19506 82ND PL W.PDF11111111111111
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19506 82ND PL W
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ADDRESS: Zt."I
TAX ACCOUNT/PARCEL
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: — DETERMINATION: [:] Conditional Waiver 0 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 $:
SHORT PLAT FILE:
LOT:
LID #:- Z22�
BLOCK:
SIDE SEWER AS BUILT DATED:-Y26�g &U- SIDE SEWER PERMIT(S) #:
SOILS REPORT DA
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DA
LATEMP\DS7s\Fomis\Street File Checklist.doc
CITY OF EDMONDS 7 SIDE SEWER PERMIT.,
WATERSEVVEWDEPARTMENT
WZ.
PERMIT
Call 716-1107 for side sewer inspections BEFORE covering any* portion of the constructio
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(Inspect -ion will be provided within 24 hours after request. NO SaL, Sun., or holiday inspectiow.)
P I 'a C e
ADDR ss LocArnow OF cONSTgucTION .................
............... ............................................ . ................ .................................... .
ot 3 S. --F I a z. C' 31 �j i c; G'J
PROPERTYLEGAL DESCRIPnW ....... . .......... . .. . ............................................................ .. . .. . ...... . .................. . ..................................................... I .......
a
. .. .................. ....... . ............... ........ . ..... . .. ....... .... . ........ . . . ..................... .................... . .............. ....... .. . .. . .................. . ..................................... . ..... ...
5
. . . . . . .................. . . . ................................ OVVN�ERA14MIOR BUILDER ........................................................................................ .............................
CONTRACTOWS NAME ADDRESS .... R.,I.S.S_... Inson, "t �,009 N a d, g w.a, I Rj
--------------- - -------------------------------------------------- - ------------ I ....... .. . ............ ................. ....................
Peindsslbla 1, g,"td .......... I ............................ . ... ........... 119 ... for repali and/orconnectlon of *a, s16 sewer to tlie� �clo shiiltaryz sew6r
system in accordance with City of Edmonds ordinances.
NOTE No.. ir�7te. owners of the,,propertY In"'obtaln a permit to construct sewer inside property lz A licensed Sid. S,7er- Contractor must be employed-jov6ustruct
In: street ares. Do not cover any portion of �sewer before it -has been Inspected.:
a,&.-a—er
�NOTE No, '2—All -wbrk. perform . ed! L12 :cilty. .. rIiht-of,.*ay1 reqgilrez an Invazton of Rigbf-of-Way-Permit.obtaInable frbin the Cit' En*
gineim's.office.:
E.Na.- 3—obtain �tuli.informatlon resardlngordi�" 'li.18.03"0- and Regulations governing side seWers%wben'you jet permIL
'o
have at Ig". �Jlk P'� e�_p& a�.FT eVK 2.1?aches tnside pr
j p %?, c T I ne; minimum No bend
ill bi"peri- M,
�p
shzqper'1rhnn: %'%W Wits
JVOTE No. 5-7Yenches in street must be water settled and surface of street restored..* to, original condition. Contractors shall be responsible for failure due to Impmper:
work which may develop within one year of completion. 6
NOTE No. 6—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.se wer or its appurte . nances except to'in�-
sert the pipe into the wye.
DISAPPROVED "0" D ...... ... By ... . ........... - ------- "Mte ................................. BY ......
.............. Date ........ ;PO61 .............
7 ... �r ................ ........ ...............................
APPROVM
Remarks: Fli AL INSPECTION bEND'ING 'LCS,FT o, EASEMENT
....... ..... 1i - - ------------ - -- - -- - - .......... A ................ . .................. .... . .... . ....... ...... w .. . .. . ...... . ..................................
.... ........
......... ;e!� . . ......... M_15� .......... ................ ....................................................... . .............. ................. ............. . . . .. . ..............................................
B rmit C ieS S Be Signed By -Owner of Fi= -Performing Ponstruction PRIOR Tor Request -For Inspection:-.---7:
.......... - -- ---- * ........ . . .......... ... hereby certify that the side sewer installation constructed under this permit
0 er 0 t, Per 9 6;�strllctlon)
was ins ed in acco with, all governing ordinances of the City of Edmonds.
Dated this --- 1/_V ... . ........... day of --- 70 .. .......................... .. .... U97-3.
Telephone 0,' Poive �iv6 Other;
Check'BEFORE you'dig foi:.:Jy�ater 0 Gas o, r 0,
APPLICATION
The City of Edmonds for
SEDE SEWER PERMffl
EASEhlENT No... 4?
NEW CONSTRUCTION REPAIRS'o ......... ... .........
41,0 /39. .(�i&
OWNER
..........
........... CONTRACTOR..
....... J-0.-
PERIM
ADDRESS ...... 4- 4 It-
........................ ...... ��.LEOAL DESCRnMON: LOT No.
................................. BLOCK No . ..............................................
NAbM OF ADDIT N ...... ne
............. ......... / ................................... ................ ..........
3
4
Approved:
DATE.............. ................................. BY ................... ............
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eifOrm�d In 61.ty. befor6 It 'h I.denaed, Side sov;
NOTE No.-.. Hght-61!4&� requi
relli an j ...qrlContral
vaslon of r must',be.elnWo
NOTE N 4tajn fuAl `Jnf4n�atibn� retardl�g ny"op -of ght -0,1!4�. P � i � ". I , - - yed �O, 6dj!jjruCt
oj�sjdle' ' , - . Oidlfiiin'ce ii M03p�.Od_Regulat obtainable' fi-olij jh
stF*erimust hav�'f 13-.Iclty,`Rn4in�ir�' ' ': -� ' . . .. -i , �;? ,
8 Office'.
ehaiper- than- ki lea�t -:36i J�chei - EW4rdfs,whb pe`r'zn-jt'�'j
will -be pb cove&We-�at�Il line and * ' ' " * ' 4', - . 4
. I , i-ffilited,` p"Xou:6t
t
4A,10dheiij�81dii, JW6il
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n,Vade,
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"mus "be,�vai��,iettled:andij�urfi;�e�.'�t ,MY� line' i�jhl_um ill �f'
�whlCIIFMAYA6�rel6p*.,* e o. 1,s reeC r6tBrea
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an`.*is.-P",de&' f6j'In th
�Psert'thd'jij6l� lifta fth Ye �WO�kAh 0
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. . . . . . . . es
-excePt. to.. in-
qo kany woik on the In*
aill' sewir or:'Its k.
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