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PUBLIC WORKS DEPARDEqPCKLIST
BUILDING PERM REVIEW, sla
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SITR LAW I I(AddDess)
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Street Right -of -Way Existing 10MO 0
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Access Easements Existing. MtON
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Utility Easement Exist
REQD
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lot Per Subdivision =090 Plat
Assessor Nap
Site Plan Checked for Accur acy
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Underground Wiring Reqd.
Check Accuracy of Legal Description
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Date— Ic 79
Existing Water Main*Size —
Water Required
ervice Line red_
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Hydrant Size Existing
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Hydrant Reqd.Per Fire Code
Size
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Detector Check Meter,�.
Cross Con>nect-i�nspection
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�Fi�r�artment Conuients
Water 116ter Charge Reqd.'.
Review by
Date
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tic Tank Design Approved
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Date
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Sep i Tank Permit Reqd.
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Permit No.
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Sanit ewer Availability
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Drm7ing No.
Side Sewer Availa *ijity
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anitary Sewer Connect Fee Reqd.
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Review by
Date
Open Ditch Existing
Reqd.
Culvert Reqd.
Size —
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Catch Basin Reqd
In te on Site Plan
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Shoulder d&r- * ge maintain collection on
swale open ff
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Mamn-ah, reqd.
Indicate on Site
1 Conditions and Ground Water Field Checked
Review by
Date
Revised: 1vl0-1977
Page 2
,Kevised: iv 10-1977
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STREET FILE
INSPECTION RECORD
..CITY OF EDMONDS, PUBLIC WORKS DEPARMENT
DATE: PROJECT:
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F. H. A.
700 Norton Buildinr
Seattle, Washington
Gentlenen:
This is to
within the City of
sewerage system ac��
JEM: j c
December 30, 1968
.ertify tha� �te house at 18604 80th Avenue West,
.ionds , n�'-qonnacted to the City of Edmonds
Ung to the;City of Unonds standards.
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Yours very truly,
CITY OF EDMONDS
JOHN E. IAORAN'
Director of Public Works
60 60
December 30, 1968
Re: GREENE, Beverly F.
1804 - 8oth West
Edmonds, Washington
Edmonds Water Department
Public Works
200,'bayto"nO St�e6t
Edmodds'i.�.,,W'"a"sh:ingit�o.nl�.I',,�,-�'.-
Gentlemen,
With regard to referred property, FHA requires evidence that
sewer is in and connected on same. Please verify same,
Very truly yours,
James E. Maher
JEM: blj
We hereby certify that the above referred sewer is in & connected.
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
4T,-K- U FUNEW CONSTRUCTION El REPAIRS El
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LYRN PLANT
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EASEMENT No . ..........................................
OWNER �7
.i —.w X ---------- PERMIT No
........ ............................ CONTRACTOR .0-W.,V.5 . .....
ADDRESS ..... 7-3-0 .. ....... ........ �,Q, .............. ........... LEGAL DESCRIPTION: LOT No . ...... .................................... BLOCK No . ....... / .......... .......................
NAME OF ADDITION . ........... ........
Approved:
........... BY.A.--lu ...... ... ............................
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-reque sting a
copy should conduct an independent
inquiry regarding the information shown on
th-e -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
employees or officer-,-) sh-all be liab-fle for the
information given on this map(s), nor for
a I ny one representation provided based
upon said map(s).
CITY OF EDMONDS
Can PRospect 6-1107 when worig
CIVIC CENTER —WATER-SEWER DEPARTMENT' Is ready for Inspection. (No inspec-
tions Saftwday, Sunday or holidays.) N2 1995
SIDE SEWER PERMIT
ADDRESS ------------- 1-8-6- --- 0. - 4� ... ....... 8 ... 0. th ... Avenue West
- - J- --------------------------------- * ------------- * ----------- * -------- * --------- -* -------------------------- ------ * ------------
OWNER .... BY-!ZQA Kt.—QP"Ag� ................................................. CONTRACTOR ... Cwner
............................................... . ..........................
Permission is granted ----Ap.ri-I ... 11 .. . ................ iq.6.7.-, for ---------------------- days, to REPAIR or CONNECT a side sewer
with City Sewers in accordance With application on 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.
-E 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 ap-
purtenances except to insert the pipe into the wye.
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