19005 DELLWOOD DR.PDF10880
19005 DELLWOOD
DR
10-0
ADDRESS:
TAX ACCOUNTIPARCEL NUMBER: 00QW:,3MQ
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED: 15 - m - &D
SEWER LID FEE $:
DETERMINATION: n Conditionat Waiver 0 Study Required 0 Waiver
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DA
OTHER:
LID #: 1 &9
BLOCK:
L\TEMP\DSTs\Fomis\Street File CheckBtdoc
APPLICATION LYNN PLANT
CA-RD No . ......................................
for
The City of Edmonds SW SEVVER PERMIT EASE
1�0�T No . ................ .
OUTSIDE INSIDE REPAIRS E]
LJ I li P%Lj JA 0% /-]A 1--Z
-------------- --- --- Tj ----- V
OWNER 1-aAAl" . ..... . yy� ... Q.A-Y.. ............................................... CONTRACTOR .. .. .... .. .. 0,,jL,(2-4Lt) ------ - ------- - ---- ... PERMIT N
STREET
HOUSE No . ...... 1. cf. - -------- ldt .. . .............. AVENUE LOT 'No . ...... ------------------------------------------------- BLOCK No . .................................
NAME ADD. _1,4 ....... . &.
----------------------- ------------------------ * ----------------- * ------
Lye I IV T-
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BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $
SEWER WORK ORDER ISSUED ..........................................
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DATE .114.7... BY Al ......
...........
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MEYERS, Larry
19005 Dellwood Dr'.
Edmonds, WA
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P.O. Box 1333 Bothell. WA
N/
98011 (2061-US-9697
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DATE,:
M"NO TO: lluildir.F
CommuniLy DevelopmenL DCPIrClTleljL
FROLN; Enllineering' Division
Public lqorl.-,s Department
'eulj-pl e_lwc z
SUBJECT: 10
F. 9f & & t-92 1,-74- �c'ol
'% fL e 1: 1--evi(2,7 0 F che subi ec L buf ld ing perini L 11)r I ica t ion , we have
t.11c' Fol-lowil-IF, commencs :
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A)QFF- F—)Z/7 " PRO PO-S 622 C- A Aj -S TR OC 7-7 0 &1
pEaptI&L"; )Ali -IT-Y OF= P PD P 9!22�
4C. 661
711
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-XITY �,DF Eb
MOM.N.bS j
CM
_r,C,CF1 t�-� WATM7, Can pnes
SEWER #EPARTMEN Peet -'6-1107 vih
q en w!Irk
(NO inspe
is
fir
or h
P
fill
.�,`SEWER�
MIT
AjD
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.. .............. ............................
rive
7 .....
....................... ......... . ....... .....
�OWNER ....
..... ----------------
----------------------- . .. . ....... COM11" 01 111 C
CTOR ...................
- ------ ------- ---- - -- 67
.:*fth City Seweirs,in iLGwrdanc,- ------- -------- z, for ........................ . 4) REI�AIR, or CONNE
With -Application on Me and gove CT a side se*er
rning� ordin=ces.
ATTENTioN jS CALLE
b. To THE FIOLL.OwING.
NO';`E NO. I --- 4he owners of the Property may,. obtain, a permit to construe sewer inside property 11 . ne. A licensed Side Sewer
cover
be,eOP!*yed to, construct, side sewer in street arm Do not t
NOTE 2--Obtairl. full information re any Portion Of sewer before it has n inspected Contractor must
bee
NOTE No. garding Ordinance 11.16.&0 and Regulations goverulng,sl&
3—Top � Of side'sewer must bave at'least 30, . inaes. cove sewer.. when you get permit.
]��b 'bends in grade, r rage at property lin and 12:. i
..;�enclj . , � - �, , slarPe . tl�au -11 be Pirinift-id: property line;.minj
NOTE No. 4�—rj MuM grade Of 2
be w1ter'-settled an
f ce in street%must - d surface Of -street r red
allure.'due to improper work which may'devilop"within 6.6�k*csto to original. coriditjon.
CITE No..5-_jtt.js..jj�awful jo,.it �d, r. of completion. Contractors sball be responsible , for
rte qr. or; 0 aPY other work than'&'!Prol�lded for in the permit,
n"c�s e�xcept tp,4nseA thii'_Pipe into the wye. or to do an
:. . - I Y work,on the,main sewer or lts.ap-
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DATE.:
1117,110 To: Building Division
CommuniLy Dc\7e1.()pi,.ienL DeparLmenL
FROH; Engineering Division
Public Norks DeparLmenL
SUBJECT:
07 12-71 n giol 141�nlyl lz�
-17 .-.. An-,
A�Cer review oF Che subject building �, 7
the 1011w."ing commellLs: , permit IPPLication, le have
0
PUBLIC WORKS DEPAR& OCKLIST
0 46
I ;III Ito) I O."em U 5.0 IN a 5 Da coi
/q,00:� 1�_z M, --5--,p
(address) (date)
Street Right -of -Way Exist*g-
REQD�_���
Z
I
Access Easements Exist*
Al
_jEQD
%�4
Utility Easement Exist
Int Per Subdivision Plat
407 30
o4ew-gyve L11
/t4atAssessor Yap�_
Site Plan Checked for Accuracy,
Z
Underground 14iring Reqd. AMA
0
Check Accuracy of Legal Desgrlptlon
a&
Z
Review by____AQdj3, Z44,�3�
Date
r4*
Existing Water Main Size
MT in M CT 1: 11
Water Main Required
0 1 nLF. I FILL�
Service Line Required
Hydrant Size Existi
1:4
Hydrant Reqd Per Fire Code
Size
Detector Check Meter Reqd.
I r- POO G 4=# u &Z j9 Y 0�o &E 0 ve
Cross Connection Inspectial���v4rc/vn lmsrpA�b 011:1119"LL
Fire Department Comments
t4o 56 616 -s — 'iDie-acr tcArro, raro v7seari �
J!071415LE Ly-4754e- -Se/jO 1_U Ljt4r= &tj 4fiW6Vg
R.P vs44cs 4!evuwZjo.
Water Yeter Charge Reqd.
Review by
Date e,
Septic Tank Design Approved
Date
Septic Tank Pern-Lit Reqd.
Permit No.
Sanitary . Sewer Avail -ability
Pro'.
Drmqimg No.
File No.
Side Sewer Availability
Sanitary Sewer Connection Fee Reqd.
:3:
Review by.
Date
W
Open Ditch Existing
Culvert Reqd.
—Size
P4
Catch Basin Reqd.
Indicate on Site Plan
0
Shoulder drainage mainta
///l e c
le open runoff
E-4
Yanhole reqd. j
Indicate on Site Plan
Soil Conditions andGround Water Field
Checked
Review
Date
Revised: lvlO-1977
Page 2 010
0 *
E-4 Street Paving Reqd.
Curb and Cutter Reqd.
Sidewalk Reqd.-
Curb Cut for Driveway Reqd.
c4 Right -of -Way Construction Permit Reqd.
E-4 Bond Reqd. for Public Inpravements
Street Name Sign Reqd.
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Other Signing Reqd.
P, ' Pre Permit Site Inspection made on
z
BY: SMER,,�
WATER
P4
V)
HZ STREET
F4
P4 ENGINEERING
Special Requirements listed 4 in mew to Communi6j Development Department,
Bui-lding Divisiah
BY Date
o All item filled in on Building Permit Application
c4 BY Date
0' Drawings Stanped and Notations Made
BY Date
Approved by Public Works Department
M
Revised: 1v 10-1977