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19325 80TH AVE W
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city of EdmoiWs
411.1 - 0�5 f _no
APPLICATION
auk for
i1ce SIDE SEWER PERMIT
T Fll&,CONSTRUCTION REPAIRS E]
OWNER ----- ........ A ..... . M FY
. ........... ............................
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ADDRESS ... ....... ao ............. 4lej
............................................
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EASEMENT No . ..........................................
........................... ................................. PERMI
0 N c- re- ..... ......
CONTRACTOR ............. T N
LEGAL DESCRIPTION: LOT No . ............................................. BLOCK No . ...........................................
NAME OF ADDITION .....
.......................... :7 .......................................................................
K",'T!�E- NO WARRANTY 0 CtIRACY—
attmr,�.-d map wz.s cdmoij, We—Informatiop shnwn on the
'd'I Pr use by the City of Edmcr,,3, q:; c;mr:!, S
an�: ccjjs;'�tar 0
as. The Ci' 1111Z
,Y 0' Edmonds does not warrarit"; t�-
aw"" 1,
scttorO On the rn�ap, Any Person or entity requc,-,�;,..
sk�!'� c0ndluct an indeponde it Inquiry regarding the Info
th0l r'1111P, includiing, but not limited to, the ri-112tion sho"vj) C'j
S location Of any sevver st,..'b
hcvm. Such sewer stubs mal � or may not e)dst and may or M:iy not e)jc!t at
tk', 10cati0t' ShOt"n Neithei the CItYof Edmonds nor Its empicy.,,2�, r
offic8ts shall be Ii 0
able for the I formation given an this map, nor for any orlf-I
representgor provided based Ponsaldrnap
C-b
1i
6711".
11 P Irl V E D
A R 7
Approved:
Ac.'a .... Axi . .......
DATE aA.;> ........... By
�q
S�
NOTICE:
No warranty of accuracy.
The -information on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of 'Edmonds does not warrant the
accuracy of anything set forth on these
map(s-). Any person or entity-reque sting a
copy should conduct an independent
inquiry regarding the information shown on
th-e -map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may* not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
employees or officers shall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
for
The City of Edmonds SEDE SEWER PERMIT
41 t I - GC,)- f no S EET FAZICONSTRUCTION EB� REPAIRS M
'Y
OWNER.... . ........ A ------- Mti-: .................................................
ADDRESS ... L��3.Z.5 . ....... aQ�_' ......... \l/ ......................................
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U)
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V?
00
'�j
P- 'c
EASEMENT No . ..........................................
nI#
CONTRACTOR ......... 0. ....... "It, ----- - - ---- -------------------------------------- PERMIT N4117 t/ ..
LEGAL DESCRIPTION: LOT No . ............................................. BLOCK No . ............................................
5. � �i.p' la R .........................................................................................................
_ZAME OF ADDITION .....
NO WARRAMY 0 FRGY'Wj_'- — _" _"
&w!-,s.rj rp4,j e Information sholjr, on the
compil'ad
o use by the City of Ecimend., if,�
Th 1' 3
'�; chy I Edmonds dow not warran, th:
8�!.' f04*1 m' in
sh:-' UU M AnY person or enfity rellqu —
af.
i Inquiry rewding the Infoi III
th 64q), incille"ilg di 1� sh
bu!,' noi limited to, the locauoj'l of any se,�!;
--tit siidj)� ME
'0Y may ft e)dst and may or m:y not e�d,,i &i
0-hilc;% Shu-wa Nelia'ailthe City of Edmonds yz:�; Of
wan wil MIS map, nol fol ak M,
Off I mds s b (-, Ii f on a ncT Its empic
rePresell� ci-Prc'Adz0 bajtd Q'i Uld map
Approved:
0
'7— U V i�_": D
,R1 c 126?
I ...... B Y . ...................... ------
DATE .211A.? .....
Q
OF IDMON6S
CITY
C V WATER7SEWER DEPARTMENT Call .;�PltOspact 64101., when,
��C -ENTER -work
Is, ready -for ffispectlom (N9, inpec-
y unday or he
tions Saturda N2 17-25
-ADDRESS ............................ 1932.5 .... ..... 80th Av*enu6Vest
.......... .. .. ................................ ............ : .................. ..........................
. .............................................................
'OWNER ......... Ju - lian A'. Meyer
Owner
. . ................................................................ ......... ... CONTRACTOR ... ................. ..................... t ............................. .......
Permission Is.granted . ..... March
.................. ................ 1 19..6.7 2for ........... ........... da�s,..to'REPAI --or-CONNECT a'side--sewer
With -Rify'Seweis, in accordance with application on lile'an �governing ordinances. .
d
ATTENTION IS CALLED TO -THE
FOLLOWING:
NOT No. I —The owners of the property may obtain a permit. to. cbristr et sewer Inside property -line. A -licensed -Siae -Sew
be employed to.construct side s6wer In street area. -Do -not. cover any portl6n:,qf, a ewer,before It er Contractor must
NOTE No. 2—Obtain -full Information regardi . ng Ordina I nee has been inspected.
11.16;030 and Regulations gove, - rn ' Ing. �side sewers when you get - permit.
NOTE No. 3—Top of side sewer must have at least 30 inches -coverage at property itne Ind 12'inches Inside property line; minimum grade of 2%.
No hands in grade aharper than 'A will be permitted.
fE No., 4—Trenches In street must be water settled and surface of at
failure d 0 reet'.restored to original condition.. Contractors shall be responsible for
ue to Improper work which may develop within ne year"bf'
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 ap--
purtenahces except to Insert the,pipe Into the wye.
STREET FILE
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:. ... !jq1A.a_n --- A ....... M-ey.er ............ ......
For installation at: (street address) ---- 1-9-32-5 ... _80th --- W� ----- Ed-m&nd-s-,---Wa.sh ------------------------------------------------------
Additionor Subdivision ----- ............................ ...... ----------- ------------------------------------ Lot ................ Block ................
Type of Building: New ....... .... Existing --- X ...... Single family residence _� --- X ....... Number of bedrooms ------ 3� .................
Other: (specify type or use).--.. ----- __ ---------------- ____ -------- ------------------ __ ...... _ -------- ..................... ............ I ..........................
Builder.. ------- _ ......................................... ----------------- __ ........ ..... Address ............................. __ .......................................................
Designer- . ......... .......... ............ -_----------------- -------------- - ----------- Address._ _ --------- _ ----------------------------------------------- ..................
SoilLog Hole No. 1 ---- ---------------------- ............... -------- -- ....... ... . _ _ .. ................ ...... . ..................... ............... ...
SoilLog Hole No. 2 ............................................... ... __ --------------------- ------------_ .................................... ............. ................
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 ... ..None .......................... ......... ...............................................
..........................................................................................................................................................................................................
Percolation:
Test Hole No. I
—Average
Rate ... .2-2t min
......... .... .......... .......
(Fall in inintites/inch-bottom 6" test hole)
Test Hole No. 2—Average
Rate ---- -----------------------
..... (Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 3—Average
Rate. -mi.n ..... ........
.. ..... ...
- ------ (Fall in minutes/inch-bottom 6" test hole)
Average vercolation rate on which to base drain field design
.... 2 ... m.in ....... ............ . Date Taken-V5166
... ... ..........
Septi c tank requirements based on present rules and regulations:
Septic Tank Size. --goo...---
...... gallons.
Amount of Square Feet of Disposal Field .... 2.2.5 ........ .... ....
Signature — Designe!�.—_
DO NOT WRITE4dL
Permit issued (date) ------
Remarks: ...........................
-4 ... 4�1_96 ..............
THIS LINE (To be completed by Issuing Agency)
............... .................................. Permit Number .......... _ ................................
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-__._.a�ilan --- A ...... Mp_ye�r .......... ..
.. ..... ...
For installation at: (street address) _19 32 5 80th W Edmonds, Wash
....... ........................................... 11 ........................... ........... ............... I .........................
Additionor Subdivision ...... ............................................. _ ----------------------------------- _ ............... Lot ................ Block ................
Type of Building: New. .......... . Existing.--.-X ---- Single family residence ----- X ........ Number of* bedrooms_ ---- 3 .................
Other: (specify type or use) ............ ................... ............................................................... _ ..... ........................................
Builder........................................... _ --- ----- -_--_------------------- ...... Address .................................................................... ...................
Designer.................................. __ .................... .... _ ...................... Address ........................ ...................... ......... ------------- ................
Soil Lo Hole No. 1 ......... .................. .............. _ ....... : ..... .. ....... _ - ------- - ---- ................ ........... .....
.9
SoilLog Hole No. 2 ..................... ---_--------------------- ............. ......................................................................................
............................................................................................................ ...... ......................................... I ........................................
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 ....... NQnP ...................................................................................
............................................................................................................... ..........................................................................................
Percolation: 2� min
Test Hole No. I —Average Rate ................. ................... .... (Fall in ininutes/inch-bottom 6" test hole)
1J- min
Test Hole No. 2—Average Rate ....... � ............................................ (Fall in minutes/inch-bottom 6" test hole)
2 min
Test Hole No. 3—Average Rate ......... I ...................... .............. ....... (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design ... _2 ... min Date Taken 6/5&�....
Septic tank requirements based on present rules and regulations:
Septic Tank Size. ... 9-0.0 ................ gallons.
Amount of Square Feet of Disposal Field .... 2.2.5 ....... . ..... .
Signature — Designd�.; . ......... e: �?. - �_ ..... ....................................... Date5;L--1-_ _41_6 -----------
DO NOT WRITEWLOW THIS LINE (To be completed by Issuing Agency)
Permit issued (date) . ....... ................ ........... .......................... Permit Number .............................................
Remarks: ......... ................................................................................................ ............ ......................... ............ .................
a 0
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:_j�qjlan --- A ...... M.ey��X! .................... . . ......
----- ... . ... ..
For installation at: (street address) ----- !��25 80th W Edmonds, Wash
..................... ............... ............................ I ....................................... ...........
Additionor Subdivision ............................ ------------------- _ ............... .... _ ................................ .. Lot ..... .......... Block ................
Type of Building: New ------- .... Existing .... Single family residence . X Number of* bedrooms 3 .. . .......
Other: (specify type or use) ........ ----------- ........................ ..................... __ ..... ........................ .....................................
Builder............................................. ... . 1 .................... ............ Address ................ .................... ................................... _ .............
Designer_. ................................ ................................ ................ Address.. .................. ...................................................................
Soil Log Hole No. 1 ------- ....... .... _ ...... ---------- --------------
SoilLog Hole No. 2 ..................................................... __ ......................................................................................... ..........
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 ....... None ..................................................................................
..........................................................................................................................................................................................................
Percolation:
Test Hole No. I —Average Rate ...... ?j. m.in ..... ...... ... .. . (Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 2 —Average Rate ...... 11 ... m.in ............. ................ (Fall in iiiinutes/inch-bottom 6" test hole)
.. .. ... .. ..
Test Hole No. 3 —Average Rate_ .... 2 .... m.i.n ........... .......... .. ....... (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design ..... 2 min Date Taken. .6/516.6..
Septic tank requirements based on present rules and regulations:
Septic Tank Size ... .........
...... gallons.
Amount of Square Feet of Disposal Field ...... 22.5 ----- -
Signature — Designer..(.;a'_e. ------- - ------ ............... .............. .. Date,
_el
...........
L.1�
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issued (date) . ............. ................................................. Permit Number .......... _ .................................
Remarks: ...... ... ... ..... .................... ... ........... .. . ........ ... . ........... ......... ........................ ..........