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CITY OF EDMONDS
anit No. le"
PUBLIC WORKS DEPARTMENT Issue Date
RIGHT - OF - WAY CONSTRUCTION PERMlSTREET FILE
A. oAddress or vicinity of Construction
19106,19114 & 19128 88 Av West.
Owner: Washington Natural Gas Co
Name
805 156 AV NE
Mailing Address
Bellevue, Washington 98007
city, State, Zip Code
Contractor: Same As Above
Name
Mailing Address
City, State, Zip Code
0 Permit Issued To:
Type of Work to be Done: Install a Main (2")
On Job # 793 266
• W ork n Connection With:
0 Sub or Plat 1� Single Fa ' mily
El Comml. / Ind. 0 Apt. Condo.
• Pavement Cut: 0 Yes 0- No
State License Number
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE .* *
B. APPLICANT TO READ AND SIGN
INDEMITY: 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 description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and, attorney fees by reason of granting this permit'.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this perm . t be available at t e
Sig nature V40A,(,f&
Owner or- �RvV
for inspection purposes at all times.
te Aug 28, 1979
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: �1-
Time AuthOrX�ed
Special.Conditions:
Ammendments:
F .
oid after days
Permit Fee: 'eV. C
Security Deposit:
Receipt No.:
Fund I I I Fee:
Street Cut Dimensions
— X
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
APPLICATION
for
The City of EdmondsUllcff
FUZ
SIDE SEWER PERMIT
EASEMENT
No. .............
NEW CONSTRUCTION E] REPAIRS
r
OWNER ........ X.0 .... . . ..........
ADDRESS ............. ............. ............................................
CONTRACTOR .................... Zq-,21 . ...... .........................................................
LEGAL DESCRIPTION: LOT No . ........... :� . . ............. ....... - ...
PERMIT
BLOCK No . ............................................
NAME OF ADDITION ------
. ........ e5z .. ......................................
A P-01,11;
J U�L 22:1 1 96 . 9
3- 8 4to, Approved:
DATE. ................................................. By ......................................................................
W
when
-Rosoect �6-1107-
'QND��
111spection. (No ins
for N2 532D
is
'��,WATER'�;S]9"TEA.
Sunday or boli"Ys-)
CENTER ti6ris satOrday,
ERMI.
ER P
------------------ -------------------- --------------
8 8th' A -f�P --Yest
---------------------------------------
---------- --------------
A4tI ..................
..............................
ACTOR -----
... L,.e �44r4�---- C014TR
--------------
!�OWNI�, CT a side sewer
jq_!�9_ for --------------- . ....... days to REpAjR or CONNE
----------------- _�qjy
is .,granteA on file and governing ordinances.
wj I �h, C I ity Sew ers, in accordance with aPPI'cat'on
THE FOLLOWING: inside Property line. A licensed Side sewer Contractor must
.kTTENTION IS CALLED TO ermit to construct sewer f sewer before it has been inspected
)perty may obtain a P, cover any Portion o
NOTE NO- 1—The owners of the pr( . street area. Do not s when You get permit.
be employed to construct side sewer in
rdinance 11.16.030 and Regulations governing side sewer minimum grade of 2/.-
2—Obtain full information regarding 0 property line and 12 inches inside property line;
wer must have at least 30 inches coverage at shall be responsible for
NO. No 3—Tor; Of side se rper than i/s v�ilj be permitted- inal condition. Contractors
No bends in grade sha . street restored to Ong
er settled and surface of pi ion.
NOTE NO. 4—Treriches in street must be wat ch may develop within one year Of com et frisin sewer or Its apPur-
failure due to improper work whi is provided for in the Permit, or to do any work on the
NOTE No. 5_1t is unlawful to alter or do any other work than
tenances except to insert the pipe into the wye.