20316 87TH AVE W.PDF111111111111
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20316 87TH AVE W
890 - 19() -
City of Edmonds .
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number:
.9-6-422�1
Issue Date: /-/j - / i - ;� �- ,
A. Address or Vicinity of Construction: 20636 81 A-v W (9622812)
B. Type of Work (be specific): lastaIl Siury5.czi
C. Contractor: Nggjftrq,� r�tlg
Mailing Address: 1122 J5 St SW �Kytnrptt
State License #: 98203
D. Building Permit # (if applicable):
Contact: NariaLlne Kingsbury
Phone: fi-xv 'i-AA
Liability Insurance: Bond: $
Side Sewer Permit # (if applicable):
E. [-] Commercial F] Subdivision El City Project Ja Utility (PUD, GTE, WNG, CABLE, WATER)
E] Multi -Family E] Single Family F1 Other
INSPECTOR: 114SPECTOR:
F. Pavement or Concrete Cut: El Yes []No G. Size of Cut:_ H. Chargt�,$
APPLICANT TO READ AND�i4�N
INDEMNITY. �Applicant understands and by his signature to this application, agrees to hold the City ofEdmond8 harmle8sfrom 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 its departments or
employees, including or not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason ofgranting thi8permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
Construction drawing of proposed work required with permit application.
A 24 hour notice is requ'ired for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the above statements and understand the permit requirements and thepink copyof thepermit willbe
available on site at all tjm for inspection.purposes.
Signature: Date:
�Wontractol�;r Ag-e?�i)-/
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER VDF-(— 10 DAYS
SPECIAL CONDITIONS: WA
COMMENTS:
DATE:
DISRUPTION FEE/FUND 111:
RESTORATION FEE:
PERMIT FEE.
TOTAL FEE:
RECEIPT FEE:
ISSUED BY -
NO WORK SHALL BEGIN PRIOR TO PERMIT'ISSUANCE Eng. Div. 1994
FIELD INSPECTION NOTES
Comments:
Diagram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION El YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
El NO
MAAL- —IL2—
IMUMN 7w�-
306as—
AVAY)*Vlcn ErOW CcrrVMV
Watermain depth---�-? 11
gas main
Addendum to: CitV of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
Key:
-W-
-G-
-SS-
0
Water
Gas
Sever
Water hydrant
Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett. Washington 98203, (206) 355-3.131
AML- M-IL-
Vw0VM9V%wV9 —
HatLmrMGww`
AVWdvXfion ErXwWCaTVtYV
I
Watermain depth--5,7 11
IYar gas main
Addendum to: City Of Edmonds
Right of Way
Permit Application
Submitted by: Mariamne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
Key:
-G-
-SS-
0
Water
Gas
Sever
Water hydrant
Water valve
Washington Natural Gas Company
1122 75th Street S.W.. Everett. Washington 98203, (206) 355-3-131
AML- IL-2—
NaINENGOIs—
A V&tO*Kjfcn I rXwWCOrrVkTV
I
Ckk1—
Watermain depth-:�? /I
Iyar gas main
Addendum to: c1tv of Edmonds
Right of Way
Permit Application
Submitted by: Marianne Kingsbury
Engineering Aide
Washington Natural Gas
1356-7500 X7596
Key:
-G-
-SS-
0
Water
Gas
Sever
Water hydrant
Water valve
Washington Natural Gas Company
1122 75th Street S.W.. Everett. Washington 98203, (206) 355-3331
JUMPUCATION
for
The City of Edmonds SIDE F5EVVEB PEBNW
STREET FIL&W CONSTRUCTION E] REPAIRS r]
-, "I
OWNER ...... ..........
ADDRESS .2-9-3.14 ........... 6 7
...........
....................
EASEAMM No.
CONTRACTOR
....... PMUUT No
LEGAL DESCRIPTION: LOT No . ........ ? ................................. BLOCR No . ............................................
, -_2
NAME OF ADDITION ... ........ it ';_,*
Approved:
MV
11M
. .... ........... ............
............ BY -- ............
NOTICE:
nt—yOT
No--Wa r-ra
The information *shown on the attached
map(s) was compiled for use by the City Of
Edmonds/ its Employees and Consultants.
The City of �Edm.qnds does not. wa rra nt the
accuracy of anything set for.th on these
Map(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform-ati - on shown on
t-Fe -map(s), including, but not limited to, -h
th . e lociation of any sew-er stub shown. Suc
not ex st and may
sewer stubs may or may
or may not exist at the location shown.
Neitheir the r-ity of Edmo'nds nor its
empl-o-yee-s o-r office-rs -shalfl be 11a.b.-Ife for -11-he
information given on this rnap(s), nor for
e representation provided based
any on
upon . said map(s),
CITY OF EDMONDS Can pp
,ospect 6-1101 when work
civic CENTER—WATEH-SEwER DEPARTMENT is ready for inspection- (No 'naPec'
tions Saturday, Sunday or holidays.) N2 3559
SIDE SEWER PERMIT
20316 - 87th Avenue West ......................................
ADDRESS---------------------------------------------------------------------------
O'"WER -------------- )�� --- prq i A --- S)Iiqlld .................................. CONTRACTOR ... ----------------
Perinission is granted ------ F@1?;P!kary --- 4 ------------ 19.:TQ., for --------------- - ------- dAYS to REPAIR or CONNECT a side sewer
witIl City Sewers in accordance with aPPlication on file and governing ordinances.
ATTENTION is CALLED TO THE FOLLOWING: side property line. A licensed Side sewer contractor must
NOTE No. i—The owners of the Property may obtain a permit to construct sewer in
be employed to construct side sewer in street area. I)o not cover any portion of sewer before it has been inspected.
—Obtain full information regarding ordinance 11.16.030 and Regulations governing side sewers when You get permit.
NOTE No. 2 must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%.
NOTE No. 3—Top of side serwer
No bends in grade sharper than % will be permitted. s shall be responsible for
NOTE No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractor
failure due to improper work which may develop within one year of completion. a
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 PPur-
tenances except to insert the pipe into the wye.