19232 92ND AVE W.PDFiiiiiiiiii'll
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19232 92ND AVE W
I
NOTICE:
Ko..War-ranty ... oT., -a-
The -information'shown on the attached
map(s) was compiled for use by the City Of
Edmonds/ its Empl-oyees and Consultants.
Th,..e CitY ofEdm.onds does. not. warrant the
accuracy of anything set for.th on these
rnap('�). An-y. person or entity -requesting a
copy should conduct an -independent
inquiry regarding th*e info'rm-ation shown or
_t:F�e -map(s)/ including, but not limited to,
th'e location of any sewer stub shown. Sud
sewer stubs may or may- not e.xist and may
or may not exist at the location shown.
Neither the city of Edmo'nals nor its
empto'yee's o'r office-rs -sh-al-1 be 1.1a.b.11--e for the
information given on this map(5), nor for
'ded based
any one representa tion provi
upon said map(s).
CITY OF EDMONDS - SIDE SEWER PERMIT
WA
,,�SEWER DEPARTMENT
PERMIT
�� \j
Call 776-1107 for side sewer inspections BEFORE corvering any portto of othe construction )
Inspection will be provided within 24 hours after request. NO Sat., Sun., nor. h liday inspections'
ADDRESS LOCATION OF CONSTRUCTION ........ . .
........... ....................... t .................................................................. ........................................................
PROPERTY LEGAL DESCRIPTION ----
............ . .. .... ..................... mt: ....... I ...............................................................................................................
.................... ........................ .. . .........................................................................................................................................................................................................
................................................................ OWNER AND/OR BUILDER ....... .
-------------- * ------------- * -------- * -------------------- ------------- ..................................
CONTRACTOR'S NAME & ADDRESS ..... -9
..................... ............. C"f(If_ ,
--------------- -- ! .. ....................... i7, S
-------- -- .. ...................................
Permission is granted ........... . ........ ---------------- 19 ... 72, for repair and/or connection of a side sewer to the city sanitary sewer
----------
System in accordance with City of Edmonds 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.
_�JTE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office.
3TE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—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. 5--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. 6�—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 appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED 0 Date --- - ----------------------------------- By ................ 1)90� ...........
....... ....... o0q.. Date .................................... By ................
0
APPROVED D �i77 ........ By
.... . . ........ ................................................................
&Y
Remarks:
...............................
..............
— BC
was inst
MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
'!� ............... ... I hereby certify that -the side sewer installation
--- ------ --- -, -
Con'tract'i-n g 171'rrn --- i�ericrmin.'— onstruction) constructed under this permit
clance with all governing ordinances of the City of Edmonds'.
Dated this ....... 1-d ............. d,.v of
-V V Check BEFORE you dig for: Water E], Gas Ej, Telephone E], Power E],
;V ........................................ I 197A
"ll
Other
APPLICATION
for
The,Cfty-of Ednmnds SIDE SEVV= POO= 9EASEMENTNo - ------------------------------------------
NEW CONSTRUCTION REPAIRS C
c) 2
------------------------------ PERMIT No.
OWNER ... !20AVLVI�lf - -------- Z-Z�� ------------------------------------------ ....... CONTRACTOR fs -------
9;7- LEGAL DESCRIPTION: LOT No - ----- // ------------------------------ LOCK No . ....................... ....................
ADDRESS----------------- --------------------------------------------- * ......... NAME OF ADDITION
..................................................
RECSVED
i
AUG 9 19'2
Approved: VD
M7
DATE ... . ................. By
A oop- om 92
'17 l'6csfim.+P-
-07
Ati7y eW
9 0 - 199
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
lDlu RMIT Permit Number:
STREET FILF.
Issue Date:
A. Address or Vicinity of Construction: 1.92 .3 Z. 9Z -, 0 , ,
B. Type of Work (be specific): A1X7'1 — L-
C. Contractor: _C_ 1-14m jt��.57 ed1_5-vWe I(J4 e-,4 Contact: 441d.1-1 L_
Mailing Address: AeAlAl j7- Phone: 7 7 4- - _S714 6
State License#: yyl;��,e re eal jVA Liability Insurance: Bond: $
I
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. 'F� Commercial Subdivision El City Project X Utility (PUD, GTE, WN<� , ATER)
F-1 Multi -Family 0 Single Family r_J Other
'INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut El Yes 5dNo G. Size of Cut: x H. Charge$
A
APPLICANT TO READ 'P� IGN /,V1 3
INDEMNITY. Applicant understands and by his signature to this application, agrees-tq hold the City of Edmonds harmless from injuries, damages, or
claims of any )dnd or description whatsoever, foreseen or unforeen, that may be madea�jdih�t 1helCity of Edmonds, or any, of its departments or em loy-
' , I ' - 7 p
ees, includingor not limited to the defense of any legal proceedings including defense'�cons, and attomeyfee's-by reason of granii�ng th�is permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATER[Ad'FOR A PERIOD Ok ONE YEAR FOLLOWING Tfii�INAbNSPE(�itON
AND ACCEPTANCE OF THE WORK ES77MA7ED RESTORA77ON FEES WILL BE HELD UN77L THE FINAL SYREETPATCH IS COMPLETED BY
CITYFORCEI,,��H 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Con'st'ruction drawing of proposed work required with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Department -
Work is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes. 771-0220
Street shall be kept clean at all times.
Traffic Control and Public SOety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall,o'e patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and
on site at all times forrinspeoion Pur
Signature:
. 4�
i-
or Agent)
permit requirements and the pink copy of the permit will be available
Date:
TOTAL TEE::
.:::iCOMMEN .................. ........
TS: 1: RECEIPT NO:::
....... .... ...... ...... — -
ISSUED BY:
NO WORK. SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES
(Fund I I I - Route copy to Street Dept'
Comments:
Diagram:
w
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
rng. Ljjv. Ju
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