19015 78TH PL W.PDFlill 11111111
6747
19015 78TH PL W
61MIC WORKS DEPA=Tr. CHEam* Date
BUIIJ)ING PERMIT REVIEW
�ss
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'Street.-Right-of-Wa3i REQD
lAccess Easements Existing REQD
tility Easement Existing
REQD
Lot per Subdivision. 1—,� L Plat 6�wessor Map
aP--ZI-A Vi LL
Site Plan CheckedforAccuracy
Underground Wiring Reqd.
'Check Accuracy of Legal Description
Environmentally Sensitive Area
-Environmental Checklist Reqd.
Tlood Hazard Zone
Shoreline Management Area
,Slqpp-,,Soil, Vegetation
.Stream.. Creek, Drainage Basin
Existing'Zoning - Per Code
Amenities Design Board Approval Reqd. ADB # Approval
�Board of Adjustment Approval Reqde
Review By: Date: :fS;XI -7 En
Existing Water Main Size
Water Main Reqd.
Service Line Reqd.
Hydrant Size Existing
E`
Hydrant Reqd. Per Fire Code
Size
Detector Check Meter Reqd.
Cross Connection Inspection
Fire Department Camients
Water Meter Charge Reqd.
Review by:
Date:
Septic T sign prove
ate:
Septic Tank Permit Reqd.
Permit No.
Sanitary Sewer Availability
Proi.
Drawing No.
File No.
'Side.Sewer Availability
Sanitary Sewer Comiection Fee Reqd.
Review By:
Date:
Open Ditch Existing
Culvert Reqd.
Size
P4 Catch Basin Reqd. Indicate on Site Plan
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P4
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Shoulder drainage maintain collection on swal
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1,1,u-ihole reqd. Indicate on Site Plan
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Soil Conditions and Ground Water Field Checked
R O"'jew by
eviejq by_ Date
Street Paving Reqd.
Curb and Gutter Reqd.
W Sidewalk Reqd.
Curb Cut -for Driveway Reqd.
c4 Right -of -Way Construction Permit Reqd.
Bond Reqd. for Public In.proven-ents
Street Nane Sign Reqd.
10ther Signin,> Reqd.
Pre Permit Site Inspection made on <SZ1 -7 AA
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BY: MIER
TAIATER
STREET
ENGINEERING
Special Requirements listed in mew to Conminity Development Departrrent,
Building Division
BY Date
c) All items filled in on Building Permit Application
BY -Date
PA Drawings Stamped and Notations Made
BY Date
-d by Public 1-Jorks DeparnnenU
,jApprove
�evised: 1v 10-1977
STREET
FILE
REGARDING: 19015 - 78th Place West
0.2 - 0 Q S-6 1)
(address)
R E C
0 R D 0 F C 0 N T A C T S
DATE
WE, PHONE NO., &
COMMENTS
ADDRESS of'CALLER
S/l/74
Ronald Thorvilson
Certified
Letter No� 406274 sent
requiring
hook-up within 60 days.
7/1/74
Certified
Letter No. 406545 sent
requiring
response by July 12.
7/12/74
Signed 2-day extension.lbtter.
7/22/74
D.T.O.S.
ACTION TAKEN
Letter received.
Letter received.
INITIALS
TE
TE
TE
TE
0
0
CITY of EDMONDS
200 Dayton Street - Edmonds, Washington 98020 - Telephone (206) 775-2525
Department of Public Works
July 12, 1974
Mr. or Mrs. Ronald Thorvilson
19015 - 78th Place West -
Edmonds, Washington 98020
Dear Mr. or Mrs. Ronald Thorvilson:
According to two previous Certified Letters to you from this office,
water service to your property located at 19015 - 78th Place Vest, Edmonds
was to have been terminated on July 12, 1974. In accordance with the Edmonds
City Code, it is required to connect any I property within the City of Edmonds
to the sewer, where it is available.
It is now required that you appear in person at the Public Works
Department, 200 Dayton Street, Edmonds, or contact Mr. John B. Mitchell,
Water/Sewer Superintendent at 775-2525, extension 226, within two (2)
days after receipt of this letter to make the necessary arrangement for
connection. If no contact is made, your water service will be terminated.
Your prompt response will be appreciated, as it is not our desire to
discontinue your water service.
JBM: te
Sincerely,
ACKNOWLEDGED BY PROPERTY OWNER:
PROPERTY:ADDRESS:
MAILING ADDRESS:
ACKNOWLEDGEMENT DATE:
GRAPH SHEET: Draw your lawn area on this sheet to scale, 1[3 1 '"1" 10'. Show valve location. Shc�w trees, etc.
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PS Form NO INSURANCE COVERAGE ORO
VIDEO (See other side)
Apr. 1971 3800 NOT FOR INTERNATIONAL MAIL GPO: 10700-397-458
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