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19115 89TH AVE W.PDF111111111111 8571 19115 89TH AVE W NOTICE: T.- U -1 <2 -y- ar-ranty ... o -N- W, The information *shown on the attached map(s) was compiled for use by the OtY Of Edmonds/ its Employees and Consultants. Th,.e City of Edmonds does not warrant the these accuracy of anything set for.th on . * Map(s�. Any person or entity -requesting a copy should conduct an independent inquiry regarding the inform - ation shown on -t-Fe -map(s)l Including, but not limited to, -1- the location of any sew-er stub shown. Suc sewer stubs may or may not e-xist and may or may not exist at the location shown of Edmonds nor its Neither the City emp-1-o-yee-s o-r offi-ce-rs -sh-a-1-1 be 11a-b-[e for the information given on this map(5), nor for e representation provided based any on upon said map(S) APPLICATION for The City of EdmoncISSTRE.E. T, FUl- SIDE SE14rM PEFAM EASEMENT No . ........................ ......... NEW CONSTRUCTION [] REPAIRS 0 ?(( 41-� OWNER ------ ..... ............... ..... CONTRACTOR ------ ................ ................ ...... . .. . . PERMIT No. ADDRESS .... . ........ d.f ................... ........... LEGAL DESCRIPTION: LOT No . ....... ------------------------------ BIJ)CK No . ......................... ............. NAME OF' ADDITION ...... ......... I m Approved: DATE ./-:-Z ....... ......... IBBy APP-,'. QEC 41967 CITY OF EDMONDS Call FRospect 6-1107 when work CIVIC CENTER — WATER -SEWER DEPARTMENT is ready for Inspection. (No in8pec- vo tions Saturday, Sunday or holida,�q.) 'A V 2596 SIDE SEWER PERMIT ADDRESS ..... 19.11.5 ......... 8.9. t.h ...... S.tre.e.t ... W.es.t .................. .............................................................................................................. .. ....... .. .. .. .... .. OWNER ......... JAck .... Laff oo-n ..................................................... CONTRACTOR ........... ................................ ............ .. .. .... ....... ....... .. Permission is granted ........ 1i.e ... c ... eP ... b ... e ... r ............ 4., 19.�5:L, for ... ........................ days to REPAIR or CONNECT a side sewer with City Sewers In accordance with application on file and governing ordinances. ATTENTION IS CALLED TO THE FOLLOWING: NOTE No. I —The owners of the property may obtain a permit to construct sewer Inside property line. A licensed Side Sewer Contractor must be employed to construct side sewer In street area. Do not cover any portion of sewer before it has been Inspected. NOTE No. 2—Obtain full Information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE 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 % 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 whJch may 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 appur- tenances except to insert the pipe into the wye. City of Edmonds RIGHT-OF-WAY CONSTRUCTION PERMIT Permit Number. STREET FILE Issue Date: 4.1 0 A. Address or Vicinity of Construction: 19115 89 Ay W (931 632) fnstall 371 of 1%" PE IP Main in 192 St SW 890 B. Type of Work (be specific): f rnm 7 #.q r -n t p -pri ne to 301N centerliae-192 St SW at SW at 266'W centerline 88 Av W. C. Contractor: Washington Natural Gas ComRany. Mailing Adaress: 815 Mercer St. Seattle WA State License #: - 9 ts ITY D.- Building Permit # (if applicable): Contact: Frank Swan Phone: 224-2278 Liability Insuirance: Bond: $ Side Sewer Permit # (if applicable): E. F1 Commercial E] Subdivision El City Project [� Utility (PUD, GTE, WNG, CABLE, WATER) E] Multi -Family ki Single Family F] Other INSPECTOR: INSPECTOR: (Al6i'Llm F. Pavement or Concrete Cut: FLI Yes []No G. "Size of Cut: 2 11-42 H. Chargq�,$- APPLICANT TO READ AND N INDEMNITY. Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless from injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made ag5inst the City of Edmonds, or any of its departments or I employees, including or not limited to the defense ofany legal proceedings including defen�e 16sts, and attorney fees by reasr of-graniing-,this permit. THE CONTRACTOR IS RESPONSIBLE FOR I�ORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMA TED RESTORA TION FEES WILL BE HELD UNTH THE FINAL STREET PA TCH IS COMPLETED B V CITY FORCES, AT WHICH TIMEA DEBITOR CREDIT 11'ler-BE)�ROCFSSED FOR ISSITANC�ITO THEAPPLICANT. I . - >%--) _ , C, - 'I-? Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220. Work and�naterial is to be inspected during progress and at completion. Restoration is*to be in accordance with City Codes. Street 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. Ihave readthe abovestatements and understand the permit requirements and thepink copyof thepermit wi#be available on site at al�t�s fqr in t' urposes. Signature: #�&w �� Date: November 9, 1993 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: RIGHT OF WAY DEPOSIT TIME AUTHORIZED VOID AFTER JA.AJ 2. DAYS DISRUPTION FEE/FUND 1,11: SPECIAL CONDITIONS: AZA- 1* COMMENTS: RESTORATION FEE: PERMIT FEE: TOTAL FEE: if 3o- f, i" RECEIPT FEE: DATE: ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng�g. Nv. 1991 x FIELD INSPECTION NOTES (Fund 111 Route copy to Street Dept.) Comments: Diagram.: CONTRACTOR CALLED FOR INSPECTION El YES El NO Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: The City of Edmonds Water Service Drawing EASEMENT . NO . ................................. .......... NEW CONSTRUCTION REPAIR" C9 LID NO . .................. . ASMT. NO . .................. PERMIT 1,40. -40L>-tala! OWNER......................................................... 1�.. 6 ...... . 0 ........... . ... CONTRACTOR .— ... ..... .......... ..................... ..................................... ........... - BLOCK NO . ........ -- ............... ...... 14W LEGAL DESCRIPTION: LOT P10 . ...................................... JOB ADDRESS ............. * ..... *_ ........ :P .................................................................. NAMEOF ADDITION ........... ................................................. ........................................... ............. 15 Ck A�-, I <-- Ito -Z-11 <- AE 4- r �L 01- 70 17 13 Approved: DATE.................. By ... M.?) ................. — ............................ Pww-00w. 11175 (REVA 1/78) & 1-7 e-r_ I- -lSW- S.At e2 m --,- - --r -PqL- 71 li _Tl c___ I" <� '1" 4- N-0 DESCRIPTION BY REViSlOilS L NOTES: EDMONDS 1.) FIELD LOCATE ALL UTILITIES CALL 1-800-424—SSSS 48 HOURS BEFORE DIGGING 2.) INSTALL LOCATING WIRE OVER ALL PE DIRECT BURIAL PIPE 3.) INSTALL A ONE POUND ANODE FOR EVE RY 1000' OF LOCATING WIRE 4.) SURVEY IS NOT REQUIRED 5.) MAINTAIN A MINIMUM OF S' HORIZONTAL AND A 3' VERTICAL CLEARANCE FROM ALL CITY UTILITIES AND APPURTENANCES 6.) CUTS IN PAVING ARE SHOWN AS 7.) CUTS ANTICIPATED 8.) COMPLETE EXPOSED PIPE CONDITION REPORT WNG FORM 0563.13 (D-1) c" c, 4 3 04" T-�N� .-re-ra 7b - -70 - cx>l -7 c�> ITEM C T DESCRIPT ON S'OCK BILL OF MATERIAL PERMITS 1 /4 SEC 1, 4 PLAT OP MAP AREA TAX CODE Washbu on fi _ SEQ NO NaturblGas AWasN)qt(Dn D (iR (jr5 DWN I R R R C_ JOB -z- 7AP P_ DRAWING