19508 82ND PL W.PDF111111111111
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19508 82ND PL W
ADDRESS: e��tol"110L zy
TAX ACCOUNT/PARCEL NUM13ER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DA'
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:-&/Xbs
I I
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
DETERMINATION: [] Conditional Waiver E] Study Required F] Waiver
LID #:- 134
LOT: BLOCK:
SIDE SEWER PERMIT(S) #:-y2zQ
LATEMP\DSrs\Fonrs\Street Filc Checklist.doc
P
IF
APPLICATION
for
The City of Edmonds-, SEDE SEWER PERNHT
EASEMENT No . . ..........................................
NEW CONSTRUCTION REPAIRS 0
OWNER .............................................................................................................. CONTRACTOR ......
....................... PERMIT
ADDRESS ...... 7. .......... P .... L ............ W- LEGAL DESCRIPTION: LOT No. —.9.4 ------------------- BLOCK No . ........... ........ .......................
NAME: OF ADDITION ..FL-bCr <:)F t--AbbJ=L-VMW4=X=�=
.................................................................................................................................
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Approved:
'TOO e6LA%LJ0%"4:9q-w6
DATE
'of Edmonds
PPLICATION
for
SH)E SEWER PERa0uT
EASEMENT No . ... . ..... .... .....
NEW CONSTRUCTION PVV A TlDQ
Li
400or
...... CONTRACTOR..
.................. ............................... PERMIT
....... V0.5-S ......
....... LEGAL DESCRIPTION: LOT No . ......
k9 ......... .......... ......................... . BLOCK. No . ............................................
NAME OF ADDITION .........
............... ......................
4-07-
b
NJ-
/00e
&)F5/7-
Approved:
DATE .............. By ..... .................................................................
-------------- ------- --
NOTICE:
No warranty of accuracy.
The -information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edrn.onds does not - wa rra nt the
accuracy of anything set for.th on t hese
map(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
-map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may'not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
e rn p-'I- o-y e e-s o r o ffi C e rS S' h a. 11 1 b e Il a. b-.11. e f o r 11 h e
information given on this map(s), nor for
ion provided based
any one representat'
upon . said map(s).
CITY OF-cDMONDS SIDE SEV�� PERMIT
WATER -SEWER DFPARTMENT
PERMIT .7"
Call 7�76-1107 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.
ADDRESS LOCATION OF CONSTRUCTION ----- 190"'u(J & 19508 - 0"2nd Place t,!est
. ...............................................................................................................................................................
J_"' L Na,� cf
PROPERTY LEGAL DESCRIPTION ........
.................................................. . ...................... . ... ; ........................................................................................................................ . ..................................................
.................................................. I ............... OWNER AND/OR BUILDER_ I I. Harrison, Seattle 98119
CONST. , 5 1,
.................................................................................................................
........................................................... . ................ ............. . .. . ....... ......... r)
CONTRACTOWS NAME & ADDRESS ----- 'I �,U S S .... khVison, 1600C) i"' rinadnt1fdalp pd� FrImor"tiq OR02
...... ig .... 73 for repair and/or connection of a side Sewer to e city t r wer
Permission Is granted ..... ................................ . ............ .1 th sani a y se
system in accordance with City of Edmonds ordinances.
A'� TION IS CALLED TO THE FOLLOWING:
Nt __/.�o. 1—The o ners 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 wn�k ne.rf—pd in e0v rioht_nf_w v i Tn—i— �f RiOtW c 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.
NOTE 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
shaxper than % will be permitted.
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
work which may develop within one year of completion.
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 sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED 0 Date...- ---- * By ---------------- Date .......... --------- * ------------- B ................ Date ............... . ................... By ................
APPROVED Date--- By ..... __z
eX2_7 ----------------
L F-SPR-TTOPI PFAIMP RE
...... F- �, I CF'11-1 of rA.C.FN,"7i',!T
........................................ .....................................................................................................................................................
. .......................... 2n ---------------- in ----------- - ---------------------------------------------------------------------------------------- - ---------------------------------- --------------------------------------------------------
- BOT� ��mit Cop�s *
'JJ�d Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
'W' .................... .... hereby certify that the side sewer installation constructed under this permit
(Ver o� Co n Firaf-PerfGrming Construction)
a in a d ?1`5wt4iPth all governing ordinances of the City of Edmonds.
Dated this ....... /_� ............ day of--
....... - -- - --------
7
V Cke7ek BEFORE you dig for: Water E], Gas E], Telephone [], P ower E], SevVer [:], Other