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18926 83RD AVE W (2).PDF111111111111 7713 18926 83RD AVE W W-r-lZm. llr�4111111111 Ewa amd CITY OF EDMONDS CONSTRUCTION PERMIT APPLICATION OWNER NAME/NAME OF BUSINESS Rod Addicott 18926 83rd Ave W y ZIP TELEPHONE NUMBEF Edmonds 98026 774-7945 N/A ADDRESS CITY NAME N/"r ADDRESS CITY Z 8 STATE LICENSE NUMBER I Leaal Description o P I TELEPHONE NU MEER 'CC IF TELEPHONE NUMBER EXPIRATION DATE ZONE C - f ) - / JOB ADDRESS �A E� PERMIT 9roo-3W NUMBER — C� 7 /S "A' ,EGAL DESCRIPTION CHFCKI SUBDIVISION NO. PUBLIC RIGHT OF WAY PER OFFICIAL STREET MAP. EXISTING REQUIRED DEDICATION PpnpnqFn METER SIZE LINE SIZE I NO. OF FIXTUF DATED SIGN AREA ALLOWED PROPOSED z Lot 7, Block 3. Oscar E. Jansens a Seattle suburban tbractsp accord]in VARIANCEORCU 8 - &_ -4 P-) Lu 0 to plat thereof recorded in volume SETBACKS -FEET P111:b8p Page 0 Re,.;w&d of Sn FRONT ?`�_ SIDE" .j - include all easements j ax Account 'A816-003-007-0003 Parcel No. NEW 12 RESIDENTIAL PLUMBING ADDITION 11 COMMERCIAL MECHANICAL REMODEL 1:1 APT. BLDG. El SIGN REPAIR GRADING CYOS. FENCE, 1 '515' . _1.�FT) I DEMOLISH WOODSTOVE INSERT SWIM POOL r HOT TUB/SPA G ARAGE WALL/ C E].FIETAINING ROCKERY 1:1 RENEWAL TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN: I TESCP Approved 0 RW Permit Required 0 Street Use Permit Req'd 13 Inspection Required 0 Sidewalk Required 0 M W PRV REQUIRED YES C3 NO 0 0 Z 5 W Z 0 Z 1.1 SEPA REVIEW ADB NO. COMPLETE - 1EXEMPT SHORE LINE# EXP PLANNING REVI BY DATE 7w Y, H,�IGHT REAR ILOTCOVERAGE I 12 'HECKED BY TYPEOF CONSTRUCTION GOOF OCC PANT el, C� 4i 1 GR . P--2 je .,_ SPECIAL INSPECTOR AREA OCCUPANT REQUIRED 13 YES I LOAD PROGRESS INSPECTIONS PER USC 305 (A NUMBER ui NUMBER OF CRITICAL 0 OF DWELLING AREAS STORIES I UNITS INUMBER DESCRIBE WORK TO DONE (ATTACH PLOT PLAN) Remove 61 cedar I x 6 from-existi: 4:INAL INSPECTION REQUIRED fence'structure and install 91 VALUATION FEE 1 x'B cedar boards back* PLAN CHECK FEE BUILDING HEAT SOURCE: GLAZING % PLUMBING Plan Check No. MECHANICAL GRADING/FILL This Permit covers work to be done on private property ONLY. Any construction on the public domain (curbs, sidewolks, driveways, marquees, etc.) will require separate permission. STATE SURCHARGE Permit Application: 180 Days Permit Limit: I Year - Provided Work Is Started Within 180 Days . STORM DRAINAGE FEE ENG. INSPECTION FEE "Applicant, on behalf of his or her spouse, heirs, assigns and w successors in interest, agrees to indemnify, defend and hold Lo Wmless the City of Edmonds, W4.shington, Its officials, 2 employees, ind agents frdni any and all claims for dlimagbp'of < whatever nature, arising directly or Indirectly from the Issuance of this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any requirement of any city ordinance 0 I nor limit In any way the City's ability to enforce any ordinance provision." PLAN CHECK DEPOSIT TOTAL AMOUNT DUE 1 1, ­h —k-1-4 . thof I have road this amnlicatione that the . y V information given is correct; and that I am the owner, or the duly ATTENTION APPLICATION APPROVAL authorized, agent of the owner. I agree to. comply with city and state laws regulating construction; and In doing the work authoriz- THIS PERMIT AUTHORIZES This application Is not a permit until ed thereby, no person will be employed in violation of the Labor ONLY THE signed by the Building Official or his/her Code of the State of Washington relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is ion InsLvMe an44;CW 18.27. INSPECTION acknowledged In space provided. I NAT �KE to ER AGENI) DATE SIGNED DEPARTMENT I CITY OF EDMONDS �FICI I TURE DATE OF Al.'� $jGNA tReZ CALL FOR RELEASED BY: DATE ATTENTION INSPECTION IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR 771-0220 ORIGINAL — File YELLOW — Inspector A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC CHAPTER 3. PINK — Owner GOLD — Assessor 9 102-87 ..... .... . ce- 7i \4 _�r Cie MAY BY, co TE eal C2M -LIL �—A VJL—rl Critical Areas Checklist Site Information (soils/topography/hydrology/vegetation) 1. Si.te.A, ddress/Location: alZ -j 4a E 2. Pro'perty-Tax Account Number: (4?16- (903 -00-7 Ooo-3 3. ..,.Approximate Site Size (acres or square feet): -70 K 919' 4. Is,this..site-'currendy developed? —yes; no. If yes; how is site developed? Ke-5-,,Qe^4 1-q I 5. Describe the general site topography. Check all that apply. X Flat: less than 5-feet elevation changeover entire site. MAY C 6 1, c-`S� 6 POMIT COUNY-LIR 4� -r- q ,+. Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal distance*of 66-feet). Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of 10-feet over a horizontal distance of 33 to 66-feet). Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal distance of less than 33-feet). Other (please describe): 6. Site contains areas of year-round standing water: M 0 Ap . prox. Depth: 7. Site contains areas of seasonal standing vraw: V-% 0 Approx. Depth: What season(s) of the year? rYLA— r S. Site is in the floodway Y, o floodplain rl 0 of a water course. 9. Site contains a creelc or an area where water flows across the grounds surface? Flows are year- round? ' r, 0 — Flows are seasonal? _ (What time of year? 10. Site is primarily: forested ;meadow shrubs mixed urban landscaped (lawn,shrubs etc) 11. Obvious wetland is present on site: 'n 0 For City Staff Use Only 1. Site is Zoned? 2.. kS mapped soil type(s)? (1, 4 L 3. Wetland inventory or C.A. rnap indicates wetland present on site? &"­ :,,..Critical Axeas inventory or C.A. map indicates Critical Area on site? /6v 5� Site within' designated earth subsidence landslide hazard area? ';gnated on the Environmentally Sensitive Areas Map9 6.. 1 esi .DETERKMATION REQUIRED VVAIVER -d Revie . wed by:_, LLd I ( 1.141 Planner. Rcv 0118N94 CONDMONAL WAIVER 'Date. 0 -5 o- City of Edmonds Critical Are--a--s--_ �Gh--,-e'-c*"'.k''l.i*s't'....-. *Me Critical Areas Checklist contained on .-and submit -it to the City. TheCitywi this form is to be filled out by any person review the checklist, make a precursory site preparing a Deve�opment Permit, Visit, and make a determination of the Application for 66 Cityd Edmonds Prior subsequent steps necessary to complete a to his/her submittal of a development development Permit application - permit to the - City'.' - The purpose of the Checklist is . to enable With a signed copy of this form, the applicant should also submit'a vicinity map. City staff to determine whether any-- or plot plan for individual lotsof the parcel potential Critical Areas are or may be with enough detail that City staff can find present on the subject property. The and identify the subject parcet(s). in information needed to 66mpletethe'� -addition, th� applicant shall include Checklist should be easily available from other Pertinent inionination (e-g. site observations of the site or data available at plan, topography n=p, etc.) or studies in City Hall (Critical Areas inventories, maps, conjunction with this Checklist to assist or soil surveys).-` staff in completing their preliminM assessment of the site. An applicant, or his/her representative, must fill out the checklist, sign and date it, I have completed the attached Critical Area Checklist and attest that the answers. provided are factual, to the best of my knowledge (fill out the appropriate column below). Owner/ Applicant: Applicant Representative: a Asir. H Name Nam Street Address Street Address City, IP - Phone, City, State, ZIP I?hone. ..Signature Date . ,,Signature A or CITY OF EDMXRfET FILE 250 - 5TH AVE. N. * EDMONDS, WA 98020 * (206) 771-3202 COMMUNITY SERVICES: ICZ3 Public Works a Planning 9 Parks and Recreation * Engineering 8 9 0 9 q May 8, 1990 Rod Addicott 18926 - 83rd Ave. W. Edmonds, WA 98020 Dear Mr. Addicott: LARRY S. NAUGHTEN MAYOR PETER E. HAHN DIRECTOR Per my review and visit to your resident, I will allow a credit per our policy as follows: the average consumption for the same period during the previous year charged at normal customer rates, plus the excess usage charged at the City's cost, plus a surcharge of 15% applied to the excess only. Should you have any questions, please call Ilene Larson or myself. Sincerely, e goin -z!14 BOBBY R. MILLS PUBLIC WORKS SUPERINTENDENT BM/l k cc: Ilene Larson Utility Billing Clerk #428800/TXTWATER 0 Incorporated August 11, 1890 0 Sister Cities International — Hekinan, Japan IT Lx—caut I 4--Z221— 7-7 E PRINT KEY FROM--Y4 BY USER--lJI_250 05/01/90 14*33*01 5/01/90 crry OF EDMONDS Ur-42011 234'3214'45 PM I TVL U i r e Customer History DETAIL. C us t o mer Key Customer No# 428800 ADDICOTT R OR OCCUPANT OLd No+ 40616000 0-9 Tran Description/ Tran Elate Gry Date Reading Type Rate Cons Seq Type Amount BaLance 04/09/90 03V28190 000494 2-1 0001 64 000 1 28o92 95.99 04/09/90 03/28/90 000494 1-2 0001. 64 000 1 3.65 67407 04/09/90 03/28/90 000494 1.-1 0001 64 000+ 1 63.42 63*42 02/13/90 P 544-14-- 02/08/90 01/30/90 000430 2-1 0001 19 000 1 28.00 54*14 02/08/90 01/30/90 000430 1­2 0001 19 000 1 1+42 26*14 02/08/90 01/30/90 000430 1-1 000:1. 19 000 1 24o72 24.72 12/26/89 51.41-- 12/12/89 12/02/89 000411 2-1 0001 16 000 C 28*00 51*41 12/.12/89 12/02/89 000411 1-2 0001 16 000 C 1*27 23*41 12/12/89 12/02/89 000411 1-1 0001 16 000 C 22*14 22*14 10/19/89 P 55+05-- Due Efate Total. Cur -rent 1 2 3 5/03/90 95.99 too 95499 000 Cmd2-Dil./Sum F i L L i n requ i red i nf ormat i on and press en'ter Cmd6--Cst Rec 'Cmd4---Cst Sry Ile Lp 2 CONTINUE END 2 Cmd5-Src Add CmdG--Notes - --------- ---- --- ---------- - - - -- ------- of SZ 0 MW ftTREET FILE FILEPOPY February 2, 1981 MEMO TO: Mary Lou Block Planning Department FROM: Jim Adams Engineering Division SUBJECT: APPLICATION FOR STREET USE PERMIT Right-of-way between 83rd and 84thAvenues at�190th St. S.W. 18926 83rd Avenue West Attached is an application for a Street Use Permit and a copy of a letter to Mr. Addicott request- ing a Certificate of Insurance. When you get the Certificate of Insurance, have Hal sign the application indicating his approval. Please send the permit back to me for rred's signature. We will then return it so you can assign the permit number. 'OF JEA/j f Encl. 0 0 CITY OF EDMONDS HARVE H. HARRISON 200 DAYTON ST, - EDMONDS, WASHINGTON 98020 - (206) 775-2525 MAYOR DEPARTMENT OF PUBLIC WORKS February 2, 1981 Mr. Rod A. Addicott 18926 83rd Avenue West Edmonds, Washington 98020 Dear Mr. Addicott: SUBJECT: STREET USE PERMIT/18926 83rd Ave. West Your application for a Street Use Permit has been re7 viewed and has preliminary approval. Prior to issuance of the permit, you are required to furnish the City with a Certificate of Insurance which is to includel��the following: 1) $300,000.00 Bodily Injury; $100,000.00 Property Damage. 2) Cancellation statement: Should the above -describ- ed policy be cancelled before the expiration date thereof, the issuing company will mail a 30-days written'notice to the City of Edmonds by Certified Mail. 3) Hold Harmless clause: It is understood and agreed that the City of Edmonds is named as an additional insured, and'held harmless from all claims and/or property damage as pertains to the above -named per- mit. When you obtain the Certificate of Insurance with the above inclusions, please take it to our Permit Section located at 505 Bell Street and they will issue the Street Use Permit for a $10.00 annual fee. If you have any further questions, please call me at 771-3202, Extension 279. JEA/j f Sincerelvf JAMES E. ADAMS, P.E. City Engineer cc: mary Lou Block, Planning Dept. IV. 0 CITY OF EDMONDS, PULIC WORKS DEPARTMENT 200 DAYTQN S-LREET EDMONDS, WA .98020 775-2525 APPLI-CATION FOR STREET USE PERMIT Name of Applicant:.- Rc-3,4 -A A"t' c 6—H . J,�f Mailing Address: e F",( VVI Ir Telephone Number: ? Date: 4/2 A Description of Public Place or Portion thereof desired to be used: (exhibit may be attached) P11) A 12 i 's, R 1P, of Public Place: Type of Use desired to he m —Pe. 1 4.0 (CA r -e c- r aj- !e Q A -if— /t, if dpplicable, attach plans and specifications for any utility or structure to be erected and/or maintained on the Public Place: AC)Uf:_ TEMPORARY PERMIT: Unless otherwise designated herein, this permit is understood by applicant to be wholly of a temporary nature, that it vests no permanent right whatsoever. If the permitted use beconles dangerous or such structure shall become insecure or unsafe, or shall not be constructed, maintained or used in accordance with the nroviSinnc nf thic and obstructions ordered removed by order a specified period of time, the terms title, the same may be revoked and the structure of the City Engineer. If this application is for of said applicatiop is: INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages or claims of any kind or descrip- tion whatsoever, foreseen or unforeseen, that may be made against the applicant or the City of Edmonds, or any of its departments or employees, includinq but not limited to the defense of any legal proceedings including defense costs, court costs-, and attorney fees by reason of granting this permit. In addition, applicant understands that the City shall be provided a certificate of insurance to indemnify and hold the City of Edmonds harmless from all claims and/or property damage, naming the City of Ednionds as an also insured. APPLICATION OF CHAPTER 6.40 OF THE EDMONDS CITY CODE: Applicant warrants that he has read, or had the opportunity to riad, Chapter 6.4U—F—Te—Edmonds City Code, attached herewith, and understands that all terms of that Ordinance are incorporated herein as if set forth in full and this application and permit therefore are subject to the terms of that Chapter of the Edmonds City Code. 6 1"16 Applicant's Signature / 6 Date 11/7/74 rev. City of Edmonds Puble Works Dept. APPLICATION FOR , STREET USE PERMIT -- PaQe 2 Approval (and Agreement, if applicable) of Abutting Property Owners: Sionature Printed Name Address Date ate- TL" 72 <! t- n ,7�� -f" a..-.... �9-t DO NO77XWRITE BELO1.4 THIS LINE (To be completed by Issuing Agency) City Council Approval (Attach Minute Entry): Permit Fee: - Annual Fee: due January 1, 19 Amenities Design Board Approval (if applicable) Attach Minute Entry: Building Official Approval (if applicable): Signature Date Provision for Indemnity: Terms and Provision of Perfomiance Bond, if applicable: (Reference 6.40.050 of applicable Ordinance) PERMIT AUTHORIZATION By P.W. DIRECTOR: Signature Date PERMIT NO. DATE Remarks: 11/7/74 rev. I , 0 0 0 Cl F n - J vy, ovids q c?ox o C- To r -ch— -0-1-A = -'t q04�- ��, + S L..; Ed v,,,ov.,d k A /0 -.0 -11� -C--L -- - ---lQ---�---l--�----�-- - - , 1--t. -W9 %J- - T, w 0- c / R- -- 7-1- � � i *kc---i —.,,i )o zjp��vwLeP -i , c-k—q-3— IT 14� r 4,z _o%—x 1-0 - - 0 0 V17 Tio goer ckv-,-- 47— - - — ci 6 '-s fo- - 9-3 Ot C-tP-P-O-r-:�--CLLV\ -e- - - - A-C U-) Lc-,� s — — — b - , 4 - C- Lo "'s C. '000, I V., �AXA.-, Applicant:--- RoJ 'A Ad�i' t-(6-6 Address:_ -e F, V vvi 0 1 J b J -S Name of Mai I ing 9 STREET FILE * CITY OF EDMONDS, PU�LIC WORKS DEPARTMENT 200 DAYTQN STREET E�DMONDS, WA .98020 775-2525 APPLICATION FOR STREET USE PERMIT Telephone Number: -)?Y q11-S- Date: elgj Description of Publ,ic Place or Portion thereof desired to be used: (exhibit may be attached) Q 5 0 "' � Vn Cl P Type of Use desired to be made of, Public Place:--- C? "n 1J If dpplicable, attach plans and specifications for any utility or structure to be erected and/or maintained on the Public Place:_AC),,C_ (�TEMPORARY PERMIT: Unless otherwise designated herein, this permit is understood by �* �appl�icant �to�ewholly of a temporary nature, that it vests no permanent right whatsoever. If the permitted use becomes dangerous or such stru'cture shall become insecure or unsafe, or shall not be constructed, maintained or used in 'accordance with the provisions of this title, the same may be revoked and the structure and obstructions ordered removed by order of the City Engineer. If this application is for a specified period of time, the terms of said application is: — INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from any injuries, damages or claims of any kind or descr4,p- tion whatsoever, foreseen or unforeseen, that may be made against the applicant or the City of Edmonds, or any of its departments or emoloyees, including but not limited to the defense of any legal proceedings including defense costs, court costs, and attorney fees by,reason of granting this permit. In addition, applicant understands that the City shall be provided a certificate of insurance to indemnify and hold the City of Edmonds harmless from all claims and/or property damage, naming the City of Edmonds as an also insured. APPLICATION OF CHAPTER 6.40 OF THE EDMONDS CITY CODE: Applicant warrants that he has read, or -had the opportunity to read, Chapter 6.40 of the Edmonds City Code, attached herewith, and understands that all terms of that Ordinance are incorporated herein as if set forth in full and this application and permit therefore are subject to the terms of that Chapter of the Edmonds City Code. Applicant's Signature / Z2 Date 11/7/74 rev. City of Edmonds , Public rks Dept. APPLICATION FOR STREET USERERMIT -- Page 2 Approval (and Agreement, if applicable) of Abutting Property Owners: Sionature Printed Name Address - WA 0EEC==ff-0A r DO NOT WRITE BELOW THIS LINE (To be completed . by Issuinq Agency) City Council Approval (Attach Minute Entry): Permit Fee: Annual Fee: due January 1, 19 Amenities Design Board Approval (if applicable) Attach Minute Entry: Building Official Approval (if applicable): m , z / - /,y I Signature 'Date Provision for Indeni.nity: Terms and Provision of PerforTilance Bond, if applicable: (Reference 6.40.050 of applicable Ordinance) PERMIT AUTHORIZATION BY P.W. DIRECTOR: nature-,) PERMIT NO. S/ - I Remarks: 11/7/74 rev. r"Alm DATE,--Z,/4--,,/ Of EDAI 0 CP CITY OF EDMOftflLf 121 5TH AVENUE NORTH - EDMONDS, WA 98020 PHONE: (425) 771-0220 - FAX: (425) 771-0221 STATUS: APPROVED ENG20130186 Encroachment Permit Permit Number: ENG20130186 Address of Public Use/Encroachment: 18926 83RD AVE W, EDMONDS PROPERTY OWNER BUSINESS OWNER 18926 83RD AVE W EDMONDS, WA 98026-6017 STREET USE/ENCROACHMENT Encroachment of gate and use of 15ft of the unimproved portion of 190th St between 83rd and 84th. (originally permitted in 1982) STREET USE. Placement of any temporary or movable objects in any portion ofpublic space or City right-of-way shall meet all code requirements as setforth in thefollowing chapters of the Edmonds Community Development Code. ENCROACHMENT. Permanent structures encroaching upon any portion ofpublic space, City right-of-way or easement area shall meet all Code Requirements as setforth in 1hefollowing chapter of the Edmonds Community Development Code. CODE APPLICATION. Chapter 18.70,17.65, and 17.70.040 of the Edmonds Community Development Code. All terms of the adopted ordinance are incorporated herein as if setforth in full and this permit therefore is subject to the terms of those chapters. FOR THE TERM IN WHICH THIS PUBLIC USEIENCROA CHMENT IS IN EFFECT, THE OWNER SHALL COMPE Y WITH THE PERMIT CONDITIONS SET FORTH BY THIS PERMIT NOTE.- The issuance of this permit is understood by the owner to be of a temporary nature, shall vest no permanent right and shall be issued and may in any case be revoked at the sole discretion of the City per ECDC 18.70.040. Applicant is responsible to provide a copy of the insurance certificate to the City at the beginning of each calendar year, no later than the 21st day of January. INDEMNITY.- The Applicant understands and agrees to hold the City of Edmonds harmlessftom any injuries, damages or claims of any kind or description whatsoever, foreseen or"unforeseen, that may be made against the applicant or the City ofEdmonds, or any of its departments or employees, including but not limited to the defense of any legal proceedings including defense costs, court cost, and attorneyfees by reason ofgranting this permit. In addition, the applicant understands that helshe shall provide and continually maintain during the term of the permit a ceritificate of insurance naming the city as an additional insured, with respect to liability, andproviding that it shall be primary as to any other policy of insurance. TRIS APPLICATION IS NOT A PERMIT UNTTL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN SPACE PROVIDED. Printed: Friday, Avril 12, 2013 F-1 FILE COPY F-] INSPECTOR COPY F-1 APPLICANT COPY STATUS: APPROVED ENG20130186 The proposal will not adversely impact public space open to vehicular or pedestrian travel. Architectural Design Board Approval has been granted or the process has been administratively approved. The proposal will not unreasonably interfere with the rights of the public. The proposal either benefits the public interest, safety or convenience (e.g., supports or protects the city street) or is an accessory structure such as fence normally associated with residential use of the property as fully complies with the requirements of criteria above. Applicant shall repair/replace all damage to utilities or frontage improvements in City right-of-way per City standards that is caused by or occurs during the permitted project. Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits of ECC Chapter 5.30 only during the hours'of 7:00am to 6:00pm on weekdays and 10:00arn and 6:00prn on Saturdays, excluding Sundays and Federal Holidays. At all other times the noise originating fiorn construction sites/activities must comply with the noise limits of Chapter 5.30, unless a variance has been granted pursuant to ECC 5.30.120. Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of whatever nature, ani sing directly or indirectly from the issuance fo this permit. Issuance of this permit shall not be deemed to modify, waive or reduce any requirements of any City ordinance not limit in any way the City's ability to enforce any ordinance provision. I INSPECTIONS 0 None APPLICATION tYNN PLANT for The City of Edmonds %EFT F I SIDE, SEWER PERMIT SEMENT No . .................................. NEW CONSTRUCTION 0 REPAIRS /cy ------- ... OWNER - ----- - ------------ - -4ft- ERMIT No. ADDRESS ............. ................. .. ........................ ....... ............ LEGAL DESCRIPTION: LOT No . ........................ .................... BLOCK No . ............................................ NAME OF ADDITION N 7- 3 L Approved: -------- ---- DATE------ ...... By L ............................... ; ...... .................... EDMONDS'.' Call, -Plto�p ect '6�1167_` wlien work -SEWERDEPARTMEN to ready for ant, o;InspeC7 —WATER 111spectf, Saturday, S"daj,,or holidays 'MIT "."s 118426,-- 8 3rd A ADDRESS ............... . ......... ..................... yqpge West ................................................................. .................... ................................. .............. .. OWNER ........................ ..... QPLQr99 ... Addlcntt ........................... coNTRAcTok ... Ly.nm?.od ... $egtic ... Tank. ... QQ ............ .c Permission4s,granted ................ 19.5.7.., for ...................... days; fo REPAIR or CONNECT a side sewer With City -Sewers in accordance with application on file and, gov prning ordinances. ATTENTION IS CALLED TO THE FOLLOWING: NOTE No. 1—The,"owners. of the property may obtain a permit to . construct- sewer, Inside property - line. A 41censed Side. Sew . er Contractor must be employed to construct side sewer, in street area. Do not -cover any portion of' sewer before it ties -been inspected. NOTE No. 2—Obtaiii full information regarding Ordinance 11.16 030 and Regula t ons gov�arnfng side sew ers when you get permit. 140TE, 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 '/a will be permitted. NOTE No. 4—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 m-ay 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 ap- purtenances. except to ins�rt the pipe into the wye.