19409 82ND PL W.PDF111111111111
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19409 82ND PL W
ADDRESS: /,NO q — 3�z,/Ijlp
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE)-.
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: E] Conditional Waiver Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED: —
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #: 72 L
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:-7JZ,7/13 (cN�
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER:
LOT: BLOCK:
SIDE SEWER PERMIT(S) #: - 4KZZ�e
LATEMP\DSTs\Fonns\Street File Checklist.doc
0
NAME: 1-60 kAS-e::P--
SITE ADDRESS: 19 q
PROJECT DESCRIPTION:
PLANNING DATA
W& 2 01 M- T
—j=;1`1
REDUCED SITE PLAN PROVIDED?(gggpNo)
CHK#:
MAP PAGE: 30(P— CORNER LOT: ()Le� FLAG LOT: (Yes �/o)
ZONING: P—M - *3 CRITICAL AREAS DETERMINATION M-05 - ls�E�
Ll Study Required:
rnr`1'--
U Conditional Waiver
SEPA DETERMINATION:
Ll Fee
UChecklist
Ll APO list w/ notarized form
Ll (Needed for 500 cubic yards of grading, Shoreline Area- site within 200 ft. of Puget Sound or Lake Ballinger)
LJ Exempt
SETBACKS:
Required Setbacks- I
Street: 15" Left Side: IS' Right Side:_ 197 Rear: I E5
Actual Setbacks:
Street: —Left Side: Right Side: Rear:
Street map checked for additional setback required? (Yes / No / DR
LJ DETACHED STRUCTURES:
Ll ROCKERIES:
U FENCES/TRELLISES:
U BAY WINDOWS / PROJECTING MODULATION:
Ll STAIRS/ DECKS:
PARKING: Required: Actual: A/0 6,ktca,--
LOTAREA: 'On
LOT CO ERAGE, I
. . Y /.# It -A I A-. A -1
BUILDING HEIGHT:
Datum Point: Datum Elevation:
Maximum Allowed: Actual Height:
A.D.U. CREATED?: (No / Yes)_
SUBDIVISION:
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED: (Yes / No)
OTHER:
Plan Review By:
NewBPPlanningDataFonTi.DOC
-7
for
The City of EdmonD ME SIDE SEWER PERAW
EASEMENT Nor22c2>M=-tr--l7'
...........................................
NEW CONST.RUCTIOpT EL REPAIRS
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................. . ... ....................
ION TMAMOR
OWNMR� ................... ... ........ .......... ........ .. .. ......... ................. COr
...................... PERMIT No.
ADD-----li-;>-*Cr7-- k=i
RESS. ................................................................. .................. 9— - l%aEGAL DESCRI M-ON: -LOT- No. ........... ....... ................ 131,,()4= No . ............................................
............... ..
NAME OF AD
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Approved:
DATE .. . ... . ..... 712 ....... By, ... . ...........
NOTICE:
Nb-warranty of a:ccuracy�-
shown on the attached
The Informat on
'led for use by the City of
map(s) was compi
Edmonds, its Employees and Consultants.
The City of �Edm.onds does not warrant the
forth on these
accuracy of anything set
a
map(�-). Any person or enti
copy should conduct.an independent
inquiry regarding the information shown on
I
t-R� -map(s), Including, but not limited to,
ch
the loc'ation of any sewer stub shown. Su
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
H be H-a-b-`e for the
empto-yee-s o-r office-rs -shal L
information given on this rnap(s), nor for
ion pr 'ded based
esentat' ovi
any one repr
upon said map(s).
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 776-1107 for side sewer inspections BEFORE covering any portion of the construction.)
Inspection will be provided within 24 hours after request. NO Sat., Sun., or holiday inspections.
10 J.-
ADDRESS LOCATION OF CONSTRUCTION -------- ... P-J..ac.e ... fts.t ................... . ..........................................
PROPERTY LEGAL DESCRIPTION ....... ...... MaR1_e.wp_o.d ..................
...................... ........................... . ...................... . ........................................................................................ . ................................... ..................................................
........... !;� ----------------------------------- : ------------- OWNER AND/OR BUILDER ......... �jprd ... H.on, e-s .......................................... .......................................................
CONTRACTOR'S NAME & ADDRESS --- Russ Johnson Sewer & Plumbing 16009 North Meadowdale Road
'* ------------------- * ------- * ------------------------------------------------------ - ------------------------- * ----- --- -------------- * --------------------- ** .................
Permtss;ion is granted ........... . ....... J-0 V .... 1.8 ------- - ----------- 119 .... 731 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.
NOTE 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.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NO—. 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
I
I shaxper than % will be permitted.
NL - ,,No. 5—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for fallure due to improper
work which may develop within one year of completion.
NOTE No. r�—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the maln sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVEDE] Date ... . ..... -------- . ............. By ................ Date ... �;�4 .................. By ---------------- Date .............. . ................... By ----------------
APPROVED Da --------------- 11 01111!
------------------------------------------------------ * ---------------------------
Remarks: -------------------------------------------- -------
BOTY
U e As MYST 13 Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
Ir
.;2dit ConU e
hereby certify that the side sewer installation constructed under this permit
was inst ed in a the City of Edmonds.
Datedthis ................ ........... day of ................................................................. 19 .........
V Check BEFORE you dig for: Water [], Gas C], Telephone [3, Power [:], Sewer [], Other C] V V