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19502 82ND PL W
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TAX ACCOUNT/PARCEL NLTM13ER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: — DETERMINATION: F1 Conditional Waiver El 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
SHORT PLAT FILE:. LOT: BLOCK:
SIDE SEWER AS BUILT DATED:-&/9b/-,-3 SIDE SEWER PERMIT(S) #:
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DA
OTHER:
LATEMP\DST1s\Fomis\Street File Checklist.doc
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7Y OF EDMONDS. SIF-47, SEWER PERMIT
WATER -SEWER DEPAx.-MENT
PERMIT N?
4364
Call 7.76-1107 for side sewer Inspections BEFORE covering any portion of the construction.
Impection. will be provided within 24 hours after request. NO Sat., Sun., or holiday Inspections)
.1.9.50.0 ... 82nd Place West'
.. .. .... .. .22
ADDRESS LOCATION OF CONSTRUCTION ........................................ ...... ........................... ..................... ....................................
PROPERTY LEGAL DESCRIPTION ................... . .................................... LQ.t .. 4
ewood
...........................................................................
....................... ............... . .......... . .......... . .......... . .......... . ............................................................ . .. ........... ................................... . ..................................................
........ . .................. . ................................... OWNERAND/ORBUILDER.NORD CONST., 5 W. Harrison, Seattle 98119
..............................................................................................................................
CONTRACTOR'S NAKE & ADDRESS ... RuA ... ...................................
Permission is granted .... x4y ... NA .................. . .. . ........... # 19.1a, for repair and/or connection of a side sewer to the city sanitary sewer
system In accordance with City of Edmonds ordinances.
ATTFJ4TION 18 CALZED TO THE.-FOLLOVaNG,:,
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
adds sewer In street area. Do not cover any portion of sewer before it has been Inspects&
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.
X= - 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 grarle
shaxper thn JA will be permitted.
NOTE No. 5—Trenches In street must be water settled and surface of street restored to original condition. Contractors aball be responsible for failure due to improper
work which may develop within one year of completion. 0
NOTE No. 6—It Is unlawful to alter or do any other work than to 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.
DISAPPROVEDDate .. . ................................... By ................ Date ............... ................... By ................ Date ....... . .. . .. . .. ................ By ... . ...........
APPROVED0 Date .................... ......... . .......................... BY ........................... ....... ............................... ........................................................
FINAL INSPECTION PENDING RECEIPT of EASEMENT . I
Remarks: .............. ................................................................2 ..................... .............................................. ... .. ..............................................
................................................................................................................................................................................................................................................
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection 0
I ....................................................................................... ... I hereby certify that the side sewer installation constructed under this permit
(Owner of Contracting Firm Performing Construction)
was installed in accordance with all governing ordinances of the City of Edmonds.
Datedthis ........ ...... . ........... day of ........................................................... 19 .........
Check BEFORE you dig for: Water [], Gas C], Telephone Power Sewer Ej, Other
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