Loading...
18502 84TH AVE W.PDF111111111111 7824 18502 84TH AVE W k 1,7 C. 1,6 o �) C. Contractor: Mailing Address: State License #: City of Edmonds RIGHT-OF-WAY CONSTRUCTION PERMIT Permit Number. Lssue Date: A. Address or Vicinity of Construction: ave, B. Type of Work (be specific): W41AX12t (A) V 44-1 Contact: Phone: Liability Insurance: Bond: $ D. Building Permit # (if applicable): Side Sewer Permit # (if applicable)- E. F1 Commercial _E] Subdivision El City Project /W Utility (PUD, GTE, WNG, CABLE, WATER) F1 Multi -Family E] Single Family Other INSPECTOR: INSPECTOR: F. Pavement or Concrete Cut: 0 Yes []No G. Size of Cut: x H. Chargq�_$ APPLICANT TO READ AND SIGN INDEMNITY: Applicant understands and by his signature to this application to hold the City of Edmonds harmlessfrom injuries, damages, or claims ofany 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 defense costs and altorneyfees by reason of granting this permit. THE i�ONTRA CTOR IS RESPONSIBLE FOR WORKAJA NSHIP A ND MA TERIA LS FOR A PERIOD OF ONE YEA R FOLIO IFING THE FINA L INSPEC- TIONANDACCEPTANCEOF THE WORK. ESTIMATED RESTORATION FEES WILLBE HELD UNTIL THE FINAL STREETPATCHIS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT Two sets of construction drawings of proposed work required with permit application. A 24 hour notice is required for inspection. Please call the Engineering Division, 771-0220. Work and material is to be inspe�cted during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut trench work shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. I have read the above statements and understand the permit requirements and the pink copy of the permit will be available on site at all timesfor inspection purposes. Signature: (Contractor or Agent) Date: CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: V., RIGHT OF WAY FEE: 00 F -_ 14ER DISRUPTION FEEIFUND I 11: TIME AUTHORIZED: VOID A DAYS SPECIAL CONDITIONS: RESTORATION FEE: Q.TAL FEE: RECtIPTNO.: 4 JSSUED BY: NO WORK SHALL BEGIN PRIOR TO 4�' ISSUANCE Eng. Div 1997 �IT�:'X7 7 FIELD INSPECTION NOTES (Fund 111 Route copy to Street Dept.) Comments. CONTRACTOR CALLED FOR INSPECTION El YES El NO Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: S"EET FILE CITY OF EDMONDS DEPARTMENT OF PUBLIC WORKS 250- Fifth Avenue North, Edmonds, Wash ingion''*-'. -SEPTIC"TANK INSTALLATION-.. PLAN (Subniit in Triplicate) ... Lot N,....j --_--_-------- Permit N....I�Z.3... ..... A? . AW ADDRESS OF PROPERTY ............ ; Owner ...... .. A., Is, 4, N ------ Address .......... . ................ ................ Phone ................ Builder.. Chffrles- A-. lanse�' __ A - ddress Phone ... RR.-8-7452 ...................... DesignerSo 0 _4no._ Be ptic/.. Tank. -De oVdress.. 5208 Installer .... Cr&Wfor S ... so. I-C ---- T-&n-k --- CV�ress._Box -246-j- Alderwood ------------- Phone ... P.R.-S-87-71 I hereby certify the acco anying drawing is an accurate representation of the system installed at the listed address. I also certify all recommendations and restrictions (con I cerning plumbing stub elevations,, maintenance of grades' fills, surface drains, etc.) listed by me on my sewage disposal system permit application dated ................ . ...... 7-27- 63 ..................... have been complied with. ..................... Date T TO BE FILLED IN BY CITY ENOINEER ONLY 0 B Accepted ...... ------- .. ........... . .. ..... Date ...... zl_� ........................ Not Accepted .. .. ....... .................. . ....... ....... Date. . . Signatureof Sanit an .. ......... ... . .. ............................................... Remarks:. ............ .................. .................. ............ .................. ............................................... ........................................ INSTRUCTIONS: Use'the reverse side of this form foi- the drawing. Use a scale which will permit the greatest detail.and still contain the entire site on one page. ATTENTION HOME OWNER: Your septic tank ha!s�' limitations! It was designed and installed to care for an average -size family. Over- luadin.g the septic tank or disturbance of the drain -field- may seriously impair satisfactory operation. Points to remember: 1. Have your tank checked periodically to see if pumping is necessary (2y2-3 years). 2. Do not channel ground water, surface water, footing drains or downspouts into the tank or drainfield. 3. Do not excavate, fill, place a structure, driveway . or.patio in, on, or over the'drainfield. 4. Limit toilet fixture disposal to sanitary wastes and toilet tissue. 5. Detergents and bleaches used in nornial household quantities will not liarni tile action of the septic tank and disposal field. J13 4A uc' S I oil F, 'R EArold Olson S2W.180th 3. 1W. Lynnwood,. Wash. AS. RUI LT Inatelled 1000 091. So To 87Z3 q. Ft 0 Requi red 1000 Gple 3, To 564 Scl. Ft. SNOHOMISH HEALTH DISTRICT DIVISION OF SANITATION 3011 Rockefeller Avenue, Everett, Washington APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT ­ffubmit-3xC-apie' t Permit to be issued to: ----- For installation at: (street address) ----- - 1 W C-54, ....................................................... ............ .............. ........ Addition or Subdivision --------- .. A`or-est ... m-�" --- C .... ­ ........ .......... 1. Lot ------- 1 ..... .-IBlock ....... -------- X ... Existing---. Single-famil'y" residencefr4yx, - Num -of -bedrogm ..... .. Type of Building: New.. b[i, Other: (specify type or use) ............................ 1� ........................................... ............................................... ---------------------- Builder .... ........ ....................... Address ---- Designer. ... �*D.* --- $nrA..­3.e.rytj-c ... Address.... SoilLog Hole No. .. ... . ... . . ....... . ... ................... ....... ...................... ------------------------------------------------ ---------------------------------------------------- ........ ......................................... ........ ...... ............ Soil Log Hole No. 2 --- n ---------- - ----------------- . ........... ...... .......... ............................................ -------- ------------------------------------- ................... ............................... ....................................... Elevation of Water Table, if encountered. (Distance from ground su frce) ........................... ......... ......................... Corrections to control surface water7f 7 ............ .......... ...... .......... ........ ........................... ................................................................... .......................................................... .................................. I .............................. ----------- Sp�e ading of topsoil in field, area.t .......................................... ............................. cify if any removing or gr .................. r ... ...................................................................................................................................................................... ......... X ........................ Percolation: Test Hole No. I — Av�erage Rk-te--i .... 5 .............................. (Fall in ininutes/in bottom 6.1" test hole) 4- 12 1: Test Hole No. 2—Average Rate .... ----- ...... ....................... (Fall in ininutes/inc -bottom 6" test hole) —A (Fall in ininutes/inch-bottoni 6" test hole) .3 Test Hole No. 3 verage Rate ----- ; 1 11 ---------------------- --- * ---- ----- --- Average percolation rate on which to base drain field design .. ....... 7 ... ........... ------ Date Taken --- 7-45;463 Septic tank requirements based on preseWtrules and regulations: LSeptic Tank Size ---- Amount of Square Feet of Disposal-PO—d.'Tr 7...­.. co 'e Signature —, Designer'.1. ........ ­­ ......... --­-----­ --------------------------- ------- --------- Date ------ 7"2.7. -W ....................... DO NOT WRITE-RE-EEM THIS LINE (To be completed by Issuing Agency) o Permit issued (dat�77 ................... Permit Number ......... ........ ­­ ........... Remarks: ............................... .................. ---------------------------------- ------ ---- - -- ft." � - - � � 1-7 W ------------------------------------------------------------------------------------------------------------------- . ..................... ­ ......................................................... DRowk DR S I G" T r,' R Hn-old Oison Ptak )Ar. Lynnwood, Wrzah 1 a --20 1000 Gel, So To IM- Lin. f to of drpinti le 31 wide trench.*. 564 Sq. M rec,,ulred 0 Per. r1ole Sat 1 Lor 411 Tir, , ,.It Line -,.411 Drpin Tile 0 NOTICE: -N�o-w-arraniy­o-i The information'shown on the attached Map(s) was compiled for use by the City of Edmonds', its Employees and Consultants. Th,�e City of 'Edmonds does not. warrant the accuracy.of anything set for.th on these rnap(�_). Any person or entity -requesting a copy should conduct an ind,ependent -ation shown on inquiry regarding the inform I it tFe -map(s), including, but not I'm* ed to, th-e lociation of any sewer stub shown. Such sewer stubs may or may, not exist and may or may not exist at the location shown. city of Edmonds nor its Neither the k_- I emp]-o-yee-s o-r office.rs -sh-a-11.1 be Via-b-'Fe for -11-he information given' on this map(s), nor for ovided based any one representation pr I upon said map(s). The City of Edmonds \N for SIDE SEWER PERMIT NEW CONSTRUCTION [:] REPAIRS EASEMENT No. . 7�1 OWNER l-) ......... ........... ...................... ........ .............. ............................................ ;Z;;� . ........................................... CONTRACTOR,�,??� PERMIT No. . ............... I C�l ADDRESS ......... ..................... .... LEGAL DESCRIPTION: LOT;�N.. ................................... 4:v BbOCTC-90. ... ................ NAME OF ADDITION . .......... ........ ..... . ....... 7 Approved: DATE ........................... By SEWAGE DISPOSAL'..- PERMIT No. Septic Tank /�OA`�A- ,....gals. ... lf?.,,`;i� ........... CITY,OF EDMONDS 'ks Disp. Field .... �-�-Z .. .... sq. ft. Department of Public Wo,r Other..... ...................... .............. Na .............. . . ................... ...... is hereby authorized -to install/ ...................... .... ... repair sewage disposal'system at t ... ................... ............. ........... ------------------- ................. ----- - �v Date issued on ......... ............ ......... ................................ Termit expires one year from date of issue DO NOT COVER BEFORE APPROVED BY., DESIGNER"OR -SANITARIAN I hereby certify this system was installed 'u�der -my supe rvision and -control and complies with all provisions of the City of Edmonds Resolutions. . ........... Date ................................... Signature of Installer ........ ............................................... ApprovedDisapproved M Date,. ----- ................................. ---_--_-_-_--- BY ............................................ .................................. Remarks:. ................................................................................ ............... ....................... ........................................................................................ SANITARIAN- OR DESIGNER ........ : ............................................................................ ............. . Date ...................................... ................... This permit shall be posted in a reasonably conspicuous ,place on the job -until inspection has been completed. CITY OF EDMONDS CIVIC CENTER — WATER -SEWER DEPARTMENT SIDE SEWER PERMIT Call PRospect 6-1107 when worl '0 Is ready for Inspection. (No Inspec- Al tions Saturday, Sunday or holidays.) 2890 ADDRESS ............... &YgniAg.. We_s.t OWNER ..... 99.9rgf� ....................................... ...... CONTRACTOR .... Lee W001eV ........................ ................................................. Permission is granted ... ftri * 1 " 9 ........ 19.fi.P, for ........................ days to REPAIR or CONNECT a side sewer with City Sewers in accordance with application oil file and governing 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. NOTE No. 2—Obtain full Information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 3—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. 4—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. 5—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 appur- tenances except to insert the pipe Into the wye.