20024 80TH AVE W.PDF111111111111
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20024 80TH AVE W
PUBLIC WORKS DEPAR11E.00HECKLIST
BUILDING
PER"IT&MET FILLs (address)
e
Street Right-of-Way.Exist*
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Access Easements Existing..
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Utility EasaTient Existing_W
REQD N�&
Lot Per Subdivision Plat
Assessor Map
Site Plan Checked for Accuracy_
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Underground 14iring Reqd.
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Check Accuracy of Legal Description
10,4
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Review by_
Date
Existing Water Main Size
a in Required.
Service quired
ce ul red" —
H y t z
ydrant Size Exis
s)4
Hydrant Reqd Per Fire Co
Size —
Detector Check Meter Reqd.,
Cross Connection Inspe
E-4
Fire DepEar:tm��ent ts
t ts
�3:
0'11E Charge Reqd.
Pter
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R View I
eview by.
Date
Septic Tank Design Approved
Date
tit Tank PernrLt Reqd.
ank it Req d
t T Pe
Permit -No. 41f�—
-1c
n Sewer Ava ab*lit�
il
SaSawn Sewer Availability
Proj.
Drm,rin No.
File No.
S ew r _1 il
Side Sewer ailability
—
S i S _w
Sanitary Sewer ection Fee Reqd.
�3,
j
Review by
_ate
Open Ditch Exist:*,-ng_
d.
Culvert Reqd.
Size
c4
Catch Basin Reqd.
icate on Site Plan
0
Shoulder drainage tain collection on
of
swale open off
0 eqd.
Indicate on Site
C _ti,
So on
KReViManhole
S i Conditions and Ground Water Field Checked
w y
ewby
Date
Revised: lvlO-1977
Page 2
�t�reP d
et aving Req
Curb tter Reqd.
Sidewalk Reqd.
Curb Cut for Driveway Req
Right -of -Way Const ermit Mqd.
Bond Reqd. lic Inprovement . s.
eet Nam Sign Reqd.
Other Signing Reqd.
�"t ermi Site Inspection made on
nnit Site Inspection Trade on.
0 S
4 F4 BY-, SEWER
WATER
H z STREET
ENGINEERING
'4 Special Requirenients listed in memo.to Commmity Development Department,
Building Division
> BY Q 0 MjFYWfC) Date I
o All items filled in on Building Permit Application
BY - 140 Date 141
P4 , Drawings Stanped and Notations Made,
P4 BY Date
Approved by Public Works Department
Revised: 1v 10-1977
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 'Edmonds does not warrant the
accuracy of anything set forth on these
map(s-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
th-e -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
empio-yee-s or offiCer's Shdall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
The City of Edmonds for EASEMENT NO . ............................................
SIDE SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS E] LID NO. ..... . ASMT. NO.
OWNER ........... ........ .......................... CONTRACTOR --- �AQ.P\7. PERMIT NO.
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JOB ADDRESS 200Z-4- -* .... LEGAL DESCRIPTION: LOT NO. -() - � ---------- 2 ----- BLOCK NO - ------------------------------------
................................................. ................................................................
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PROPERTY; LEGAL MESC'R1pnON.!.: ... ... ......... .......................................................................... ..............................................................................
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sewer-
ssionr: sigran
THE: FOLLOWING:�'
�A7 TIONr-IS 'CANLLEDt Tbt,
y.%may�,obtain,.,a:,permlt tai, C6`6s r6ct-!s�wer*.,'jn$lde,.Property�'�" A41censedI.SideASe e e,eT 1_ e.,,t
-cove
��slde,isewm:inuitr6ev, b' i ' V r anyi-poiti6n,;of'se%�er bef6r�'.It';has::been.in'spe�t6d�-
area., _o,,jo%
�dnj- . city right-o
for V tay--'ri4u'liei'skA a"s'lioLn'.' oi` M9'fit"0'f t W` aY4 Permit,obtalna�1'e'i'f'r*o-;'rr'r"t*h' CIt3 klnIglnee�.'��-&fiL'�
rdina.nce overning.!sl pjsewers �vheni.ybu�;get,,permit`,
,E: re 9 �Itr d
.Top;�of- side isewei r
30'r inches', covFr4ge;;,�Lt�Rropqrty 1 b
i;fiar6erttth&n,
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'6e;!�tb,rksettleclqancr sur . face of,.street restoredi�.t'6,oriki'nalt:cbn'dition.' 'Contractors-'s all �1)ej responsible. f 11
;'146Th' No. (54-!:T�ehchcst;l�*qst�eef�
kwhich��ir�ay�idevelopi��vithin.�biie, �e�ar iof,:complett'on�.?:-' %;
i: ,�'work`
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The -City of Edmonds
APPUCATION
for
SWE SEWMR PERSM
NEW CONSTRUCTION 0 REPAIRS 0 EASEMENT No - -------- ............
OWNER
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��.4� .... .......................................................... CONTRACTOR ef�7c ............................ PERhM No.!V&Y
ADDRESS .... .. . ....... .............. LEGAL DESCRIPTION: LOT No - ------------------- .......................... BL4DCK No - ---------------------
.......................
NAME OF ADDITION ................
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REGARDING: 20024 - 80th Avenue 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
ADDRESS of CALLER
5/l/74 Hunter Hicks Certified Letter No. 406306 sent Letter received.
5/1/74
5/13/74
6/25/74
7/1/74
7/9/74
7/23/74
requiring hook-up within 60 days.
Called with*numerous questions re
procedures for connection.
Explained that he can't pay connect ion
charges. Will keep in touch.
North End Septic obtained permit #4893.
Certified Letter No. 406563 sent Letter received.
requiring response by July 12.
INITIALS
TE
TE
TE
TE
TE
Called and requested.an extension to Extension granted and letter signed TE
7/31/74. 7/12/74.
Connection completed. TE
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CITY of EDMONDS
200 Dayton Street - Edmonds, Washington 98020 - Telephone (206) 775-2525
Department of Pubfic Works
Mr. Hunter Hicks
20024 - 80th Avenue West
Edmonds, Washington 98020
July 9, 1974
Re: Property at 20024 - 80th Avenue West, Edmonds
Dear Mr. Hicks: -
In reference to your receipt of a Certified Letter of -May 1,
1974,*requesting you to connect your property to the Edmonds s'anitary
sewer within sixty days; due to the hardship stated by you and indicated
below, you are herewith allowed an extension to July 31, 1974,
in order to make the subject sewer connection:
JBM:jt.
Time Extension Requested Because:
Contractor cannot
complete installation until end of month.
Sincerely,
,CITY OF MONDS
LBO
J. HERB G LBO
Director
ACKNOWLEDGED BY PROPERTY OWNER:
PROPERTY ADDRESS:
MAILING ADDRESS:
ACKNOWLEDGEMENT DATE: '7- /
4z
SEWAGE DISPOSAL PERMIT
Septic Tank .............. e9A. 9 ...... gals. No . ..... .7 ........
CITY OF EDMONDS
Department of P�Wic'*brks�
Diso..'Field ............. ..... sq.. ft.
Other.................................................
Name....................... ........................... ........................ 11� ........................................... is hereby authorized -to install/
repair se . wage disposal system -at
.......... J"e.
. ...................... 1.7 ....... . ....... .. ..................... ........................................ ...............................
..........
Date issued on ......
Permit expires ond: ear from date of issue
DO NOT COVER'BEFORE APPROVED BY DESIGNER OR SANITARIAN
I hereby certify this system was installed under my supervision.and-c6ntrol and comolies N�ith all provisions of the City.,
ofJDdmonds Resolutions...
Signatureof Installer ....................................... ....................................... Date .... ................... I ...........
ApprovedEJ D I isapproved- F-1 Date ................................................................. . By ...................................................................................
................................................... ..................... .. ........................................................................................... ...................
Remariki,'..: ..... ...... .
SANITARIANOR DESIGNER .................................................. Z ........................ ...................... Date ........ ...........................................
it.shall be posted in a reasonably"'c'onspic'uous place -job u leted.
This ':pe'rm on the ritil inspection has been comp
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STREET FILE
CITY OF EDMONDS
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
SEPTIC TANK INSTALLATION PLAN
Subnat in Triplicate)
r
—ADDRESS—OF�13R.0 Lot N Permit No .......................
.................
4 q P1
Owner ..... -T. 17 o�7 ...... ?7e- R_-,4_77. ............ Address. ....... ... i-A. Phone ......................
P1 -57
Builder ----- 04.ew oa.A . co._ ...... Address ...... ..... Phone. "V ................
Designer...,447F Address-
............................ Phone.PA... ....... ...
Installer_.A/-.r%� .................................................................... Phone,/!�,
. _W
Address
I hereby certify. the accompanying drawing is an accurate representation of the system installed at the listed
address. I also certify all recommendations and restrictions (concerning plumbing stub elevations, maintenance of
grades, fills, surface drains, etc.) listed by me on my scwage disposal system permit application dated ................
/W. 4
......... have been complied with.
.......................................
s1g... Date
TO BE FILLED IN BY CITY ENGINEER ONLY
Accepted......................... ....... ......... ............... Date...
Not Accepted ............. Date . . . .....................
Signature of framftmIlff-h ...... 1� ........ .. ... -------- . ..................................
Remarks:.... . ....... ..........
................ . ....... .......... .............. ......
.. ... ........
INSTRUCTIONS: Use the reverse side of thi's form for the drawing. Use a scale which will permit the greatest
detail and still contain the entire site on one page.
ATTENTION HOME OWNER:
Your septic tank has limitations! It was designed and installed to care for an average -size family. Over-
loading the septic tank or disturbance of the. drain -field may seriously impair satisfactory operation. Points to
remember:
I . Have your tank checked periodically to see if pumping is necessary (2y2-3 years).
2. Do not channel ground water, surface water, footing drains or downspouts into the tank or drainfield.
3. Do not excavate, fill, place a structure, driveway or - patio in, on, or over the drainfield.
4. Limit toilet fixture disposal to sanitary wastes and toilet tissue.
5. Detergents and bleaches used in normal household quantities will not harm the action of the septic tank and
disposal field.
31V17 JN10-C AV-7eO
IN
CITY OF EDMONDS
DEPARTMENT OF PUBLIC WORKS
250 Fifth Avenue North, Edmonds, Washington
APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT
(�ubmit 3 Copies)
Permit to be issued to: ------------ HerT ... Lumbar ... Co!*' --------- for -Roy ... Treat.
For installation at: (street address) ... .......... Z0024-8Qth--Ave�.---Wi . ............ MdjnonAs .... ....... I .........................................
Addition or Subdivision ... Eaat.-Ed=nds.-Aer.es-.Dii�...Xo�. _2 --- ...... �!...*..Of ........ Lot --- 22 ........ Block ................
Type of Building: New.T0.8.... Existing -No..... Single family residence.-YeV ...... Number of bedrooms ----- ... I ..........
Other: (specify type or use) ------------------------------------------------------------------- ------_------- _ ----------- ----------------- ---_---_------ ...............
Builder..4�rr Lumber Coi
........... _!!� ........ ................................. Address_ 490-. Haxbor Ave* S,W.9 Seattle
.................... ............................
Designer ... X0.0 8_QhT0.e:tQr ------------ ------------------_- Address.. 15.62-2.114-leV414.. AT01.4...
Soil Log Hole No. 1 ---- � ..3.6"...yellow --- sand -and gravel;-1211-tight.white -silt ... .. ................. . .
Soil Log Hole No. 2 ....... 4211 sand and gravel; 6.11 --- vi_lt� ................................. ............................................
------------_ ----- . .................
Elevation of Water Table, if encountered. (Distance from ground surface) ............... non .............................................
Corrections to control surface water if needed... ............ none ................................................. ..............................................
Specify if any removing or grading of topsoil in field area— &M.-V.-to ... 121.1 ... 0f...topaoil-.from ...................
... aver ... drainftald..area ........................................................
Percolation:
Test Hole No. I —Average Rate .............. 2.)....Q. .................. (Fall in ininutes/inch-bottom 6" test hole)
Test Hole No. 2—Average Rate ............. 3f.4 ............................... .... (Fall iff minutes/ ottorn 6" test hole)
Test Hole No. 3 —Average Rate ............. 24.0_ ........... ........ ... . ....... (Fall in in nlh- test hole)
4�4 -Qj� WAs
. ... ......... ..
Average percolation rate on which to base drain field desgn ...... 10-25."fi5_
rT"
Septic tank requirements based on present rules and regulations: 'k, W
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Septic Tank Size .... ............. ..gallons.
Amount of Square Feet of Di osal �Field . . . 300
00
"W"
. . ..................
Desi .. ... .. . D_ 6 ri
Signature igner ...... . ... ... 4 .... . .... .................... ...........
I
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit issued date) ................. ..... _ ............. Permit Number ---------- ................
Remarks:..��. ... f_it- ..........
"-e . ................. ..................
----------- ... . . Z ... . .........
/ . ..............................................
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L--"GEND
GAL. c-,EPTI(-- TANK MIN.
F1 T 0 N BO X
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LINE (41")
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LEONARD 1, SCH.RO921ER
Civil Enginew &Land Surva-for
L-i:-.d F--odivision & Utilities
Perc-Ant;on Tests & Structural Design
i5622 Maplawlid S. W.
Sea'�tle; Washington Y8166
CH 2—.5621
Dete
RECEIPT FOR CERTIFIED MAI L.30�. (plus. postage)
R ARK
SENT TO
(Y) S'REET AND -NO.
0
L(l) P.O., STATE AND ZIP CODE
C2) OPTIO41L SERVICff FOR Ab ONAL FEES
—�I. Shows to whom and ame aulivuruu
RETURN , With delivery to addressee only 650
RECEIPT 2. Shows to whom, date and where delhiered 350
SERVICE With delivery to addressee only ............ 850
—'6—ELIVER—fO —ADDRESSEE ONLY .. - - - .. - =�
SPECIAL DELIVERY (extra fee requi red) -
PS Form 3800 NO INSURANCE' COVERAGE PROVIDED— (Sao other side)
* GPO: 1970 0.397-455
Ap 1971 NOT FOR MERNATIONAL MAIL
CD
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7-30� (plus, postage)"'
RECEIPT FOR CERTIFIP-MNk,
P-1
4 18-04 100 , * ORI)AT
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HICKS, HUNTER E_
W. APR
20024 80TH AVE.
EDMONDS, WASHINGI'ON 0-,
98020 10 V
OPTIONAL SER CES FOR ADDITIONAL FEES
ham and date de
1 Shows livered ............ 150
RETU - With delivery. to.ad,dressee only 650
I �T 2. 'She t whom, date an i 850
RE IP d where delivered 350
W' to only
SERV W h delivery to addressee_ ....
NS ' — I 50d
At EE ONLY .... . ...... ............. 50d
red) I ....................
Form NO INSURANCE cuvERAGE PROVIDED— (See other side)
PS 3800 * GPO: 19700-397,4116
Apr. 1971 NOT FOR INTERNATIONAL MAIL
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