18706 79TH PL W.PDF6874
18706 79TH PL W
C ty f Edmonds
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RIGHT-OF-WAY CONSTRUCTION'.
PERMIT Permit'Number. C 17
Issue Date: _,F a?
A. Address or Vicinity of Construction: - 18706 79 PL W
AEON— 1�
c;s main(graveiparkinc
9 9 C) B. Type of Work (be specific): Install anode on q j strip)
MWO 29()17A
C. Contractor: -Washington Natural Gas Co. Contact: Rick Kessler
Mailing Address: 805-156 AV NE, Bellevue, WA Phone: 208-7,691
State License #: - 98W7 ' Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer, Permit # (if applicable):
E. [3 Commercial. F
Subdivision iNG, CABLE, WATER)
-F mil Single Fami E3 City Project W Utility (PUD,., . GTE, V
Multi a y ly E] Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cui 0Yes,.,0No G. Size of Cut: Y/ H. Chargq�_$
APPL ICANT TO READ AND46N
J'% 1 Ae City ofEdmonds harmQ zniuri��_,Iaamage., or
INDEMNITY. Applicant understands and by his signature to this application, agr.936"lk
claims of any kind or description whatsoever, foreseen or unforeseen, that maybe q!!& against the City of Edmonds, ranyof, t nt or
�b / � i!s depar me s
N / _,C,
employees, including or not limited to the defense ofany legalproceedings including and attorney fees by reason org46tiftg thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS 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 TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
Construction drawing 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 inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be'kept clean at all times.
T�raffic Control and Public Safety shall be in accordance with, City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the above statements and understand thepermit requirements and thepink copy of thepermit will be
available on site at all tim for inspection purposes.
Signature: Date: 8/21/96
(Coraracto�jr-Agent)
Assistant, Corporate pr;a;�Irm
ng (447-3151)
CALL DIAL- IG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
-APPROVED BY: RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID,AFTER DAYS. DISRUPTION FEE/FUND III:
x
SPECIAL CONDITIONS: RESTORATION FEE:
COMMENTS:
PERMIT FEE.
TOTAL FEE:
RECEIPT FEE:
DATE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO, PERMIT IISSUANCE
Eng. Div. 1994
. A
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES
Partial. Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
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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 for ' th on these
map(s). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
the -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 officers S13hall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
for
The City of Edmonde --r FILSIDE SEWER PERMIT
Scr
f4--% NEW CONSTRUCTION E] REPAIRS
1111 2�- L-XI b U
OWNER........ ...................................
.7� ...........
ADDRESS JIT ..... 0.4 ..... ........... .........
0
LYNN PLANT'
BASEMENT No . ..........................................
/� 11D /3 �,
CONTRACTOR ------ ...... PERMIT NO.
LEGAL DESCRIPTION: LOT No . ..... ......................... BLOCK No . ................... ............. ..........
L eZ 4
NAME OF ADDITION ..... 11%0 ......................................
#Oos
APPROVED
APR 10 1961
Approved:
DATE ..... By
/* --------- ... --------------
&
P�I�T _—XI-TY _�OV EDMONDS
Call PRospect 6-1107 when work
IS i5biPARTMENT,
R;.
,IVIC'CENTER' MATE
is ready for'Ins'pection. (No pec--l.— IV, 0--
tionsSaturday, Sim 197"& -
S I D E -S E WA E R PER-M-IT
I'; Plade We_s�,
s 18706!`7�t
................... ................ ........ . ....................................
................................ ................... ....... .................... ...............
Rb R
-b e nt _01 s o n U S
OWNER ...... 'CONTRACTOR
.............................. ..............
........................................ ........................ ........
............... ...............
A
pril 10
Permission ls,granted .......................... ....... ........ M ..... for .... ................. days, to REPAIR or - CONNEPT:a side sewe . r
,q -,,with �C.ity Sewers In accordance with application on file and governing ordi"neeii.
ATTENTION IS _CALLEI5 TO THE FOLLOWING:
TE No.1—The owners of the property may -obtain -a permit to construct': sewer. Inside property line. A licensed Bids Sewer. Contractor -must
be employed. to construct side.sewer in street area.' Do not cover an
portion of sewer . before, -it. fias� been Inspected.
NOTE No. 2�Obtain full- Information -regarding Ordinance 11.16.030 and Regulations governing side � isewers.�when you get per�t.
NOTE No. 3�Top of.slde�sewer must have at least
No bends. In. 30 Inches coverage at property line and 12 Inches Inside property line; minimum grade, of 2%.
grade shaxper than 'A will be permitted.-
,T� . NOTE No. .4—Trenches in street must. be water -set . tled and surf ac e of street restored -to original conditl on. Co I nt I r actors sha 11 be-responsibld f . or,
failure due to improper work which may develop within one year �of.-6ompletfon.-
NOTE -No. 511; Is unlawful to a1ter or do any other.work than is provided for in the permit, or to do any work on the. main -sewer or. Its ap-
Urtenances except to Insert the pipe Into the wye.
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