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20301 MAPLEWOOD
DR
CITY OF EDMONDS - SIDE SEWER PERMIT
I WATER -SEWER DEPARTMENT
PERMIT -
0
Call 775-2525 for side sewer inspections BEFORE covering any portion of the construction.
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.)
ADDRESS LOCATION OF CONSTRUCTION ........ 20301 Nin-plewood Drive
. .................................................................................................. . .......................................................
PROPERTY LEGAL DESCRIPTION ......................... (see attached)
..............................................................................................................................................................
...................... . .......................... . ...................... . ........................................................................ . ............... .................................. . ..................................................
................................................................ OWNER AND/OR BUILDER --- E'.&HOYAk ................. . .................................. . .......................................................
CON�TRACTOWS NAM & ADDRESS ..... L...J ...... R.oth --- Conslruc.ticn ... Co ....... ... 2.392.0 ... ..... 84.th._W...� ... Edm.onds .................................
.. .... .. .......... .. ....... .......... ..... . .... ..... ..... . ........ ..........
Permission Is gran ' Seaember 19
ted ..... ...... ................................ ............ 1 1917., for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City of Edmonds ordinances.
A&TION IS CALLED TO THE FOLLOWING: — %
NOTE No. 1—The owners of the property may obtain a permit to construct sewer inside property lllne.?,�A licensr-FS—ide Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before It has been inspeelied. N, \ 1k
NOTE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way PermJt obtal - nable from-thffity Engineer's office.
NOTE No. 3—Obtaln full information regarding Ordinance 11.16.030 and Regulations governing side sewers jvhen yo-T-9ejApermit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inkib-property line\; minimum grade of 2%. No bends in grade
sharper than % will be permitted.
NOTE No. 5--TrencheB in street must be water settled and surface of street restored to originaJ condition. Contractors shall be responsible for failure due to Improper
work which may develop within one year of completion.
NOTE No. 6—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 appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED n Date .... ........................... By ..... Date .............. it; ... . .......... B ................ Date ............... . ................... . By ................
..........
D Date ... . .....................
APPROVE ...... By ... . ........ . ......... ...... .....................................................................................
RemaLl: ........ ............................................................................................. 11 ...... . ....................................... ..............
..................................................................... . ........................................................................................ . .................................. . ................ .....................................
BOTH Permitc6pl S ST Be Signedy �Ow7. of, Firm Performing donstruction PRIOR To Request For Inspection
P
r G .................
I .............. X, .... ...... ..... ..... . . ........ ... hereby certify that the side sewer installation constructed under this permit
(Owne� cti g - rn�ing Construction)
wne j, of,.66'nt� P r G
'i'
c wt I go
�astalled�.in accof&n It ning ordinan�es of the City of Edmonds.
Datedthis ............... . ........... day of ................................................................. 19 ........ 1.
Check BEFORE you dig goi: Water C], Gas E], Telephone El, Po wer E], Sewer E]i Other 0 VV
The City of Edmonds
APPLICAPON
for
SIDE SEWER PERMIT
NEW CONSTRUCTION A----iEPAIRS R
d
OWNER--------- /Z,0*Ur- L - ---------------------------------- --------------
JOB ADDRE SS ----- ---- I ---------------- ----- An, - --------
Al
EASEMENT NO - ------------------------ -------------------
LID NO - --------- ------ - IASMT. NO - ------------------
CONTRACTOR k - ----- -- -- - ------------------ PERMIT NO. -15?Z5
---------- - ----- -- -- I -----------------
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LEGAL DESCRIPTION: LOT NO. ------------------ BLOCK NO - ---------------------- -------------
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. . . - --- --- �l i ---------------------
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
Approved:
DATE
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Examined by
APPLICATION
The City of Edmonds for EASEMENT NO . ................. --------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS F� LID NO - ------------------ - ASMT. NO . ..................
OWNER ......... ................................................. CONTRACTOR - ----- 5;�Qt�4� -------------- PERMIT NO.
JOB ADDRESS LEGAL DESCRIPTION: LOT NO - ------------ t-s: --------------------- BLOCK NO - ------------------------------------
11
NAME OF ADDITION -------- ...... t
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Approved:
DATE.. By
............... ............. -------- -- - ----
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ApplicantFill
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OERMIT APPLICATION
Inside Heavy Lines
JOB
ADDRESS
0301
NAME (OR.NAME OF BUSINESS)
16 US k1A AJ IQ
IMArLING ADDRESS
]REMARKS
LEGAL LOT
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LOT
VIEA
SUBDIVISION NO.
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STREET R/W
EXISTING STREET R/W
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COMP. PLAN ST. R/W (ID
FT. DEFICIENCY THIS PROPERTY
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CITY
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ELEPHONE NUMBER
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NAME
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TELEPHONE NUMBER
STREET AND/OR UTILITY WORK
R/W PERMIT REQUIRED
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REQ'D. 0 YES
V NO
1:1 YES ;RkNO
NAME
UNDERGROUND
m I(LA 03 #A /V U e0A)YER
WIRING REQ'D.
2 YES ONO
0 ADDRESS
TYPE CONNECTION
&YES
VERIFIEDfY
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SANITARY SEWER
El NO I
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TELEPHONE NUPSER
SEPTIC SYSTEM
E]yES
PERMIT NUMBER
APPV'D BY CITY ENG.
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CITY LICENSE NUMBER
REMARKS
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Legal Description of Property (Show/Below or Attach Four Copies)
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BUILDING SUPPL Y SIZE
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REMARKS
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SIGN AREA
ENV. REVIEW
ADS NO.
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ALLOWED PROPOSED
COMPLETE EXEMPT
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REMARKS
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VARIANCE OR CU
PLANNING REVIEW BY
DATE
YARDS
FRONT
SIDE '�!;"R E A RI
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LOT COVE AGE
NEW R:SIDENTIAL GAS
FIRE ZONE
TYPE OF
CONSTRUCTION
LINE
L
N N-RESIDENTIA SIGN
ADD
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ICODE
ECIAL INSPECTOR
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-TO
DEMOLISH RETAINING
WALL
ElALTER EXCAVATE FENCE
REQUIRED
0 YES 0 NO
JOCCUPANCY
GROUP
LOCCUPANT
LOAD
OR FILL I— X—Fr)
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
0 REPAIR PRE -MOVE WIM
INSP. ;OOL
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
NUMBER OF STORIES
-
NUMBER OF
REMARKS
DWELLING
UNITS
NATURE: OF WORK TO BE DONE
A�A) & A I _'�' 7 P 0 e'J I n eLIT
PROPOSED USE
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PLOT PLAN (INDICATE BUILDING S
ABUTTING STREETS)
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VALUATION FEE
PLAN CHECK
NO.
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
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