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CITY OF EDMONDS Wermit No. /
PUBLIC WORKS DEPARTMENT _" Issue Date Zoo
RIGHT - OF - WAY CONSTRUCTION PERMIT SYLH'Eff FLE
OCT 15 1980
A. eAddress or vicinity of Construction Dir. Of P
19929 86 AV W
0 Owner: Washington Nntural Gas Co
Name
805 156 AV NE
Mailing Address
Bellevue, Wa. 98007
City, State, Zip Code
0 Contractor: Washington Natural Gas Co.
Name
805 156 AV NE
Mailing Address
Bellevue, Wa. 98007
City, State, Zip Code
, �IorkPermit Issued To:
e Type of Work to be Done:Tnstal 1 new Service
• Work in Connection With:
11 Sub or Plat 0 Single Family
0 Comml. / Ind. El Apt. Condo.
• Pavement Cut: 0 Yes El No
State License Number
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is -required for inspection by Engineering. Call
775-2525, extension 220.
I understand th�t this Permit�mu:st be available att4e j04it6 for inspection purposes at all times.
Signature:
Owner or Agent
te Oct. 13, 1980
THIS PERMIT MUST BE POSTED AT THEJOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Vold after i�o days
Special Conditions:
Ammendments:
Permit Fee:
Security Deposit:
Receipt No.:
Fund Ill Fee:
Street Cut Dimensions
X
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
2.1TY OF E �DTNNET FLE
PUBIJC WCPM — EMINEERIM
ACTION REPORT
M?
SUSPENSE DATE:
Date: Time: _File #
I Attachments: =Yes
5700 -
PHONE: -7-72 - 9 BIR +
REQUEST RECEIVED BY: TELEPHGNE
CONTACT IN OFFICE
OTHER:
RECEIVED BY:
=-MM
ACTION:
All Concerned Notified
Action Completed/File
0
0
The City of Edmond FLE
�l Ta 1 -
EASEMENTNo . ..........................................
�- 10 /1-57
OWNER ...... /?0 N ..... ............................ CONTRACTOR ........................................................ PERMIT N
r 40 .4� .... ........................................ LEGAL DESCRIPTION: LOT No . ............................... : ............... BLOCK No . ............................................
ADDRESS ........... ...... .......
NAME OF ADDITION jfrIfY7.1 .... T4- ./K72g770 ...... "T
;7,4-"g
APPLICATION
for
SEDE SEWER PERMIT
NEW CONSTRUCTION %),—REPAIRS
Approved:
DATE ..... ........ By
NOTICE:
-Krn.--VA_1-a- r-ra . n
Ur.S-70 C -Urd.-U.,
- I
The inform atio n'shown on the attached
map(s) was cOmPiled for use by the OtY Of
Edmonds� its Employees and Consultants.
Th.e City of 'Edm.onds does not warrant 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 inform-ation shown on
-map(s), Including, but not limited to, -h
th'e lociation of any sew-er stub shown. Suc
sewer stubs may or may, not exist and may
or may not exist at the location shown.
Neither the city of EdArnoinds nor its
mp-,-O-yee-s o-r office-rs -sha-'H be Via-b-11--e for the
n on this map(s), nor for
information give'
e representation provided based
any on
upon : said map(s).
CITY OF EDMONDS
CIVIC CENTER — WATER -SEWER DEPARTMENT
. SIDE SEWER PERMIT
Call FROSPeCt 6-1107 when work
18 ready for Inspection. (No inspee-
'tons SaturdoY, Sunday or holidays.) N2 2757
ADDRESS ----- 19525— 86th Avenue West
................................................................................................................................................................................ ..........
OWNER ........ Robert M. Reisen Western Sewer
------------------------------------------------------------------------------------- CONTRACTOR
Pernlission is granted ............ February 26 lg.-6.8._, for ------------------_---- days to REPAIR or CONNECT a side s . ewer
-- --------------- --------------
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 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—Obtaln 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 2%.
No bends in grade sharper than % will be permitted .
Z No. 4—Trenches in street Must be water settled and surface of street restored to original condition.
failure due to Improper work which May develop within one Year Of Completion. Contractors shall be responsible for
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.