19218 86TH AVE W.PDFIIIIIIIIIIII
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19218 86TH AVE W
APPLI.dATION
The City of
STREET
FILE
for
SIDE SEWER PERMIT
.Edmonds
EASEME N�T No . .... ..................................
NEW CONSTRUCTION E] REPAIRS C]
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OWNER ---
. . ............. ................... ............................
...... .......
CONTRACTO R ....... ..................... .................................... ......................... PERMIT No.
E� --------------
ADDRESS .......... . -..
.............................. .................. ....... .......
LEGAL DESCRIPTION: LOT No . .............................................
BLOCK No . ......... 2.7 ....................
NAME OF ADDITION
...................... ......
. .. ...... ......... ...... .............................................
ARE,
APR 1. 21ZIA
.. ......... ...
C7
6- 77 ),V,
Approved:
DATE ....... Z
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---------------------------
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C I Ty_:_�_O F -tl DM 0 N D S
61VIC CENTER-4ATER-SEWER DEPARTMENT Call FRO"Pect 6-1107 when work
is ready for inspection. (No inspec-
Mug Saturday, Sunday or holidays.) N 2: 2902
SIDE SEWER PERMIT
ADDRESS ....... .............. 19218 86th Ave. W.
.................................................................................................................................................................................
OWNER ..................................... Arthur L. Gunnin
........................................... 9 -------- _CONTRACTOR ....... Western Sewer
. ................................................................
Perniission is granted ........... A ri 1_1 .1 .......... 19 ... 6.8, for ........................ days to REPAIR or CONNECT a side sewer
.-p ........ ... 2.
with City Sewers in accordance witil application oil fije 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 grad %
No bends In grade shaxper than 'A will be Permitted. e of 2
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 may develop within one year Of completion.
NOTE No. 5—It Is unlawful to alter or do any thertwork than is provided for In the permit, or to do any work on the main sewer or its appur-
tenances except to insert the pipeointo, he wye.
NOTICE:
.r\- r n - -- vA. -/. �� r-�-a n tv o
The information *shown on the attached
map(s) was compiled for use by the City of
Edmondsl its Employees and Consultants.
Th.e City of 'Edm.onds does not warrant the
accuracy of anything set forth on t . hese
map(�_). Any person or entity -requesting a
copy should conduct an independent
orm'ation shown on
inquiry regarding the inf
t-Fe -map(s)., including, but not limited to, -h
th'e lociation of any sewer stub shown. Suc
sewer stubs may or may* not exist and may
or may not exist at the location shown.
Neither the city of Edmonds nor its
emp[o-yee-s o-r office-rs -sh-a-1-1 be lIa-b-1--e for the
information given on this map(s), nor for
any one representation provided based
upon . said map(s),
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. 9
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address orvic . ity, of Qonstruction
e Owner: Z&1�4 14--E
Name
4&Zk 7-
0 19
MallifIR Addr
<::;�Fll cnl�
City, State, Zip Code
Permit No. 9 ;(- a I -:�s
NOV 2 3 198Z F�= ue Date ///-?-2-1 e2-
Dir. Of Public Works
9 Contractor:. /' 42
2a2�2e-- 9S IJ
= ddre
&'Ps
City, State, Zip Code
0 Permit Issued To:-U—,-
e Type of Work to be Done:
Work in Connection With:
El Sub or Plat X Single Family
El Comml. / Ind. El Apt. Condo.
Pavement Cut: El Yes 2S No
42
State License Number
' 2 7 5/-- 6,52 2
Telephone Number If
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ, AND SIGN
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 description whanoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of its 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.
1 understand that this mu:st be e a the job site for inspection purposes at all times.
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Signatuir 46 Date/4 12"--Z,�-
Owner or Agent
THIS PERMIT MUST BE POSTED AT THE JOB SITE FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: /?� 1&a� ,
Time Authorized: Vol after ED days
Special Conditions:
Arnmendments:
Permit Fee: '� a o' 0 (-)
Security Deposit:
Receipt No.:
Fund III Fee:
Street Cut Dimensions
X
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. Dccember 1978
FROM: DATEs