19518 81ST PL W.PDF11111111 lill
7464
19518 81 ST PL W
NOTICE:
�-No-warran-ty 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 �Eclmonds does not warrant the
accuracy of anything set forth on these
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,
th . e loc'ation 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
ernpto-yee-s o-r office-rs -shall be Via-b-l.e for the
information given on this map(s), nor for
any one representation provided based
upon said map.(s).
V
The Eity a -;I Edmonds
6 6-0
APPLICATION
for
SME SEWER PERMIT
NEW CONSTRUCTION [-] REPAIRS
OWNER ..... /Z-� ------------------------------------
ADDRESS ..... ------------ S.>/ ......... ....................
tYNN PLANT
EASEMENT No . ..........................................
CONTRACTOR ............................
-------------- ............. ................ ....... PERMIT No.
LEGAL DESCRIPTION: I.., ................. .............. SLOCK No . ...........................................
NAME OF ADDITION .........
Approved:
DATE .... l-/ - -21 ...... Ey ............ .......... ...........
r-1-11111111-11-1-1111- I-,'-
1,jY.- OF EDMONDS Call 1PRosbect 6-1107 when work
CIVIC CENTER*=__W'ATER-SEWER DEPARTMENT
Is ready for Inspection. (No Inspee
0
tions Saturday, Sunday or holidays.) A 20 6 7
SIDE SEWER- PERMIT
.ADDRESS .............
RI.,@,ce West
. ............................................................................................................................................
OWNER ................. V.J.aln.e Helsel MCW inc.
. .. _ ................................................................ CONTRACTOR ................................................................................
Permission is granted ........ A.pr..il ... 21 .............. 19 .... 6.7, for ........................ days to REPAIR or CONNECT a side sewer
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may ObWn 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—Obtain full information regarding Ordinance 11,.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 3—Top of side sewer must have at least 30 inches coverage at property line and 12 inches Inside property line; minimum grade of 2o/,.
No bends In grade sharper than % will be permitted.
No. 4—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. 5—It is unlawful to alter or do any other work than Is provided for in the permit, or to do any work on the main sewer or its appur-
tenances except to insert the pipe into the wye.
I T V*07-�,
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
IbERMIT
Permit Number. 95
Issue Date: 41
A. Address or Vicinity of Construction: 19518 81st Place W.
8 9 0 9 C� B. Tyl� of Work (be specific): GTE to pl ace buri ed servi ce wi re f rom ped #9197,
us
p one driveway, plow 26 ft r.o.w. to residence at 19!)15 81sE ace
Please see attached sketch.
GTE Northwest Incorporated
C. Contractor: Mary Bower, Permit Coordinator Contact: Mary 206/488-1628
n er
Mailing Address: 22118 20th Av SE, Suite 130 Whel Mike Ward 206 771-9111 nr mobilA #9S4-07 4
State License #: Bothell, WA 98021 Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. F1 Commercial F] Subdivision El City Project ff] Utility (PUD, GTE, WNG, CABLE, WATER)
F] Multi -Family [K] Single Family F1 Other 2100-9POOlDB 242310
INSPECTOR: INSPECTOR: L_L_3k-4C-J-H
..S= -%�
F. Pavement or Concrete Cut 0 Yes No G. Size of Cut: x H. Chargq�,$
A
APPLICANT TO READ AND
INDEMNITY. Applicant understands and by his signature to this application, agrees to ho ofEdmonds harmless from iaiamages, or
ity'
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made againd the City of Edmonds, or any of its departments or
employees, including or not limited to the defense ofany legal proceedings including defense costs, and attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION�AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE;FhVAL-STREET PATCH
-IS COMPLETED BY CITY FORCES, AT WHICH TIMEA- . DEBIT OR CREDITWILL BEPROCESSED-FOR ISSUANCE TOVII&APPLIGANT.
Construction drawing of proposed work required with permit applicaiion.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes. �1-
Street shall be kept clean at all times. ` U-�
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihaue read the above statements and understand thepermit requirements and thepink copyof thepermit will be
available on site at a
,P-�ime�Lt<r—in--s-Nption purposes.
il . Signature:
H.
(ConJ6fjfit(9t6Wa0Went)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
F.
FOR CITY USE ONLY
APPROVED BY: i-AJ1-tiJCCJ4
TIME AUTHORIZED': VOID AFTER Q t_nAYS
SPECIAL CONDITIONS: �JA6-- —
COMMENTS:
[ITTVIL3
RIGHT OF WAY DEPOSIT
DISRUPTION FEE/FUND Ill:
RESTORATION FEE:
PERMIT FEE: 3�9,
TOTAL FEE:
RECEIPT FEE -
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Nv. 1991
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
El NO
LEGEND
LO
d
Z:
PERMIT SUBMITT BY 1-U,UllLllT rVIKULt
GTE UG TRENCHING ---4JGT—
R.O.w.
----------------------------------------- EOP
— — — — — — — — — — — — — — — — — — — — — — — — — — — —
Ln #
0)
Ln
CD
1 CUTS.
.mu pwbw-cwqp�