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19328 84TH AVE W
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TREE
T FILPity of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT
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A. Address or Vicinity of Construction:
Permit Number: R2
Iste Date: iff
19328 84 Av. W. (9312463)
B. Type of Work (be specific): Install New Service
C. ContractorWashington Nat'l. Gas Co.
Mailing Address:,915 marcar St spatt! Lin
State License #: --Tiil
D. Building Permit # (if applicable):
Contact: FrgakkSwan
Phone:
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. F-1 Commercial F1 Subdivision [I City Project �a Utility (PUD, GTE, WNG, CABLE, WATER)
F� Multi -Family E] Single Family F-1 Other
INSPECTOR: INSPECTOR: k 0,ko'A
F. Pavement or Concrete Cut : i&Yes E]No G. Size of Cut:(1)2 x4CUt@ Wa"raNgVe Fog Line,
4 Cut Ln eay.ing
APPLICANT TO READ AN[ r,��Sl GN
INDEMNITY. Applicant understands and by his signature to this application, agrees to the City of Edmonds- haiinles 'V damages, or
F0 ?i '� e,
claims of any kind or description whatsoever, foreseen or unforeen, that may be made age ins the City of Edmonds, or any o its dipa rus or employ-
ees, including or not limited to the defense of any legal proceedings including defense costs, and attorney fees by reason of granting this permit.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMA NSHIP A AD MA 7ERIA LS FOR A PERIOD OF ONE YEA R FOLLO WNG THE FINAL INSPEC77ON
AND ACCEPTANCE OF 77LE WORK ES77MA7ED RESTORA71ON FEES WILL BE HELD UN77L THE FINAL S7REETPATCH IS COMPLE7ED BY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT�Wf BE) PROCESSED 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 Deparfin
Work 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.
I have read the above statements and understand the permit requirements and the pink copy of the permit will be available
on site at all timesfor inspection purposes.
Signature: 7'7';v" �k Date: Marnh 29, 1993
(Contractor or Agent)"��L��Zl�
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
...... .... . .. ....... . .. ......... . ..... ..
FOR CITY USE ONLY
APPROVED BY::: RIGHT..,OF.WAY DEPOSM,
.TWE,.AUTHORIZED::V.01D..AF.TF-R.....—\VtJf It) .:,DAYS. DIS.R.U.P.T.I.O.N. FEE./TU.NP,, 1.11.J....41 ......
0
ISSUANCE
Engrg. Div. 1991
Eng. Div. July 1985
WM
Wal
Addendum to City of Edmonds
Right of Way
Permit Application
Submitted by: GuIqLIL, L>,JU(!!22-S
Engineering Aide
Washington Natural Gas
(el— Y4 el i i -r
IUE)
815 Mcrccr St. (P.O. Box 1869). Scattic..WA 98111 (206) 622-6767
-K:7- wd v-ez- riyurant-
0 water valve
Thd�ity of Edmonds
APPLICATION
for
REET FLE SIDE SEWER PERMIT
NEW CONSTRUCTIO14 E] REPAIRS E]
OWNER ------- .......
.................... ...................
ADDRESS... ... ..... P,� .................................... I .......
Ile
Rl�� N��. 11 71
EASEMENT No . ...........................................
CONTRACTOR ....... ... ..... .. .... ................. ..................... PERMIT MO. .... .........
-.177
LEGAL DESCRIPTION: LOT No . ....... ........ ........ BLOCK No . ............................................
C7 jj
i67
NAMEOF ADDITION ........ .......................................................... 41 ................. �t� ............................................
i)�
- -DI. ell�
Approved:
z5-Z - (� 7
DATE....... .............. / ........................ By ....
A "N
l
NOTICE:
Nbwa M�'D�
The inform ation'shown on the attached
map(s) was compiled for use by the City Of
Edmonds, its Employees and Consultants.
Th,e City of �Edm.onds does not * warrant the
accuracy of anything set forth on these
rnap(�_). Any person or entity -requesting a
copy should conduct an independent
-ation shown on
inquiry regarding the inform
I ted to
ff�e -m a p (s) . including, but not Hmi
b shown. Such
the lociation of any sewer stu
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'fo-yee-s o-r office-rs -sh-a-I'l be ['1a.b.-Ife for the
i n s ma p(s), nor for
information give on thi
tation provided based
any one represen
upon . said map(s).
CITY OF EDMONDS
CIVIC CENTER WATER -SEWER DEPARTMENT Can PROSPect 6-1107 when work
Is ready for inspection. (No Inspec-
SIDESEWER PERMIT Mug Saturday, Sunday or holidays.)
N2 1828
ADDRESS.-." ........... ... We.s.t .........
OWNER ..... Joha..CjnkCLV_jCh ...... ............................................ CONTRACTOR ......... �Kqy
.... A;�len
Perinission is granted .... ...... Mia
..............
for ---------------------- days, fi) REPAM or CO1k4 . NZ
With CitY Sewers'In accordance with appUcation on file and governing ordinances. CT a side sewer
ATTENTION IS CA-LLED TO THE FOLLOVVING:
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 arelL DO not cover any Portion f sewer before It has been inspected.
NOTE No. 2—Obtaln full Information regarding Ordlnsn e 11.16.030 and Regulations governoing 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 origina.] 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 other work than is provided for in the permit, or to do any work on the main sewer or Its ap-
purtenances except to Insert the pipe Into the wye.