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18917 86TH PL W.PDF111111111111 8205 18917 86TH PL W IN '�'SliD'E�""SIEWE,,R�,,:,iPER�,M,,iliT(�.�., CITY'Of-'VD! MAG ,,,��T WER, ? t IRMI, T 5494-.1 Call for cwer� Inspections, BEFORE covering any po . rtiont of the construe . tiom 115-2525, side: s y ov ours after ; lnspectio�,,wiu 'be pr laid�,within i4 ;h r,,equst. ..NO :Sat.. Sbn1.,,- or holida Inspections. qCATI9N','0F"CQN5tRU CTION.L.A JF ADDRESS' L PROPERTY. LZRAL,I)ES'CRIPTION ........ ............... .......... ...... ...................................... .................... ................ ............................................................................ I ......... ................................................... ................................................................. ....................... ............................ x 1"WER AND/OR BUILDEP ... ... .3L_41_x:m,!o ................................... .................................................. .. ........ 0, ........... rs ....................... CONTRACTOR'S NAME & ADDRESS ................................................ ................. C .. .. ......... L_ ...................... Permlssfon4sgrapted ............. 7 .............. 1 .................. 'for re i -and/or connection- of a .............. 1.19 ...... W., pA,r, �ja;�i.,Sewer. to'.the,clty,s�Lnitary, -sewer ;:�Sys :WoT anowwithoCity of'Edmonds ordinances.. 21TENITIODWIS rCA-LLED T6 THE FOLLOWING: 14 , OTE� No. he,.o�vi�eTs of, the�,property ma�,obtaln: a permit to construct sewer inside. property,. Ilne: A licensed'Side' Sew�r -Contractor. must be'employed to�construct :side!sewerlin street "area. DP -not cover,any portion of sewer before It' has� been, inspected. -NOTE No. All 'wo_rk'p'erforin'ea-'in city� -right.of-way requires E . Ln In vaiiion of Riglit-of Wa Permit,obtaln-able from the City 'Engineer's office. —Oplal I 'information -,regard Ing Ordinance. 11.'1�6.030.,snd Regulations :90verning,aide, sewers when you get pe . rmit.. NOTE 'No. '�3' 6- -1 . NOTE', _+.p 0 overa�ge No� eaewer, must, have at �Ieast'30 Inches c at -property, line' ajLa 12� Inches.inside' property itne';-minimum. grade of 2%. No bends in- grade sharper �thiin 'A' will belpermttted. e NOTE. No. '�Pr helie.Hn'. -ireet must',be water settled and surface of street restored to original condition. Contractors shall be' w6rk -which niay'develop -within one year. of,6ompl'etion. responsible for failure 'due� to, Improper NOTE No. 6�lt, is unla:%�I!W. to,alter or *-do-`&fiy� !other work than is provided for in the'permit, or 'to & any work on the madn sewer or its, appurten , aned "hert.the'li!pe�int6 the wy�.e. S1 e I . ice'Pt to 4 DISAPPROVED `H� .......... By .............. ...................... ...... . ........... ... Date ..................... ... ..... By ................ Date .............. BY ................. APPRO)VED? ........... . ,:� .... By ............. .. .... . . . ... . ...................................... ............................. ................ .... ................................................................. ......................... a ........ ........................................... ....... ....................... .............. ............. ........... ................................. . ................................... ................................................................................. ------- . .......................... .......... ....... ........ I% ..BOTil-Permit! Copi MUST 'Be Signed By,Owner' of. Firm Performing Construction PRIOR To.Request For Insp' ection .............. .... .. .... . ....... ......... . ..... y -certify -thatthe'side sewer instilIatiorf. constructed under' hisp�rmit' .. ............ .... hereb n ng,Fi: . , , nitriiction-) z r ';b�cdor b�rfd4�,,,N�ith'all�-governing,,6rdinaiices ofAhe'City of--EdInonds:_ Dated. , 1� Aay of. t ............ . ........... ............. '491 ......... heck-�BEEPREyou:1dig for:�;Water :Ej, fG-" [j, ',Telephone E];i Power �Ej, SbWer1,,j2],.* '(6ther, cdmonds The APPLICATION for SIDE SEWER PERMIT EASEMENT NO . .......................................... NEW CONSTRUCTION REPAIRS LID NO - ------------ ----- - ASMT. NO . ............... ... N -------------------------- PERMIT NO. OWNER CONTRACTOR ----------------------------------------------- : JOB ADDRESS --- --- P-71 ---------- LEGAL DESCRIPTION: LOT NO. ............................. ...... ....................... .... BLOCK NO . .................................... ------------------- ----------------- I --------------------------------------------------------------------------------------------------- Approved: DATE............................................ By ------------------------------------------------------------ NOTICE: Nb.--w-a r r an - 0 - all The information . shown on the attached Hed for use by the City of map(s) was coMP s Employees and Consultants Edmonds/ it The City of �Edmonds does not warrant the h on these accuracy of anything set for.t -requ sting a e Map(�-). Any person or entity n independent copys.hould conduct a "on shown on arding the informati inquiry reg ff�e -m a p (s), Including, but not limited to, the lociation of any sewer stub shown. Such t and may stubs may or may not exis. sewer at the location shown. or may not exist ts Neither the City of Edmonds nor i the Sha-'l be !Jab -'Fe for emp-l-o-yee-s o-r offi-ce-rs i n on this map(s), nor for. information g Ve tation provided based any one represen upon*said map(s). APPLICATION The. City of Edmonds for EASEMENT NO - -------------------------------------------- SIDE SEWER PERMIT NEW CONSTRUCTION REPAIRS F� LID NO . .................. . ASMT. NO . .................. OWNER ......... F� — ------------------------- CONTRACTOR ... ------- -------- - PERMIT NO. JOB ADDRESS W LEGAL DESCRIPTION: LOT NO . ..... -I=- ------------------- .................................. ........ ........................ BLOCK NO. --- ------------------------------- ......................................................................................................................................................... NAME OF ADDITION --- .............................................................. C>*, 7 %=u&.sLw -=LAa4-A= Z Approved: L ... . ... 5,7 .......... ... .A DATE.. ............... y - ----- JZ 619 0 - 199 - . EET&uc - City of Edmonds %Y1111.11OF-WAY CONSTRUCTION RECEIVED PERMIT .0�v Permit Number: ?d_0CRJ o�) A t1,11 I JAN 2"41992 (00,f 4, 1 'N Issue Date: ' '!L , k if 'L PyahNS& "'Oty of Construction: 18917 86 Place West B. Type of Work (be specific): Install New Service C. Contractor: Washington Natural Gas Company Mailing Address: 815 Mercer Street, State . License #: Seattle, WA 98111 Contact: Frank Swan Phone: 224-2278 Liability Insurance: IL Bond: $ D. Building Permit # (if applicable): Side Sewer Permit;# (if Applicabl6):�. E. Commercial n Subdivision 0 City Project K; Utility'(P-bb, GTE, -WNG, CABLE, WATER) Multi -Family El Single Family F� Other INSPECTOR: INSPECTOR: Vj, F. Pavement or Concrete Cut : El Yes E]No W G. Size of cut: — 2. 'x 4 H. Charge$ APPLICANT TO READ AND SIGN INDEMNITY. Applicant understands and by his signature to this application;-qgrees to hold the Chy of Edmonds har;nlessftom injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeen, that ni I aybe,r)ade against Lh� City, a I t- C - I _L�dmonds, or any of its departments or employ ees, including or not limited to the defense of any legal proceedings includ'n' i d5le e costs, and aKrn% ys by reason of granting this permit. A�_ F A AD MAZnIM THE CONTRA CTOR IS RESPONSIBLE FOR WORKMA NSHIP 4'OR A PER[ D F 0 YEAR FOLLOWING 7HE FINAL INSPECITON ILL AND ACCEPTANCE OF 7HE WORK ES77MA 7ED RESTORA77ON FEES WILL �F . ,,HELD UN77L THE'FINAL,S7REET PATCH IS COMPLETED BY C17Y FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSEDI�O?R,ISSUANCE TO THE iPALICANT. Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Department- 771-3202. Work is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Streit 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. f , 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: M95;�.&Z Date: January 15, 1992 (Contractor.or Agen -2 CALL DIAIA-DIG PRIOR TO BEGINNING WORK NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991 FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept.) Cornments: Diagram: CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO Partial Work Inspection by P. W.: Work Disapproved By: Date. FINAL APPROVAL BY: Date: Eng. Div. July 19 Aw�-- WashlngtLn Natural s� AW-11�5-WG-pariy [efl n 5(v A-" W Addendum to City of Edmonds Right of Way Permit Application Submitted by: Kerry Walsh Engineering Aide Washington Natural Gas 622-6767 x2761 pager 969-1686 � Ca'K'+) 0 C-A-S WNG to window Water main depth unknown 2LI' gas main7A 815 Mercer St/(P.O. Box 18 Key: -w- water -g- gas -ss- sewer water hydrant , Seattle, WA 98111 (206) 622-6767