18901 94TH AVE W.PDF9178
18901 94TH AVE W
NOTICE.
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The -information on the attached
Hed for use by the CItY Of
map(s) was corn ' pi
Edmonds/ its Empl.oyees and Consultants.
Th,e City of �Edrn.onds does. not . warrant the
accuracy of anything set for,th on t hese
M a p (S). A n . y person or entity -requesting a
copy should conduct an independent
orm . ation shown-o
inquiry regarding the infi
-t-Fe -rn a P (S) / including, but not. hm'ted to,
the location of any sewer stub shown. Suc
sewer stubs may or may- not e.xist and may
or may not exist at the location shown,
Lity of Edmond.'s nor its
Neit-heir the " or
e m pl-o-ye e-s o-r off ice-rs -sh-a- 1.1 b e 11 a-b-Ife f M E
on this map(5), nor for
infor . mation g'v e' Ided based
any one representation prov
upon said map(s'.
APPLICATION
STREff FILE for
The City of Edmonds SIDE SEWER PERMIT EASEMENT
NEW CONSTRUCTION REPAIRS E]
OV%rNF,R .... ........ /-" ....... ........... CONTRACTOR
7-11
...... , ....................................... .......... PERMIT Nof .......... .
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v / 71 LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
ADDRESS ... . . ....... 9 . . ............. ......
NAME OF ADDITION ....................
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Approved:
-DATE ... ............................................ By ........... ..................................................
CITY OF EDMONDS
Cl 6-1107 when work
�VIC CENTER WATER-SEUiM DEPARTMENT
is ready for inspection. (No inspe" myo
SIDESEWER PERMIT tions Saturday, Sunday or holidays.) 2612
ADDRESS ------------------------ 1-8.90-1 ... ..... 9.4t1h ... A-y-enp-e ... W.e.s.t --------------------------------
OwNER ------ Richard ... --------------------- -TRACTOR Northwest Sewer
..................... CON
................................................................................
Permission is granted .... De.CeMb-er ... 8 .............. iq.j5_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.
NOTE.No. 4-L-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 appur-
tenances except to insert the pipe into the wye.
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
FERM . if. Permit Numbe7l'-.4�� _'3-7/
Is -sue Date:
A. Address or Vicinity of Construction.: 18901 94 AV W (976933)
89 0 9 1� B. Type of Work (be specific): Install Service.
C. Contractor: Washington Natural Gas Contact: Mariamne Kingsbury
Mailing Address: 1122 75 St SW Everett Phone: 356-7500 �X7596
State License #: - 98290 Liability Insurance: Bond:$
D. Building Permit # (if applicable).' Side Sewer Permit # (if applicable):
E. E] Commercial [J Subdivision El City Project [0 Utility (PUD, GTE, WNG, CABLE, WATER)
[-] Multi -Family E] Single Family E) Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut 0 Yes [@No G. Size of x ChaFge-$
I"
APPLICANT TO JKLAD AN-D SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City ofEdrnondg harmless from injuri�8, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason ofgranting 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.
Traffic 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 u nderstand thepermit requirements and thepink copy of thepermit will be
bl �s��e at a t m
avat a eon 11 es for inspection urposes.
2 Signature: Date:
6yontractor'or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
"PROVED BY. RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID'AFTER 'PA V�— DAYS DISRUPTION FEE/FUND III:
SPECIAL CONDITIONS: RESTORATION FEM,
PERMIT FEE:
TOTAL FEE: or
COMMENTS:
RECEIPT FEE:
DATE: ISSUED BY:
n
NO WORK SHALL BEGIN PRIOR_'T.O PERMIT ISSUANCE Eng. Div. 1994
FIELD INSPECTION NOTES
Comments:
Diagram.:
. I (Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
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Watermain depth O/A
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""Adde6dum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
0356-7500 X7596
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Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
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Watermain depth O/A
"Z . gas main
-AddeuAum to: City of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
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��> Key:
<:Svj -V- Water
-G- Gas
-SS- Sever
-& Water hydrant
0 Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331