March 1989
FIELD INSPECTION NOTES
(Fund I I I - Route copy to Street Dept.)
4M
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES El NO
Partial Work Inspection by P. W.:
Work Disapproved By:
FINAL APPROVAL BY:
Date:
Date:
Eng. Div. July 1985
Addendum to:
City of Edmonds
Permi t Application
Engineering Aide : Kerry Walsh
Washington Natural Gas
622-6767 x 2588
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WAT9P- MAIN VaFr4
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E\�Isnt,4et 1 .,
Wbpo�SEO A GAS
KEY:
-ss- sanitary sewer
-s- storms
-w- water
M- ik
0 water valve
NOTICE:
--War*ranty ... 0 T
No
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 EcIm.onds does. not . warrant the
set forth on these
accuracy of anything
map('�). An'y person or entity -requesting a
copy should conduct an -independent
orm. . ation shown, or
Inquiry regarding th*e infi
-t-He -rnap(s), including, but not limited to,
er stub shown. Sud
the lotation of any sew
sewer stubs.may or may not e.xist and may
or may not exist at the location shown.
Neither the city of Edmonds nor its
flernpl,o*yee's o*r office-rs -sh-a-1.1 be 11a.b],-e for the
information given on this map(5), nor for
any one representation provided based
upon said map(s).
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APPLICATION
The City of Edmonds for EASEMENT NO . ..... .................... .................
SIDE SEWER PERMIT
tONSTRUCTION REPAIRS F� LID NO. --A ------- ASMT. NO.
OWNER CONTRACTOR ....... PERMIT NO . . ..................
-- - -------------------------- --------------------------------------------------------- --------------------------------------------
JOB ADDRESS -- -------------------------------- -------- LEGAL DESCRIPTION: LOT NO - ---------- --------------------------- BLOCK NO - ------------------------------------
------------------------------------------------------------------------------------------------------ ---------------------------------- ........................
NAMEOF ADDITION ------------------------------------------------------------ ----------------------------------------------------------
Approved:
DATE .... Zo�. ..... . .......... B y
---------- (a -------------
'SEWE
V` SIDE R_;,TERM
IT.,
��`CIITFYY tEDM��,QNVS_,. - . - I . - 1! 1-1- � I
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WATER -SEWER DEPARTMENT
'PERMIT
7
7,
co�ering any portion�--'df- 'the construction.
-rall, 7.75-25 5 -'for sidet 'sewer -inspections--BEFORF,
id ns
e
n s p c on -Sum,, h . ol ay' Inspe�tio
tj -,A;i ir be ',pro,ided�
wit -:aft r rc�ust, NO',
-A W
V.
90th V
1 .................
........... ...... ........ ........... ........... ............ ..........
-Lot .............. ....... ...................................... ......... ......... ...... ......... .......
iiF
VAOPERTY .............
...........
.................. .....
........... .................. ...........
....... ...... ................
............. .........
7A
-0WN:ER,A-N1D/,0R IBUMDiAAAMF.V� M .... ....................... ............ ........ 11*__1111
............
......................... ..
n- dik iY Road, E & WA.
J, h _'.1600, m Meaft, ..... ...............
4.-ADDRESS.- - nl�t: 0 nso . .1 ............................... ..............
CONTIC- 01VS5NAME — .......... �7_7 ....... ........... ................
t, e sew 0 y sanitairy sewer
9�14' id er to th Cit
...... I repair.and/or �conncc ion,
Pprn-dssi6n. 1§ igrantqd� ..............................
*ecoida- ".,,-,%�ith,,C!�y-.6f"]Cdiiiotids�ordinalices-
nee
sy�stern in,
-FOL
!NTIOTJ'IS:�'dA�LIXD� T16; THE LOWING:::'
:'dontracf6r -must be ernploy'�(T. to-iconstruct
�_NL 1!—The.�owfi6rs,� of�- ihe. prope'rty,' may,'obialn'*a permit to,'.coriitruct sewer .Inside: propert�. line., -licensed Side�Sewer,
side,s , exvc�,jln-_ street area. Dd�not-,cover any_portiom-of"sewer -before it has been 'Insp6cted..-
asion I of RJghi-of* Way Permit,- btiln-able from��the. City,�Englneerlg -office.
-ight-of-way requiresz an Inv 1 .9 ,
NOTE. No.,.2'—Alll-�' performed in �cl y'.r t.
ld sewers when yowget.perml
NOTE. No. :3—Obtain.'fulF.'Info -mation� rdg�xdin� Orainan�ce 11. 16.030 Regulations* governing. s . e
I - ` ' . ' c S' Inside property line;' mi�lmum grad'e of. 2 No 'bends In' grade
MAi�7.ewei,:ffiust have at I gc �at,.pro erty line and 12 in'he
NOTE No. �—T.�,of. east 30' Inches covers, p
sharper than i,� will -be, ii�rmitted. of st . re I ef restored to' 0 ontractors shall b -responsible 'for fa4lure due. - to Improper
NO . TE No. &�Tr6ch6s; In strect:must be water settled and, surface riginal condition. C e . . . . - 'e�
work. , %yhieh-mELy.�develop-within'6ne-year.:of com�letlon. 1 1. . . � , : I . ena_n�ce.g- -except to In-'
in the rmit, or. to do any work -on the maJn _se*er or.tts I appurt
pe
NOTID,:�qo, 6--it �is,u�lawful,�to alter or --do: any -other work than is, provided for.
I sert ttfe,:pipc'. Into'the _wye:
................. Date� ................ !-VBY'_ .. ............. .
... ..... . ........ .......
DISAPPROVE6% -E); Date.. ..... -Dht'e .........
... . ........................ . .
.........
...................... ......
. ......... . M..
'7"
...............
... ................
.... ........................... .......
................................... ...........................
............. ................
Reniarks: ..........
.... .......... ............
.............
........................... ......... ....................................
. ........................ ------------- -----------
ofis . truction. PRIOR To, Requesf F�v lPs�e�tlon
��of Firm. Plerf
B C ST. -B Signed By:gwn, 6r.rriirig,,C
OT
a�tion� on- '6nd er-thw Perm I
side sewer� iftstall :6 t
.. ..... ............ ... hereb certify that�.',-the
7 ................... ...... y
tract g -.Firm- Perfrrming. Constructlon�` City� ofEdmon
k Wy�
tal d'i- cco ce.. th -all,:g6verning. ordinancgs!�bfj.he,
................... ..........
Dated this.z --- ....... :day,
Power, Sew-e M Other -,[3
Che k-BEFQRE,;you dig -for: Water Gas _:E), Telephone jE],
APPLICATION
The City of Edmonds for EASEMENT NO . .............. - -----------------------------
SIDE.StWER. PERMIT,
NEW CONSTRUCTION REPAIRS F-1 LID NO. ------- - ASMT. NO.
----------- ----------- hr ................................ CONTRA OR --- e5�41 ------ PERMIT NO.
OWNER Re 1 ----------
------------------
JOB ADDRESS ----- ------------- LEGAL DESCRIPTION: LOT NO . ...... BLOCK NO - ------------- ............
..... . ............... ................................ .. - --------------------- ............................................ .............. ................
. ............................................
NAME OF ADDITION ...... 2Wo:� ... 6 ............ -- -- -------
Approved:
DATE............................. I ............... By'- ..........................................................