19520 94TH PL W.PDF9236
19520 94TH PL W
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11"MIC WOMQS DEPT. OJEO, LIST
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Street Pdpht-of -11a), Existing winD
Access Easemcnts Existing
=rpmlb Utility Easement Existing
skol
Lot Per Subdivision Plat Assessor YA
Site Plm (31CCked for Acmiracy 3, 1 YO 1 -7 --7
�7'
0
17'
I ilk
Undergromd '%'j,ring Rood.
Nmk Ataira4 of
ll\cvic,v�r by�- AZ Date
T'Xi.s*ti.Tl,(y fittOT �,.!ain Si7c . * 14
Later �Iain Pequircd
58(�Ice—
Hydrant ').i---c Existing
I lvdrant 1'equired per Fire. CCde, J--A, I- Size
Do-tector (liock 'L letcr RCquircd
Crn,3,; G)n n ect b n -f h,�(-->edl i)rl
1-i.rc !�-,vnrtmcnt Comnmits,
)4
We'16-Ox"I 'e
I Roviel.: bv
Septic Tank Dosi�m 1\1,)T)rovcd—__
Soptic Tuil,, Permit Pomit 'To.
Sanitan, Scv.,er Availability
Drawing N"o. L I T-�� Ji.l.0 No.
Side Sewer Availabilit.�,— lff-lu'sr
Swiitar�y Scurer Connection Fee Pequired: tJA-.#
P.CViev.7 by Date
C)lIC11 Ditch
AV (2 enk 0—
Culvcrt P.Cquired
i ---- Al 0 Al —Si.ze.
Catc)i Basin Required_L /V 01 Ind-icate on �itc Plom
Sbouldef-k dm"Maqc--
open ru n �o
ihl-�Iolc
Soil ConJitions F, Growid lValter Field Mocked
Reviovr by
Indicate on Sitc 113m
Dato
V)
Street Paying Required .1 1
Curt) 0 Al e-
4/
Sidci-.,,al]� 11,equired
Cuilb Rit for Driveway Required
Pi-ght-of-I'1ay Construction Permit Required
0 1 .
Bond Required for Public Improvements Al 0 A,- C---
Street Naic Sign Required
Other Sianimi Required Al o /t- (F
Pre PCII,,jit S4 to Inspection made on
c
C:4 BY: Scwer
u Water
Street
Engineering
JL * lding Jk-pirtmcnt
Special Rcquirom ents iistcd in memo to 11 d
13v I u �—> w /C) Date
All items filled in on Building Permit Application
By— Date VO -7 --7
Pra,,.,,,inITS Stamped and I-lotations 1�1,acic
By Dato 1/0 1-71
Approved by Public 1',lorks Department
00
APPLICATION
for
The City of Edmonds SIDE SEWER PERNPUT EASEMENT No . ..........................................
NEW CONSTRUCTION E] REPAIRS 0
ITNER ----- Id.d CONTRACTOR ......................................................................
OV .. )4
. ...................... i� ...... ---------------- ------------ ---------------------------- PERMIT No . ......................
ADDRESS A\5W ... f..7 .................. --- 1161 .................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAMEOF ADDITION .........................................................................................................................................
ed
Approved:
lq�7�
DATE................................................ By ...
'o ry
CAI, to follow instrucf,
j,01A109 PU�RNII$4fl INDICATED BY CHECKED BL
'104 - I I C r. (S)
cliaeflan rmrAiroa for Piaso scrvi,ds)
NOW
V/1 Deiiver-ONLY
I Jo add4sse6
��RECEIPT �' c!;cribcd below
77
I* E I 4A
F
t alvvpys be filled in)
2
z
173- R E N
SIG j F A S E AG NT, I F
SENDER: Be- sure f o, follo�
W insfryc*fions on other side'
LEAW -FURNISH -SERVICE(S) NDICATEIJ W �'C
yt H EP KED. i3'LP' OK�S),
641,9 er' c6i
es required for thes.e s vi
Show address,
F�
D�div6r N-EY
wherp rji-!iuPr.,I
to dr see
addr,s
Receiv��djheL nihibered ditij�le',de`scribeg-palo W
_IREGISTERED NO. Oil
I UNA I U R E U R NA M E 0 F A D D R 04
E;::SEE(.ws-t aiv ays be filled in)
CERTIFIED N6v
SIGNA U U., IJAESSEE' C EN I,
RED
D ATE", DELIVERED NHERE-DE LIVER
qu�sted, a
Code)
REC
F
--P.R CERTIFIED
219-01 JWA I L-30
G) H T 0 Y.
DR.
1 95� 0 9_,f T,, 1:)WILLIAt4
EDMOl%DS L. W.
S
IVA
PS F.", --," (. ;! ': - , 1 .1, � �, �! , , 1,1 1 - v, only J5
'" 0 Jac, I,'': � 11 50
Apr. 11 11;d). ............. 5 L4
�Q 71 3800 14 1 S1JRAN ................ ....
E COV
OT FOR I TER AGE PROVIDED—
TIONAL MAIL (See othe
Pde)
REC.EIPT FOR C ERTI F1 ED "MAI L-30�. (plus postage)
P
SENT TO
POSTMARK
ON DATE
STREET A
A
N 1) N 0.
P.O., b'AIF AND ZIP CODE c-
FOR ADDITfO—NAL —FEES -0
OPTioNAL SERVICES
1. Snowsito whom and d
W ate delivered
RECEIPT h delivery to addressee only 1.
2. Shcws to whern, dat ........ . . 6
toe and where delivered . 35,
SERVICES With delivery addressee only ........... .. 854
DELIVER TO ADDRES—SE
56-,4Q
xtl. f. r,,q.i red) ............................
PS Form I
Apr. 1971 3800 NO INSURANCE COVERAGE PROVIDED —
(See other side)
NOT FOR INTERNATIONAL MAIL GPO
REGARDING: 1�520 - 94th Place West
(address)
R E C 0 R D 0 F C 0 N T A C T S-
DATE NAME,, PHONE NO, & COMMENTS ACTION TAKEN INITIALS
ADDRESS of CALLER
5/l/74 Dr. Wm. K. Wright Certified Letter No. 406173 sent Letter received. TE
requiring hook-up within 60 days.
5/6/74 Please dye test.. TE
5/7/74 D.T.O.S. TE
6/5/74 Certified Letter No. 406473 sent Letter received. TE
rescinding letter.
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