18912 86TH PL W.PDFIIIIIIIIIIII
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18912 86TH PL W
NOTICE:
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The information . shown on the attached
map(s) was compiled for use by the City Of
Edmonds/ its -Employees and Consultants.
The City ofEdm.onds does not. warrant the
accuracy of anything set for.th on t * hese
Map(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform-ation shown on
-t-Fe -m a p (s) . including, but not limited to, -h
th*e lociation of any sew-er stub shown. Suc
exist and may
sewer stubs may or may
at the location shown.
or may not exist
Neither the City of Edm O*nds nor its
empJo-yee-s o-r off I-ce-rs -sh-a-1-1 be Via-b.-IFe for iffie
n on t I his map(5), nor for
information give'
ov'ded based
e representation pr I
any on
upon'said map(s).
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A
11P SEWER. PERMIT.
WATER,,SEW.-EW-DEPAUTMENT.
.&516
for sid e r I�specti6ns iiEFOI�r coyering� .
e .'sew any,,portion of the const uction,
lijs� pection'wilF be. pr6vlded'.w�thiii,�24 :hours. after requst. NOS6it.':- S�n.. �or,holfdayinspectjons'
ATION"OF."C, ONSTRUCTION ...... . ................
. . ........................................................
ON.,
:':.PROPERTV'LE GAL,�V E S G R . ........
......... ................. ..............
IPTI
................................. . ......................
.............................. ............. ............... ............................
........................ ............ ............................. .......... ......
VNER' r
....................... .............. .......... ....... 01,V AND/OWBUILDERI.-� .... ............................
.........................
A.
�CONTRACTOR'S%W'AMK& ADDRESS ...... ......... .........
. . ............ .....
.............
c6nfiectlorjI.,,.6f a, Side -sewer to th e'c ty
ita Sew r
r.y
spl"em, City -of-.-'Edmon �ordinances-
ds
i1xzs;9r ...
?
o A*., j�NTIONI 1SXALLED.1'T0'.THE,, FOLLOWING:
NOTE�No:'l "IT'�e�,�o�;�ervof"the pro pert�,,;rnay� obtain,,*a: pe irmit tb,,-construct tsewei �jnside:lpropbrty line,' .1 n e
_any, k: ice s d. Side, Sewer Co'ntra;cfo.r in.'sf'be,e�m�lo' ed�.io construct
sidei sewer- tntistreet area. - Do mot -cover rtion, oU�Bewer'iOofe At has'beenl..�e.t6 "Y
PO
'-peiformed-in, city, right!of,way requires �an, Invasi6rr of'�lUght-of�Way',Pe�rhit�obtal�-able from- the City Engineer's office.
0", 'i;OTi�,iq�),'3'—O�t�i�ri�.i'ull-,J�f.,m'ation,,iegaxding-�Ordinance,1,1,.16'030.andgRe ulations� governing, si e,sewers
� .�r '+*o� ` 11 .9 , & - �whem�you, get �perrnii.
446T'El 4 J�f,-side�W' ""m e,at* least 30: Inches- -coverage -at property line and' 12-'Ir
s.ew r, icbn:.in;'Ide' property, line; mlnimum;*,grad�,of.2% -146'be
T ' - , . , , - . . nds,in,Ifrade
i.sha�per'Ali will beFpermitted.'
NOTE:Nd.�-&!-�LTrenchew,tn street3 must � beFwater, settled. and.surface of, street' restored tororiginai7conditfon. Contractors' shall"be'res' 0
-�work, which �m I>o!isjbie'f r failure� due, to improper
elop�,*Jthin;one year of"completion.
ay �deir
14o. 6:--�It tis'-,Unf�wful� �f "'alter -,or, do�:any �han ls.*provlacd��or the pe nilt,. or, to-doan rt6nan'ces��except to in-
4 other. work I in r y� work on � the, main sewer or'
�sert.t e,,lplpe� to 1he.�:wye.' ,tts.,Bppu
DIS"PROVED,[3;*:,Date....� .... �"By� ......... ...... . D BY-'
ate . . ...... . ......... BY ................ ......................... ...............
-7 0
APPROVEW.,..' Date-:eza'! -4140.1 By ........... .
--- ------- ... /-ro— . ...... .......... ...................... 7 ................... I .......................
.............. .................................. ........................ ................ . ............ ....... ........ ..................
....................
................ ....... ..... ................................
................................ : ....... I ...... ; ............... : .................
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rmi , -"truction PRIOR, To Request or�lnspebtiion�--
'Si�fie,,Siined'By Owne�' of Firmt Perfo� nii-Co F
r
% hereby certify, -that ithe,,side, sewer installation- consti,6c-tbd!,undtei.�ihisl,,perm 11 it.
-6
forming, Constiuclion),
.�4(owneq' iiin'�ra*1'n 4�r
nsILall'ediiiik�a6�6r-ddiii2e.- with,, all--'zoverning., ?rdinafices of.the City, of*Edin
onds.
................ ......... 19 ........
.,,Dated'.this, ... I., ...... ..7.dA:y. �.A
r
V� t,--C6�k-�BEFORE;you di*g. for: Wati
r Telephone, Power E3; Sewer Othei,�E]:.
APPLICATION
of Edmonds for
EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS LID NO - ------------------ - ASMT. NO . ..................
-PERMIT NO ------------
---CONTR-A�C--TOR----.:"t*--�-*.-t�'4-�",(:2i'�c=,-,--,..
--------------- ...............................................
--------------------------------------------
A]DDRESS --- LEGAL DESCRIPTION: LOT NO
JOB-- ---------- ------ — ------- BLOCK NO - ------------ z -----------------------
---------------------------------------------------------------------------------- -------------------------------------------------------------------------------
NAME OF ADDITION -----------------------------------------------------------
Approved:
DATE. .... ... &-'�7 -------------------- By ---- ------------------
APPLICATION
^ ^^~' --^ of ---'---~ for
EASEMENT NO �
' �|�E SEWER P����T ------'------'—
^~ NEW CONSTRUCTION [] REPAIRS E] LID NO ------�ASMT. NO. ------
--'------'Y7�-~�-----------------'--------'—'-----'-----
NAM2 OF ADDITION ..................................
�
�
Approved:
DATE............................................ D7---''----------'-''—
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
Permit Number.
STREET FILEERmIT
Wue Date:
A. Address or Vicinity of Construction: - 18912 86 PI W (9409776)
—womm— C) Q� B. Type of Work (be specific): Tngtall Naw Service
9 0 9
C. Contractor: Washington NMt13r;31 r
as Company- Contact: Rnmak Swam
MailingAddress: 815 Mger St, ftflf le, Phone: 79 4 _9 9 7 8
State License #: Liability Insurance: Bond:$
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. R Commercial E] Subdivision El City Project 0 Utility (PUD, GTE, WNG, CABLE, WATER)
[-] Multi -Family [] Single Family EJ Other
INSPECTOR: INSPECTOR: L,-.
F. Pavement or Concrete Cut: 0 Yes G. Size of Cut: x H. Chargq�_$
APPLICANT TO READ A IGN
gh S11
INDEMNITY. Applicant understands and by his signature to this application, agree o he (City ofEdmonds harm 'ur Tages, or
-Oro rw_
claims of any kind or description whatsoever, foreseen or unforeseen, that may be aga t the City of Edmonds, or any of it8leartments or
employees, including or not limited to the defense of any legalproceedings including defense costs, and attorney fees by reason ofgranting this permit.
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 � S-W L BE HELD UNTIL THEE L T ETPATCH
,Lk� �L H _�V4 S �
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PRO6ES§kD FOR ISSUANCE TO', ANT.
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 m-ate'ri al prior to the end -of the W66rkahk day;
NO EXCEPTIONS.
Ihaue read the aboue statements and understand thepermit requirements and thepink copyof thepermit will be
auailable on site at all tim '�v inspectign purposes.
gs,7
Signature: — ;V 4�� Date: February 16,1994
rN�tractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: y" t-% I'l RIGHT OF WAY DEPOSIT
TIME AUTHORIZED': VOID AFTER I �J CA V— DAYS DISRUPTI I ON FEE/FUND 111:
SPECIAL CONDITIONS: &) A -
COMMENTS:
RESTORATION FEE:
PERMIT FEE -
TOTAL FEE:,
RECEIP_T, iFEE'"
A:—
DATE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.)
Comments:
Diagram,:
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
4
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Addendum to City of Edmonds
-Alght of Way
Permit Applicaiion
Pubmitted by: MITCHELL S.-LANKFORD
Engineering Aide
Washington Natural Gas
# ."521-'5246
lee,
[OF, G7
WNG.to window
Water main depth
unknown
(1/,4 11 gas main
Key:
-w-
water
-9-
gas
-ss-
sewei
watex hydrant
wate..- vd Ive
0. 11,-x 6) LS22 �, ",7