19709 86TH PL W.PDFIIIIIIIIIIII
8208
19709 86TH PL W
ADDRESS: 8-70 q X&
TAX ACCOUNT/PARCEL NUMBER: COS-6 57& 60�:oo 0050 ()
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS:— DETERMINATION: []Conditional Waiver E] Study Required n Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER): C&-p L&p-,6)
L
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
LID #:
LOT: BLOCK:
LATEMP\DSTs\Fomis\Street File Checklist.doc
of Edmonds
City Engineer's Office
COMPLAINT REPORT
MINIM,
Report No,
Referred to for Action
Umw Date
Received Time_4L;�.aZ— Date,_Zg::�
Made
HOW Received: Letter Telephone In Person
Nature of Complaint:
Engineering Department Recommendation or Comments
Time Date Engineer
Describe Action Completed:
Time . Date Completed by
Location.Sketch:
-7-
SNOHOMISH HEALTH DISTRICT
DIVISION OF SANITATION STREET FILE
3011 Rockefeller Avenue, Everett, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
_'Su '1 3 Co i_es)
Permitto be issued . ........ . ... . . .. . .................................................................... ------
For installation at: (street address) ----------------- -----------------------------------------------------------------
........................
Addition or Subdivision ------ .........
--------------------- Lot ----- :��7_ Block ----------------
Type of Building: New--><-.,-. Existing ------------ Single family residence ..... X Number of bedrooms ----- ;5�� .... ---------
Other: (specify type or us ............ ------ ---------------- --------- ---------------- -------------------------------
Builder --- �:i*_0_171 --------- ------------- -
- -- -- ------------------- Andress ------ -_------------------- ----
--------- - `
Designer__:�4 ------- --------- Address_./-'?0'!!57
------------------------------ --------------------- -----------------------
��;w ...............
Soil Log Hole No. I ------------------------------------ e4
.............. 444
-- ---- ? le-z ....................................................................................................... --------------------------------------
SoilLog Hole No. 2 ... ....... :;,- --.*- - - - _/ --------------------------------------------------------------------------------------------------------
Elevation of Water Table, if encountered. (Distance from ground surface) .................................... -------_----- _
Corrections to control surface water if needed --- ��p --- --------------------------------------------- -------------------------------------------------
............................................................................... ------------------------------------------------------ --------------------- ---------------------------------------------
Specify if any removing or grading of topsoil in field
5
-------- - ------------- - - ---- ---------
Percolation: �� z-'-.-_7 " ,/
Test Hole No. I —Average Rate -------- O-e ------------------ --------------------- (Fall in minutes/inch-bottom 6" test hole)
Test Hole No. 2 —Average Rate ----------- IJ.-.; ----------------------------------------- (Fall in minutes/inch-bottom 6" test hole)
Tesi' Hole No. 3 —Average Rate ------- /ep-1
------------------------------------------- (Fall in minutes/inch-bottom 6" test hole)
Average percolation rate on which to base drain field design ------ _01.2L ...... ................................
Septic tank requirements based on present rules and regulations:
Septic Tank Size____f':;P ------------- gallons.
Amount of Square Feet of Dipposal Field .... e6
Signature — Designer ...... X�__ -------------- Date
- X-14 . ..............
--- ----------------
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issued (date) -------------- ---- 9 ---------------------- Permit Number ------- : ------ /__44. ff Z ---------
Remarks: ............................................................
........................... ......................................................................... ----------------------------------------------------------------------------------------------------
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APPLICATION
for CARD No. _.. ...........
x FLE SIODE SEWER PERMIT,-,.�!'
)-The City di Edmond-sa F Y.
tEE A
OUTSIDE E] INSIDE F1 REPAIRS E] EASEMENT No . ..............
A711e J-7
OWNER.......... ----------- .................................................. CONTRACTOR ......... /Or / --------------- . ............................................................. PERMIT No.....
STREET
------------ . ........................................... BLOCK No . ...............................................
-IOUs .............. AVENUE LOT No . .............
I E No. ------ ..... ..................... _ ............
NAMEADD - ---------- ----------- ............................. .......................... ......................
f�
A PP R 0 VL.
OPT
V
Date
BACKFILL WORK ORDER ISSUED ....................
SEWER WORK ORDER ISSUED ---------------------------
Approved:
DEPOSIT, $ ---------------------------------------------
_r'BY .................... ...........................
... DATE ................ ................ .........
4 S'
-CITY OF: -EDMONDS
—1ca'11 Rospect
6-1107 when -work
!CIVIC�LUENTER� 'WATER -SEW. It
0'.
M ..-I)EPARTMENT Is ready. for, Inspection. - (No'losp6c- -
4
-319
tions S�tiirda3�r, ian'day or. holidays.') `- -1 . �
� N
e.
............
.......... ........... .............................. ........ .............
:..0 dison. R!?y_..A11e
WNE .. ....... n.-
............ ........... .............................................. .... CONTRACTOR ......... ........ .......... ........ ................
c,ob�6r':-'��-_. 65
erinissi* wl' b6d
o s,-gran ......... for ........ I ......... -or CONNECT. a, sti e,se er:.
...... ..................................... .... days,. to REPAIR W
with- City SeW.46h�,in_ 4ccordaince: with il'Wication -bn file. lLnd. goverrAng ordi"nces.
XTTENTION. IS CALLE .'To. THE -FOLLOWING:-
NOTE-No: 1—The. owners of the -,property may 'Obtaln� a permit to'�ofistruct sewer Inside p . roperty line. A licefised -Side Sewer Contractor. m - ust
be.empIdyed'to constriiet�'sld&'sewei-�in-.itreet'a:rea.'.Do not cover any portion �of- sewer before it has� been.. Inspected,.
INOTENo. 2�Obtafnjull Inforniation regardlnj-'Ordinaj�cc 11U6.030, and' Regulations goverrilng, aide sewe'ra when, ypti get, permit.
NOTE,,Ni�.' 3—Top of stde.'sewer,must have.atAeast '30 Inches coverage atproperty. line and 12 Inches Inside property Iine_-,,_ra1nImum:'gride of:2%*
&6,bends in; grade sharper'than %- will -b�'-pkmIttdd.,,
NOTE-Nd;,4—Trenches In �street,'must,;be water � settled and surface of street . restored to,origlhal condition. Cofitracton-slieffi-Ve responsible. for
failure� due. to improper work- which --
may develop within one year of. completion.
-NOT r -is provided for in the..permit; or to,, do: any -w rk on the main -sewer or It*
_E Nol ;5-_-Itj-'Is:,unIawfuI- to aIter:-or-d6,&ny.:othe _,;vork s ap-
6 ; than
purfenances weceptto��inseft-.th6�pip nto'the'-%vye.