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18706 92ND AVE W
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The City of Edmonds EET �HM
NEW
7- 0
OWNER....... S. ........... 14A. &. N .............. ......................
ADDRESS ...... I ..... =5. .................
APPLICATION
for
SIDE SEWER PERMIT
!TR.UCTION,g REPAIRS E]
E EDMONDS
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7NT
TREATIVIE-J'N,TPLANT
EASEMENT No . ........ ... ... 12
.. ... ... .... ... .........
W-0 d: .....
CONTRACTOR . ........ PERMIT No.
LEGAL DESCRIPTION: LOT No... ........ N . . ............................................
13LOCI
NAME OF ADDITION .......... 5..
q A IV /-? 14- V /-- I
Approved:
DATE .... ......
........... 13 . ....... . .....
SEWER �'PTRI MIT'
'OF: EUMONDS; SIVE''
CITY'
WATE]Ftw-SEWER DEPARTMENT'
.0
P M, 41.
ER It M)
M.,
'(,Call for sid . e 'sewer: fiuipections�'BE y
FORE covering,, an po on of the con�truc ion.
.,"VInspection w'
11 b e provided, w.i.thim.24. kiburhi after're4iiest.. NO! Sat.: -.Sun., or holida:y Inspections.'
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ADDRESS'�,., N'OFCON�TRUCVON ..............
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piltOPERTY, LEGALDESCRIPTION ......................... ...........................................................
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ER AND/91� BUI ILDER.....
. ................. ............................... . ......... QAV;N,
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CONTIVACTORI& MM. 11E7 ADDRESS ..... I ...... i t ri4 c L I
... . .. ..... ................................... ............ 6 ................. ........................................................
-permissibnAs-gra ' nthd ........................................................ . M ......... for. repair and/or: connection of a side'.sewer to the city sanitary sewer
systiem,,im accordance: With- City of Edinonds ordinances.
ATTENTIONJS,�g�I�LED-TO THE FOLL WING:
NOTE, No. I —The, owri�rs! of Ah� property, may obtain a permit to. construct sewer. Inside property -line'. A,_Iicensed.,Side,Sew r
Contractor, must be employed: to construcV.
ide� , sewer. in street area:.', Po; not cover any portion'of sewer before it ',has been%,Anspect6d.
/"TE No. 2—,Allf woik: performed In%city'right-of-way re4ulites 'an Inv"ion,zof' lUght-of-Way Permit. obtainable from the 'City''En'gi neer's office'., -
iE No. 3—Obtain 4,i�'iormation, r6garding Ordinance' li.16.0�0.� wl'qi 'Regulations governing side si6ver'sl w'hen:.you got permit.
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NOTE No; 4—T6ii 7of :side -sewer-mu�t �ha�e'. -1
at lea�st 30, inches coverage- at'property, 'line 'and 12-ii�6hes,*ins'Jde:property',iine;.�mini-murrf grade 'of
sharper than wiIU,b&�pe'rmItt4d. 2 14o ibends in. grade
NOTE No. 5-.Trenches in street st be water, settled and surface of' s treet, restored' to original . condition. . Con tractors -'shall'.' be responsible for, failure due to Improper
workwhich;,may develop within�o ' ne year of.complet.loti:
NOTE'No. _It. is �U�Iawful to,,alt��,or do., any. other -except
seA work, than is provided for -in the permit, orto do; any work on the main� sewer or its ap u�t;nanc-e� td. in-
fhe�plpe�',intathe� wye. p
DIS"TROVED.,:
- I Datet ....... .... By ............... . . 166te:. ........ ...... ..........
F .... ; ........... .............. . .....
I a By .................
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NPPROVEW D ate'. . .......
L
.,Reiyiarks:, ......................... ...........................
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BOTH P6 e!Copies MUST Be Signed By,0wner,6f4'-i'rm Pei�forMing�',Qon�trudt.i'on,PRIOR-
To-Request Fo�� nspecti'm
%
--hereby' certi�y.,'tha�o'the,�side se'werdnstallfati6n,�c s't u'cte'd un_d'e'r,,-,,thi&.permit,
6.,��nc r _'o i C o n t ra c t I W1g,,A r m: R'e,�vf�j,,&it �g- �n-s �tr u'. t i o n 1, :.7 .6n, x
was Install6dAn,"a6ed�'dance, with�,aIIIL,,gove'rning,,ordina�,iir-es �of e-City,,Of Edmonds'
. ..........
Dat s ... .
d; th-i .................. ................
'Che�i�,-�BEIFOR'E' yoivd1g,for:`Watcr'E],,.' tGh�`- E"D, T61ephone,7�E3, Powci Ell.
Sewer �Othcf:�Cj,
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NOTICE:
The information'shown on the attached
map(s) was compiled fo r. use by the City Of
Edmonds/ its Employees and Consultants.
Th,..e City ofEdrn.onds does. not. wa rra nt the
n these
accuracy of anything set for.th o . *
Map('�). An . y person or entity'requesting a
copy should conduct an independent
inquiry regarding th*e info'rrn-ation shown, or
.7--tHe -map(s)/ including, but not limited to,
the location of any sew-er stub shown. Suc
sewer stubs may or may- not e.xist and may
or may not exist at the location shown.
Neitheir the City of Edmonds nor its
Pzmpl-o-yee-s o-r offi-ce-rs -sh-a-1-1 be 11a-b-'Fe for the
I n on this map(5), nor for
information g've*
any one representation provided based
upon said map(s).