18705 80TH AVE W.PDF7048
18705 80TH AVE W
QUEdImonds
RIGHT-OF-WAY CONSTRUCTION.
PERMIT. 0'�
Permit Number.
Lssue Date*
A. Address or Vicinity of Construction: 0 r!4 LU
/n C. soci B. Type of Work (be specific): LA I A 42 If AJ V e
4,
C. Contractor: 4 se a A r R4,,,,jc Contact: ro a G gs� ?
Mailing Address: 2 7. 7 12
7- A - B Phone:
State License #: Liability Insurance:6 a4o Bond:-- $ 00 a
D. Building Permit # (if applicable): Side Sewer Permit.# (if applicable):
E. Commercial 0 Subdivision El City Project Utility (PUD, GTE, WNG, CABLE, WATER)
ng mily
M.ulti-Family Si I F Other
,INSPECTOR: INSPECT -OR:
F. Pavement or Concrete Cut 0 Yes 0No G. Size ofCut: x H. Chargq-$
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application to hold the City of Edmonds harmlessfrqm injuries, damages, or claims ofany
kind or description whatsoever, foreseen or unforeseen, that may be made, against the City of Edmonds, o�. any of its departments or
emplo�ees, including or not limited to the defense of any legal proceedings including defense costs and attorne�fees by reason of granting thispermit.
THE.CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIPAND MATERIALS FOR A PERIOD OF ONE YE�R FOLLOWING THE FINAL INSPEC-
TION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCH I IS COMPLETED
BYCITYFORCES, AT WHICH TIME AIJEBiTOR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT
Two sets of construction. drawings of proposed work re4uired with permit application.
A 24 hour notice is required for inspectiorKplease call the Engineering Divi§i6n, 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.'
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: & Date., is
IL (Contractor or igent)
-CALL DIAL -A -DIG PRIOR TCBEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: aw-l-Rz RIGHT OF WAY FEE: 30
TIME AUTHORIZED: VOID AFTER may% DAYS DISRUPTION FEEIFUND I 11:
SPECIAL CONDITIONS: RESTORATION FEE:
4 41, Q12),1' ('�A C� A j2.g ff T OTAL FEE:
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14 J/ RECEIPT NO.:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE - Eng. Div 1997
xljrq P
CONTRACTOR CALLED FOR INSPECTION DYES O'NO
Partial Work Inspection by P.W.:
Work Disapproved, By: Date:
FINAL APPROVAL BY: Date:
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The City of Edmonds
c APPLICATION
SIREU FU for
SIDE SEWER PER3111T
LYJNN PLANT
EASEMENT No . ..........................................
NEW CONSTRUCTION E] REPAIRS 0
OWNER .... CONTRACTOR ............................. ............................................... . PERMIT No. ... ....... 4,
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ADDRESS ..... 4Q)W.a� .... ...... CC-�(�..Zfk LEGAL DESCRIPTION: LOT No . ........................................ .... BLOCK No . ............................................
NAMEOF ADDITION ............................... �4; ------- c �... ....... ".. -1/- .................................................
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Approved:
J9DATE .... .... .. .... ....... .... By IV ...... .. . Y .............................
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NOTICE:
No warranty of accuracy.
The information'shown on the attached
ma-p(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 rnap(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 officerS) Shall be liable for the
information given on this map(,$), nor for
any one representation provided based
upon said map(s),
CITY OF EDMONDS
Call PRospect 6-1107 when work
CIVIC CENTER — WATER -SEWER DEPARTMENT is ready for Inspection. (No tnspe&-
tions Saturday, suu&w or houda".) N2 1927
SIDE SEWER PERMIT
ADDRESS ....................... 1.870.5 ... ..... 80.th --- Axe.n.ue .... Wes.t ............................................................................ .....................................
.. .... ..... -- ---- -- ... ....... ..
OWNER ....... Y, ... j, ... Kelliher ................ CONTRACTOR... Bwner
..................................... ................ ...........................................................................
Permission is granted ...-Ap-ri.1-5 ..... . ................ 1951., for ...................... days, to REPAIR or CONNECT a side sewer
inances.
with City Sewers in accordance with application on rile and governing ord
ATTENTION IS CA.LLED 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.
NOTIE No. 2--Obtain full Information regarding Ordin" e 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 then 'A will be permitted.
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.