19231 93RD PL W.PDFiiiiii iiiiii
9070
19231 93RD PL W
City of Edmoinds
RIGHT-OF-WAY CONSTRUCTION
Permit Number. �93 -31
STREET F
Wue Date: 10 :C2 9
A. Address or Vicinity of Construdtibn:--`192j1 93 Pi w (02j233)
9 0 1 C� B. Type of Work (be specific): Permissidu to install-231 of lk" PE I Main
in 93 P1 W from 262'W to 285'W
C. Contractor: Washington Natural Gas Company- Contact: Frank Swan
MailingAddress: 815 Mercer St, Seattle, WA Phone: 224-2278
70111
State License #: Liability Insurance: _ Bond: $
D. Building Permit #'(if applic�able): Side Sewer Permit # (if applicable)-�
E. F] Commercial Subdivision El City Project FRI Utility (PUD, GTE, WNG, CABLE, WATER)
E] Multi -Family Single Family E] Other
INSPECTOR: INSPECT R
1 0 : I. 1� z4c,, A
F. Pavement or Concrete Cut: [3 Yes []No G. Size of Cut: 'XA' H. Chargc�_$
2J'.of Jack,&.Bore
APPLICANT TO READ AN �YSIGN
(She City ofEdmonds harmle144-f-al mages, or
INDEMNITY. Applicant understands and by his signature to this application, agrees t-7-I.-
claims of any kind or description whatsoever, foreseen or unforeseen, that may be ma�e"a'g4inst the City of Edmonds, or any of its departments or
employees, including or not limited to the defense of any legalproceeding8 including defense costs, and attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTIONAND A CCEPTANCE OF THE WORK. ESTIMA TED RESTORA TI0N1WP.S-W1J.I% BE HELD UNTIL THf, IFIW2L3�iQ�T PA TCH
IS COMPLETED B Y CITY FORCES, A T WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSkD FOR ISSUANCE TO THE APPLICANT.
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 material 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.
Ihaue read the above statements and understand thepermit requirements and thepink copy of thepermit ivill be
available on site at all �or inspection purposes.
Signature: &/a � & 4 — Date: October 21, 1993
(Contractor or Agent) -
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: WWA_ RIGHT OF WAY DEPOSIT
TIME AUTHORIZED': VOID AFTER [)a 30 DAYS
SPECIAL CONDITIONS: poxmos..ee
DISRUPTION FEE/FUND ill:
11.104W[13 tV.VK1JMV a-3
H.o As 15"ay40_ PERMIT FEE:
TOTAL FEE: A AL
COMMENTS: RECEIPT FEE:
42,
DATE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
(Fund 111 - Route copy to Street Dept.)
El YES �.,- El NO
Date:
Date:
FIELD mom: go wAIER- VALVES
ou 93 PL W AMD
192- -=-,r -SW -
A jqX+-9Cf
(D0.)k,3 or
NOTICE NO WARI
attached map was i
and consultants. T
anything set forth
should conduct an
the map. Includinj
shown. Such sewei
the location shovA
officers shall be lial
representation proi
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
EVERY 1000' OF LOCATING WIRE
4.) SURVEY IS NOT REQUIRED
Wo
192- :,!:-;r SW -
sl
WA,-reR- VALVES
93 PL W AND
NOTES: EDMONDS
1.) FIELD LOCATE ALL UTILITIES
CALL 1-800-424-5555
48 HOURS BEFORE DIGGING
2.) INSTALL LOCATING WIRE OVER
ALL PE DIRECT BURIAL PIPE
3.) INSTALL A ONE POUND ANODE FOR
EVERY 1000' OF LOCATING WIRE
4.) SURVEY IS NOT REQUIRED
STREET FILE
CITY OF EDMONDS
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
(Submit in licate)
. . ................................ Lot No ....................... Permit No ... 195 ...........
V ........ 9 .......
ADDRESS OF PROPERTY ...................... I .....................
Owner...... ..... ............ - -- ---- _ Address ................ ...................... --- Phone ........................
ea Ran sen ............ .......... _t EdmondS..'' PR B-7452
Builder hP ri. .. ........ ........ . .... ........ . Address 18627- 81 a ... 7.01
.. .... ...... Phope ........................
Designer. S o...,.Sn o. Septic Tank Ds -Address-- �2 0$!!.jaQ th ... S.....W � 1��nwood
- ------- ........ . .............. ............... ... .. .... *�j ............. ... Phone ........................
Installer-L'vergrppp ... Concrete Prodtkddress ... 183.29-72n.d ---- Elm-PPd..s. Phone ... �R --- B.-.1.4-33
................... .......... ... . ... ..... ..
I hereby certify the accompanying drawing is an accurate representation of the system installed at the listed
address. , I also certify all recommendations and restrictions (concerning plumbing stub elevations, maintenance of
grades fills surface drains, etc.) listed by me on my sewage disposal system permit application dated ................
. ....... . 1-.2.$-.6-5 . ............... have been complied with.
............. a ------ . .................... .........
Signature of Designer Date
TO BE FILLED IN BY CITY ENGINEER ONLY
67
Accepte&�� ........... _ .... .............. .. .... --------- Date..4/1�0/9 .....
NotAccepted .. ........... .. ..... ... . .................. ...........
_ _ ..... .....
Signature of ......... �e? ............
........ ................... .... .. .
-marks:
Re ........................................
_ - - ----- -- ........... ........................................................... ....................................
INSTRUCTIONS: Use tile reverse side of this form for the drawing. Use a scale which will permit the greatest
detail and still contain the entire site on one page.
ATTENTION HOME OWNER:
Your septic tank has limitations! It was designed and installed to care for an avcrage-size family. Over-
loading the septic tank or disturbance of the drain -field may seriously impair satisfactory operation. Points to
remember:
1. Have your tank checked periodically to see if pumping is necessary (2V2-3 years).
2. Do not channel ground water, surface water, footing drains or downspouts into the tank or drainfield.
3. Do not excavate, fill, place a structure, driveway or - patio in, on, or ovc'r the drainfield.
4. Limit toilet fixture disposal to sanitary wastes and toilet tissue.
5. Detergents and bleaches used in normal household quantities will not harlil tile action �f the septic tank and
disposal field.
19229-93rd Ple WO
N
I-V Required
goo Dal. S T.
TrT sq. f t:
NOTICE*
n
-co
The -information shown on the attached
map(s) was com * piled for use by the City of
Edmonds,; its Empl.oyees and Consultants.
Th,.e City of Edrn.onds does ' not * warrant the
accuracy of anything set for.th on t ' hese
nt*ty -requesting a
map(s). Any person or e. I
copy should conduct an independent
orm'ation shown o
inquiry regarding the infi
_th-�� -map(s), including, but not hm'ted to,
th*e location of any sewer stub shown. Suc
sewer stubs may or may- not e.xist and may
or may not exist at the location shown.
c-ity of Edrn0'nr1_A1 S, nor its
Neitheir t1he 1�
e M 0-y e e-s o -r o ff i -c e -r s s. h. a I. I b e 1.1 a. balf.e f o r hE
information given on this map(5), nor for
Ided based
any one representation prov
upon'said map(s),
0
CITY OF EDMONDS
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
(Submit in Triplicate)
ADDRESS OF PROPERTY. 1.92.2.2-.23.rd .... . ..................................... Lot No ....................... Permit No...195 ..........
OwnerAddress ..... ....... ................ ... ...................... Phone ............. ..........
Builder Phone .... TA..$-7.452
Address.1.8-6.27—.81s t ... !7.. __E arc o nd S
Designer.3.0., --- S11.0o _4Q.P od
-t i.0 ... Tarlk...PS.Address .... 520B..- ---------------- Phone ........................
Installer vergrqen...pong.rele .... Fr.od Address ---- 77v,_�RCTMOX1.0.0. Phone ....
I hereby certify the accompanying drawing is an accurate representation of the system installed at the listed
address. I also certify all recommendations and restrictions (concerning plumbing stub elevations, maintenance of
grades, fills, Surface drains, etc.) listed by me on my sewage disposal system permit application dated.. ..............
1-�5-65 ................. have been complied with.
...... . .. ... . ....... 1.
............. 4� ------ �--a ':4
..... ...... . ................... .........
Signature of Designer Date
TO BE FILLED IN BY CITY ENGINEER ONLY
"f Accepte& ..... ......................................................... Date -- -------------------------------------
Not Accepted.. ....Date ------ .. ........ ... .................
Signatureof Sanitarian .... .................................... .......... ..................... .............
Remarks: .................... ............................................... .................................................................................................................
INSTRUCTIONS: Use the reverse side of this form for the drawing. Use a scale which will permit the greatest
detail and still contain the entire site on one page.
ATTENTION HOME OWNER;
Your septic tank has limitations! It was designed and installed to care for an average -size family. Over-
loading the septic tank or disturbance of the drain -field may seriously impair satisfactory operation. Points to
remember:
1. Have your tank checked periodically to see if pumping is necessary (2y2-3 years).
2. Do not channel ground water, surface water, footing drains or downspouts into the tank or drainfield.
3. Do not excavate, fill, place a structure, driveway or. patio in, on, or ove'r the drainfield.
4. Limit toilet fixture disposal to sanitary wastes and toilet tissue.
5. Detergents and bleaches used in normal household quantities will not harin the action of the septic tank and
disposal field.
19229-9,3rd Pl.
t.*v Recuired
90�F Ual. S. T.
37T Sq.. f t.
9
CITY OF EDMONDS
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Permit to be issued to: ...... Charles A. Hanse
........................................... .... .....
For installation at: (street address) ....... W 1. . .......................................................................... .......
Addition or Subdivision ..... _ .............. ........... ... Lot_ .... & ...... Block_ .......
---------- * -------- i", .......... ...
Type of Building: New ... ----- Existing_'.. ...... Siligle family residence. --- X -------- " Number of"bedrooms -----------
Other: (specify type or use). ............................. -------- I .......................
........................... ........................................... .........
Builder.__ChP.r1e4 'A. &neon --------- ...... Address ...... 1862.7w 8.1-0 .... it.*. J. 'F4 d W 0 �d 9
........................................... ........................................
Designer --- $0.*_ An.o.....4-pt.1-c ... :T#ink/Des.1,qp_e Address.. _..5208:-!w2,B0tb ... ........
Soil Log Hole No. 1 ........... 0 .-411
......... ...... ...... 4.,'---30"-_ SAndy'l
..................................................................................... ......... ......... ...... ........................................................................
SoilLog Hole No. 2 ............. Sal"M ------------------------------------------------ ..,_,_� ................................................................................
.............................................................. t --------------------------------------------------------------- I ...........................................................................
Elevation of Water Table, if encountered1l,(Distance from ground surfac'e) .............. ...... ..........................................
Corrections to control surface water if needed ................................... .............. ..................... ...........................................
......................................................................................................................... ...................................... I .................... ......................
Specify if any removing or grading of topsoil in field area ............................................ .........
..............................................
............................... ............................................................................................ ....... ..................... ..........................................
Percolation:
Test Hole No. I —Average Rate ....... (Fhll in ininutes/inch-bottom 6" test hole)
Test Hole No. 2 — Average Rate ..... 111-2% ...................................... ------ (Fall in ininutes/inch-bottom 6" test hole)
Tese�Hole No. 3 —Average Rate ........ .............. ....... .............. ------ (Fall in minutes/inch-bottom 6" test hole)
Average percolatiorf rate on which to base -d?ain field design ....... ....... ............... D�te -Taken.1-.2.2.— * 65 "
Septic tank requirements based on presefit rules and regulations:
Septic Tank Size .... PqQ ............... g a-1 1,6 n s.
27 5
Amount of Square Feet of Disposal Field'...� ................ ? ... ..... ..... ......
Signature — Designer.�_ �. ... . ....... ... ................. ..................... Date- 65 . ...... ---------
DO NOT WRITE BELOW THIS LINE: (To be completed by ISS11ing Agency)
Permit issued (date) ------- _z;,,5--- — e- S'
......... I ......... .................. Permit Number ......... ..................
Remarks: ................................... ...................... ................................................ .................. I ................ ........ ................... :.1 ..........
................................................................................................................... . ............ : ..................... It ............................. !,!n ................
QSIGN1IR
T'R
Herold Olson
5208-180th S.
Lynnivood., �t`psh.
0 1900 Gal. S. T.
Lin' ft.- drsintile
;Ide trench.
3'75 So. f t.. reouired.
0 rf;.
4k
I'lon-basement
Dri ve
93 F/, ur
0 Pe r. Hole
9 S?i 1 Log
4 i4ght Line
4 Drain Tile
Scale 1"--201.
CITY OF EDMONDS
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(Submit 3 Copies)
Permit to be issued to: ...... Charles A. Hansen
...............................................
For installation at: (street address)--. .... t92"!-s.!93.r.d .... Fl-W ... vft� ........... ................................... ............ .............. .........
-
Addition or Subdivision .....
....... '"nr:� .............. -----------_--- --- Lot ....... (.� ..... Block.. ..............
Type of Building: New ---- X ----- Existing. ........... Single family residence ------ X ....... Number of bedrooms ........
Other: (specify type or use). -_-------------- ---------_------ ___ -_-_-------------- __ ----------- ----------- ............................................. ..........
Builder --- qh,�,rles A. Hansen ................ Address ------ 186217---8-1-s-t NET..
............. ----------- __11 ............. .......... .. _ -_ _ -_ ___ -_ P .. )qo ....... ...........
Designer ... So -m-18-0-th --- S...__R._,_..Ly_nnvioo-d - ------
-ank ... De-sl
_5n_o_.._.5e_pt1c ---- T gnS. Address 5208
Soil Log Hole No. 1 ---------- � -0 it, --4"' Loarn Sandy
----------------------------- -- ------- .. .. .... .. . ...... ... . .......................... .......... .
SoilLog Hole No. 2-. -----_---- Same -------------- ..... _ ------ - ------ --------------- -------------------_- ------------------------------------------------------
Elevation of Water Table, if encountered. (Distance from ground surface) ........................................... ..........................
Corrections to control surface water if needed... ..................... ................................................................................................
Specify if any removing or grading of topsoil in field area ---------------- .............. ..................................... ..................
....................
Percolation:
Test Hole No. I —Average Rate ..... ................... .... .. .1 . (Fall in inintites/incti-bottom 6" test hole)
Test Hole No. 2—Average Rate ....... ....... ...................................... (Fall in ininutes/inch-bottom 6" test hole)
Test Hole No. 3—Average Rate ------- 5 --------_------------ --- ---- -- ....... (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design ..... ........ .. 5 . ......... Date Taken-1-22-65
-------------
Septic tank requirements based on present rules and regulations:
Septic Tank Size. --- �PQ --------------- gallons.
Amount of Square Feet of Disposal Field ------ ..... . ....
......... -------------- Date ----- 1!"a-_5!w65_ ...............
Signature — Designer.�M e
"e�
DO NOT WRITE BELOW THIS LINE (To be completed by ISSUing Agency)
Permit issued (date) ----------- 5— -mit Number.. 1716-'
.. ........................ ................. Pei ---------- ..............
Remarks; ....................... ............ ----- ------------------------------------------ --------------------------------- ------- ------------------ --- -----------------------------------
10
10 1"--2-01
Septic Tank ....... SEWAGE DISPOSAL
PERMIT
........... gals.
-Disp. Field ...... CITY OF EDMONDS No.
...... sq. Department of public Works
Ot�er
Name
........................................... is' hereby auth'
repair sewage disposal System at
Irized to install/
...........
: ----------------------------------------------------------
Date issued on
DO Permit expires one ye ----- --- -------------------------
ar from 'date of issue
NOT COVER BEFORE APPROVED. BY DESIG'NE OUR, S
R
�SANITARRIAIN�l
I �hereby ceitify this system was ins�talled under my sUpervisi'
Of Edmonds,.Resoi�tions. on and control and cornPlies with all provisions of the City
Signature of I , fistaller ------
-------------------------------------------------
Approved Disapproved 0 Date ----------- I . .: — ....................... Date ----------- ; ------------------------
Remarks: ... ............ By ---------------------------------------------------------------------------
------------------------------------------------------------ ........
SANITARI AN OR DESIGNER. ...... ----------------- ........ ------------------------------------- .....................
---------- ------------------------------ Date -------
.This permit shall be Posted in a reasonably conspicuous place on the j9b* until ins Iction has be
P en completed.