19414 82ND PL W.PDFIIIIIIIIIIIIII
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19414 82ND PL W
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ADDRESS: Z6!��— RL�&-)
TAX ACCOLTNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: [:] Conditional Waiver El Study Required Ej Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DA
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:-13q
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DjkTED:-S)/q/q3-(&/ - / //�,q)
I -/ �UE SEWER PERMIT(S) #:
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DST's\Fonns\StTeet File Checklist.doc
(08,11 7,76-1107 for side sewer inspections BEFO" covering aZy portion of the oGtat on -
Inspection will be PrOlvi4ed within 24 hours after ri ructi
iquest, No Sst., Sun., or 110ji4ay Inapectic.)
ADDRESS LOCATION OV CONSTRUCTION,_ ........
. . .........
DMSCRI"� ON_
. ..........
PLAT_ -OF,,
..............
.. .......
........... .. ......... ANDIOR.B1 77t....
.......... OWSM
..... C-011S.T.R.U.C.T1.0a
. . ........
b0NTRACTOR1WXA3fE & AbDRE
........ . ...
Pertnissleft Is granted . ......... .............. ... 4for rePah and/or
system In accordance with City of Edtnondq ordin"cesb of a side sewer to the atty sawtary
sewer
-44 ION 10 CALXZD TO THE r0jL6WING:
1--The owners -of the property may obtain a Permit to �Dasti4ct sewer inside property 11M. A licensed Side sewer contmotor: mlist b� emplo�-
side oew,er� in street areaj ]DO not 4"covor mov P901*4 of sewer before it R" 'been inspected.
NVM NO, '2—All v�qrk performed in city. right.ot-way requir". - jnvaajf�b of, *ght. conloq4t
an, -Way Pormit
NOT]a NO, S--�ObWft full Information tegardtug,ordina" 11.,x . �qso, an&Rq itjo Of "Obte4rAble frqr4'ths CRY ftglneerls, offj"
Us'40vemhg oldd'aevsrs�'
wb you get permjt�
ftTM No, 4—Tolil of side' sev�br must have ia least �_o Inp�o covoftk# $6 vr�ty '114i
Ishiiipfor th4n*,% will be' rmitteo,
pe �d Inches insi.4q.,
Prpel�y, iin
0;' MI, n I r4u m or*d� heA�41'n
must �oo *ater sdtleld'azd
ps, in atreef
naV,.4bye1QV �w oowiackii 60'�i
WOrk, w4fdh4 x , to 6rigin " , , 1,
AhsJI �60;reop�nsjbj*
W, h
or
nt6 th4 wyo,,� "do qvit 011.
sewthqk, pipe Ans othee "Drit to
DIS"PROVED Date-
......... AY ................ D
"PROVED BY
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.............. .. .......... ......... . . ....... I ..................
. .... . .... . ...... . ......
........................ ... ..... . .........
............. .... . . . ........... . .... . ..
OT Pernift Copies ....... I ......
ST 8 ed B � 0 -'Pr Of Firm Perforniin 'Construction.
Y Wn
PRJ1ORTO1�equeStkOk1 "cuon
.,Xhspe
. ... ..... . ......
.......... hereby, certify that the,0440, Sewer inatall'a,tion construct,
(Own bon R4rm Performing dons ug�;
na
g, or , of
All governin , Ada:
g or t1he City
ated
D
of..... ......
Check BEFORE you dig for: Water,(],
Gas [1. Telephone Power [3, Sewer 0, Other A/