18503 73RD AVE W.PDF111111111111
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18503 73RD AVE W
III-C 7 _9
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PRRMIT NO: A91A
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PERMIT EXPIRES
SIDE SEWER PERMIT
Address of Construction: 1AJ LID #
Property Tax Account Parcel No. 41-
q257 0_5)0 R E C E I V E D
Attach copies of all access and utility easements I . Verified and Approved b NOV 0 6 7000
N157 AW66LA:f
Owner and/or Contractor: PUBdUfflKS DEP!
Contractor License #: SAA — 0_Q__LC 4- ZOO — tJ 0 Building Permit #:
bToSooingle Family Invasion into City *Right -of Way: 0 Yes Eal&o
F� Multi -Family (No. of Units *RW Construction Permit #
Commercial (No. of Units Cross other "Private Property: E] Yes E��o
El PubIjc "Attach legal description and copy of recorded easement.
Owner/Contractor le; 0
,Owner or contractor signaturea� acknowledgement statement: Date
'By signing for this permit I certify that I have read the City's public handout entitled
Side Sewer Specifications, and shall comply with all City requirements outlined therein.
LLY-MWOOD
9 CALL DIAL -A -DIG (1-800-425-5555) REFORE-ANW EXCAVATION*
.2 FOR INSPECTION CALL 42'.5-771-910 extension 3'29
HOUR NOTICE REOUIRED FOR ALL -INSPECTION REOUEST-S.
. NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN.
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED.
JobSite Ready YES �NO —Date: Initial.
Partial Inspection: Date: Initial:
Partial Inspection: -Date: Initial:
FINAL INSPECTION APPROVED: Date: '1,1*-1-00 initial: %'M As -built to Street Fil'lb:
1,� PERMIT MUSTBE POSTED ON JOB SITE t�
White Copy: File ' Gr*een Copy: In.spector Buff Copy' Applicant .
L;ternp;b1dg;fornns;sspenn itj Ig4/00
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N0710E: NO WAMM OF ACCURACY The Information shown on op
attached map was compilej fo,, u" by the City of Edmc- "3 !'! . c7r,"!oyees
8n" cOnsuftM The City of Edmonds doe6 not warra'n'1'tI',,: of
anything set forth on the. map Any person or entity reque�...�j a c-'py
Shcald conduct an Indepri,cent Inquiry regarding the Inforii,zion shown on
thu map. including, but not limited to the location of apy sewer stub
shu.,�o Sum seiiei 810�; mayor may not ekst and may Or rna�-Aot eyJst at
lh� louatioit Shown, Neili��i- the City of Edmonds nor its eniployees, or
Officc-i shah be liable fo,, tN iniuirnallon given onthis map, n4j6rahyorpj
reXlelhahon Provided bas4d Upon Md map
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