20320 85TH PL W.PDF111111111111
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20320 85TH PL W
I
NOTICE: I
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I
The information'shown on the attached
Map(s) was compiled for use by the City Of
Edmonds� its Employees and Consultants.
Th.,e City of �Edm.qncls does not * wa rra nt tj ,2-
accuracy of anything set for.th on t hese
rnap(�-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform'ation shown on
tITe -map(s), including, but not limited to,
th-e lociation 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 Edrnbnds nor its
emp-1-o-yee-s o-r office-rs -sh-a-11 be Via-b-Ife for t-he
n on this map(s), nor for
information give'
any one representation provided based
upon . said map(s).
Water tervice Drawing
The City of Edmonds EASEMENT NO . ...................................
NEW CONSTRUCTION 0 REPAIRS 0 LID NO . .................. . ASMT. NO . ..................
OWNER................................................................................................ CONTRACTOR .................................................................................... PERMIT NO.9840qP ......
PL
JOB ADDRESS ............ 8 . .......................
2-039-0
8 S-rA� PL.
4 ar I, copp4n
CP 11
PWW-0001-11175 (REV. 11/78)
LL
17 1
LEGAL DESCRIPTION: LOT,.NO . ...................................... BLOCK NO . ....................................
................................................ : .................................................................................................................
NOTICE: NO WARRANTY OF ACCURACY. The information shown on the
NAME OF ADDITION .......... attached. map.was.compUed . for. use .4 -ft-City -at-Ed friployees
u
"a
and consultants. The C-4ty of Edmonds does not war=an theft cy of
anything set forth on the map. Any person or entity requesti a copy
should conduct an Independent Inquiry regarding the information hown on
Ahe map, inducing, but not limited to, the location of any sewer b showfL
Such sewer stubs may or may not e)dst and may or may not st at the
location shown. Neither the City of Edmonds nor its employees officers
shall be liable for the information given on this map, not foilany oral
representation proAdec! based upon said map
tro-5,
P/C 'I
2 1
_j
P_
Approved: *5/9 S I
DATE ..... 3/1 o .. �9 . 9 ............... B)-A ................................................
........... ...... ....
PROJECT REVIEW CHECKLIST
PROJECT NAME:--., W IA� IN_
PROJECT ADDRESS: so-� W
7
on -
PLAN CHECK #: —lam&
RECEIPT DATE-41
IREVIEWPI)
BY.
PLAN.
IWATER
�itiallDa �e,
COMMENTS
11�71 1 " r �� q W, --,
Setbacks/Variance/Set :ment
Conditional Use Permit
p p
- - - - - - . . . . . . . . . . . . . . . . . . . . . .
2
3
ADB Requirements
Other Zoning Requirements
4
XX
Underground Wiring Required
Lot Slope 15%
. . . . . . . . . . . . . . . . . . . . . . . . .
5
6
SEPA Environmental Checklist/Hydraulics Permit
Tree Cutting Plan
7.-
Plat/Subdivision Requirements
......
8 -
Legal Description Verification
. . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . .
10
Quit Claim/Street Dedications
Easements - Public/Private
. . .... X
Engineering Storm Drain Review Fee
.30
Engineering 2.2 Inspection Fee tip
3
........... ...........
Drainage Plan (On -Site)
Setback - Top of Bank, Stream, Water Courses
15- .
Setback - Storm Drain Line
Open Ditch - Existing
-23
18
Culvert Required
Culvert Size
19
20';!
Shoulder Drainage/Shale Open Runoff
Catch Basin Required
Driveway Slope & Vehicle Access
..............
23
Sidewalk Required
222;
Curb & Gutter Required
...... ...... ..........
25
Curb Cut For Driveway Required
V, ....... ---
�6
Street Paving Re uired
Right -Of -Way Construction Permit Required
*.*-.*.*.*.** - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
27
.................... . . . . . . . . . . . . . . .
28.
Street Name Sign Required
...............
Other Signing Required
..........
Bond Required For Public Improvements
FEMA Map Check/Water Table
31:�
Side Sewer Availability
Calculate Sewer Connection Fee If No
. . . . . . . . . . . . . .
Create Street File
Existing Water Main Size
... 36:
Water Meter Size
3 7
Service Line Size
�f
Water Meter Charge Required
39
Hydrant Required
_40
41,�
Hydrant Size Existing
Fire Line Charge.Required Sprinkler
IStreet Cut
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
42
43
[Miscellaneous
..... ... ..
......... . . . . .
Reviewed By:
FIRE
PLANNING
ENGINEERING
S
PUBLIC WORKS
R- WCE Fya�j
S E P I
R E C 0 R D OF C 0 N T A C T S
1
21
2
22
3
23
4
24
5
25
6
26
7
27
8
28
RW PERMIT # DATE ISSUED RECEIPT #
9
29
10
30
11
31
32
13
PAID $ RECEIPT # DATE
33
SS PERMIT # 99,20 DATE ISSU' -9,5( RECEIPT # ///y
EDal4a5L
14-
PAID $ RECEIPT # DATE
34
15
35
16
36
37
METER SIZE'//'/71. PAID $-gaZ)/Y�QATE,�/��59 RECEIPT # 111415?
18
38
19
39
20
40
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LFIC
CITY
ERICH 0. TIETZE AND AsSOCIATES INC.
Engineers and Consultants
18530 76th Avenue West Suite B Edmonds, WA 98026 206-771-6212 FAX 206-775-0236
Mr. Don Fiene November 26, 1997
City of Edmonds APPROVED
121 5b Avenue Noah
Edmonds, WA 98020 T(-1
SUBJECT: Drainage Plan for D.W.A. Construction, SF Residence, at 20320 85th Place W, Project # 97-2946ri-
9-08
Dear Don: cot,
Ine enclosed plans were developed in accordance wi the Department of Ecology Stormwater management
Manualfor the Puget Sound Basin. The total impervious area for the site and the associated easement drive is 5,621
SF. The detention design is based on matching the existing runoff rates for the I 0-year and I 00-year storms. As we
discussed previously, the system will requ re uming to discharge to the catch basin in 85h Place West. The pump
i p 7m__T _
is designed to handle the peak discharge rate or he 100-year storm. Runoff in excess of the pump capacity of
during conditions of power outage or power failure will result in overflow from the flow control structure (CB; API).
The overflow will sheet flow across the site to the low point in the southwest comer of the site. This is where runoff
from the existing site presently discharges.
The point of discharge from the pump force main will be at a catch basin located on the west side of 85th Place West,
as shown on the plans. The catch basin enters the City drainage system. No evidence of flow or erosion problems
were identified in the system for a distance of 1/4mile downstream.
Respectfully submitted,
ERICH 0. TIETZE AND ASSOCIATES, INC
RECEIVED
Erich 0. Tietze, P.E. N 0 V 2 6 1997
President
NG
- $ 000
6-
Ex PI)qK:5 9(9 -Ppq Y'5
Ai5em IT
CITY OF EDMONDS
Address of Construction:
Property Legal Description (Include all easements):
SIDE SEWER PERMIT
I
, 1�0
PERMIT I — 83 9 2. 0
TREATIVIEW PLANT
F E B � �
PUBLIC WORKS
Owner and/or Contractor:
State License No. Building Permit No. !F&C900
ASingle Family Invasion into City Right -of -Way )-p No 0 Yes
0 Multi -Family (No. of Units—) RW Construction Permit No.
0 Commercial Cross other Private Property No El Yes
El Public Attach legal description and copy of recorded easement
I certify thatl(have read and shall comply with all city requirements
as indicated on the back of the Permit Card.
7's r lilel
Date I
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION *
F sibNLY:
FOR INSPECTION CALL ff+-32ft, PUBLIC WORKS DEPT.
72 '_�J _22
Permit Fee: Issued By
Trunk Chargel'5-- Datelssued:
Assessment Fee: Receipt No.:
Lid No.: / �' J
Partial Inspection:
Comments
Date —Initial
Reason Rejected: Date —Initial
Final Inspection Approved: Date Initial 00
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant Revised 3190
Side Sewer Drawin
The City of Edmonds EASEMENT NO . ................................... 11
NEW CONSTRUCTION REPAIRS F� LID NO . .................. . ASMT. NO . ..................
OWNER................................................................................................ CONTRACTOR ..... ................. ............................................................ PERMIT NO. -43-92-P
JOB ADDRESS .... 2 01.�Z P ...... 8.5.70 .... ..................... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
..................................................................................................................................................................
NAMEOF ADDITION .......................................................................................................................
Approved:
PWW-0001-1 1/75 (REVA 1/78) DATE
IL
0
(V -
4f .............. By ........ JO) .. UT .....................
...... ... .. .... ....
17
CityofEdmonds
RIGHT-OF-WAY CONSTRUCTION.
PERMIT Permit Number.
Wue Date: 3
A. Address or Vicinity of Construction:QC2Q0 3 STIA P kw LJ
/17 C) QJ B. Type of Work (be specific):T(ZCi,30A %Itl Cil-1 -9-1Q NWO
C. Contractor: 4SMC)gCj�Ak<.-
WC6ntact:
Mailing Address: Phone: C�- 32.0 9
�k
State License #: Liability Insurance: Bond:$
D. Building Permit # (if applicable):
JE. 171 Commercial Subdivision
171 Multi-Farnily Single Family
INSPECTOR:
Side Sewer Permit # (if applicable):
'J
f
El city ProjAct) 1i lliy (PUD, GTE,-)?��G, CABLE, WATER)
EJ Other
INSPECTOR:
F. Pavement or Concrete Cut: Yes F-1No G. Size of Cut:,L(:j x fl�V_ H.. Chargq,$
APPLICANT, TO READ. AND SIGN C NC ROAO
INDEMNITY: Applicant understands and by his signature to this application to hold the City of Edmonds'harmlessfrom injuries, damages, or claims ofany
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 of any legal proceedings including defense costs and afforneyfees by reason of granting this permit.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMA NSHIP AND MA TERIA LS FOR APERIOD OF ONE YEA R FOLIO WING THE FINA L INSPEC-
TION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCHIS COMPLETED
BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT
Two sets of construction drawings of proposed work required with permit application.
A 24 hour notice is required for inspection. Please call the Engineering Division, 771-0220. C-Q)Q) zo,�.-JAP
Work and material is to be inspected during progress and at completion. A>sq(-V-k
Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times. Q(3 4:1" C)
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City En gineer.
Afi;treet cut trench work shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and under'stand,ongermit requirements and the pink copy of the permit will be
available on�&ite at alLtimes for insnection n2wnoses.
Signature,
Date: 2. — q- 58
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: kiz&Z
TIME AUTHORIZED: VOID AFTER led DAYS
RIGHT OF WAY FEE:
DISRUPTION FEE/FUND I 11:
SPECIAL CONDITIONS: RESTORATION FEE:
O,TA.L.FEE:
RECEIPT NO.:
im
ISSUED BYA6
4
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997
FIELD INSPECTION NOTES (Fund 111 Route copy to Street Dept.)
Comments:
2
Diagram.:
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
�00000_
City offEamlonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number.
Wue Date:
A. Address or Vicinity of Construction:2 0 �,)_o - 9, L , W
n o CJ
T
13. rk (be specific: GTE to lace . onerate
iI4T3-,1-6cated
& maintain a bur
ed
c J.S arvice
wire froynox1iMoing pole 0 224,St
S-K S"81'PL� W.,
then
w est to a residence @ 20320 85 P1. W_ GT9 to njp�; I
n J.%T T'7'qJz
X push
a road 20 feet.
Contractorc.-
P�LO(-r4
Contact
Nr�uAi :?r-owt-r CC-)o1)_hJ1-'JA-M0-
C�b
Mailing Address2-
g'-'N
V4 Phone:LAII-r, -11 () -0()
9Q--AA'4LL0
L4 -9 00-
State License #:
Liability Insurance:
P
Bond:$
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. F] Commercial Subdivision El City Project Utilit (PUDCGTE, WNG, CABLE, WATER)
01 P()o i b-16 -A)
E] Multi -Family Single Family E] Other
INSPECTOR: INSPECTOR:
G. Size of Cut.-_:;�_/x H. Cha.Lr/jt�/"
F. Pavement or Concrete Cut Yes EINOC'2�
APPLICANT TO READ AND SIGN
P 5 1 C8 o
INDEMNITY.- Applicant understands and by his signature to this application to hold the City of Edmonds harmlessftom injuries, damages, or claims ofany
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 of any legal proceedings including defense costs and allorneyfees by reason of graniing this permit.
THE CONTRA CTOR IS RESPONSIBLE FOR WORKMA NSHIP AND MA TERIALS FOR A PERIOD OF ONE YEAR FOLLO WING THE FINAL INSPEC-
TION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREETPATCHIS COMPLETED
BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT
Two sets of construction drawings of proposed work required with permit application.
A 24 hour notice is required 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 trench work shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and rsta th it re uiretnents and the pink copy of the permit will be
available on site at all timesfor inspe opos.
ur
Signature: Date: L4 -at _q 2
'or t'nC P
�fz�_ CCC
06v ((I S inG R:- A Cce q S
qU I 4Contractor or Agent,,5c- A
RJ� S n E -, �1' I
CALL DIAL -A -DIG PRIOR TUBMI&NING WORK
FOR CITY USE ONLY
APPROVED BY. 94
TIME AUTHORIZED: VOID AFTER lk A DAYS
RIGHT OF WAY FEE: 50 1 e0c)
DISRUPTION FEEIFUND I 11:
SPECIAL CONDITIONS:_� RESTORATION FEE:
T OTALFEE:
R-ECE.I.RT.N.O..:
ISSUED.B
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div 1997
FIELD INSPECTION NOTES (Fund 111 Route copy to Street Dep't.)
Comments:
CONTRACTOR CALLED FOR INSPECTION D YES NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
0)
OD
Q
co
CD
LECsEND
,357 PL Ld PEDS a
POLES 0
906 pet ROAD BORES
OvERHEAD LINES
.2 0-25, I.D.UTILITY P07HOLE EM
PERMIT SUBMITTED BY U(; TRENCHING --UGT-
GTE JA L ;tylr—
L -4
A 1:1 w
f.2
OR Of
R.O.W.'
-0;7---- EOP
— — — — — — — — — — — — — — — — — — — — — — — — — PA
" - — — — — — — — — — — — — — — — — — — — — —
9�011 -s-r sci
-------------------- m — — — — — — -- — — — — — — — — — m — — — — — — — — — — — — — — — — — — —
THE FOLLOWING INFO TO BE PROVIDED
RIGHT OF WAf LINES.EOP OR FACE OF CURB, EXISTING, SIDEWALK. POLES, ROAD CUTS ANO THE UTILITY LINOER R AD Ck,
0
ABOVE GROUND FACILITIES,(Ie-.) PEOS,BOXES.CABINETS, ETC..UNDERGROUND TRENCHING AND OVERHEAD LiNES.
FOOTAGE OF WORK IN R.O.W.
DATE:
� 0
0
I
MEMO TO:jr/eeZrT
FROM: (!�(f k1
SUBJECT: SEWER CONNECTION CHARGES
.:;) 03.po- (f P,�. le).
(Street Address)
�O, 4AJ 0 6-P—C o,�
(Legal Owner)
Z /,D -el4l
Single Family Residence A,"'� Subdivision Plat
PRD Multiple Commercial
LEGAL DESCRIPTION: ,S 23 (,,D C ,c-I e &-5
Z.F.F. Calculation:
Z.F.F. x $ OC? Connection Fee
Lateral x( $ Lateral Charge
$ Equivalent Count
(when applicable)
Unit(s) x($25.00 $ z Trunk Charge
$ &0 Permit
st
63
TOTAL
X . 0 0 ';z :,?,o - 7
F 1-vz�,rf- =-
43
ERICH 0. TIETZE AND AsSOCIATES INC.
Engineers and Consultants
1 18530 76th Avenue West Suite B Edmonds, WA 98026 206-771-6212 FAX 206-775-0236
Mr. Don Fiene November
City of Edmonds
0
121 5h Avenue North
Edmonds, WA 98020 'Pe
'94f 81S9
SUBJECT: Drainage Plan for D.W.A. Construction, SF Residence, at 20320 85h Place W, Project # 97-294 11041 1$1�
Dear Don:
The enclosed plans were developed in accordance with the Department of Ecology Stormwater Management
Manualfor the Puget Sound Basin. The total impervious area for the site and the associated easement drive is 5,621
SF. The detention design is based on matching the existing runoff rates for the I 0-year and I 00-year storms. As we
discussed previously, the system will require pumping to discharge to the catch basin in 85h Place West. The pump
is designed to handle the peak discharge rate for the 100-year storm. Runoff in excess of the pump capacity or
during conditions of power outage or power failure will result in overflow from the flow control structure (CB #I).
The overflow will sheet flow across the site to the low point in the southwest comer of the site. This is where runoff
from the existing site presently discharges.
The point of discharge from the pump force main will be at a catch basin located on the west side of 85h Place West,
as shown on the plans. The catch basin enters the City drainage system. No evidence of flow or erosion problems
were identified in the system for a distance of 'Amile downstream.
Respectfully submitted,
ERICH 0. TIETZE AND ASSOCIATES, INC
�� 0 * �` RECEIVED
Erich 0. Tietze, P.E. N 0 V 2 6 1997
President
4E R I N G
0
-7 $0
5� IMP
6-00
F L, 0 Uj&
=b
tR- 50 5-F I fV 6
S.C.S. TYPE -lA RAINFALL DISTRIBUTION / 0 _,�s vle
ENTER: FREQ(YEAR), OURATION(HOUR), PRECIP(INCHES)
10 24 2.0
----------------------------------------------------------------------
S.C.S. TYPE -IA DISTRIBUTION
10-YEAR 24-HOUR STORK **** 2.00" TOTAL PRECIP.
ENTER: A(PERV), CN(PERV), A(INPERV), CN(IMPERV), TC FOR BASIN NO. 1
0.371 81 0.0 98 25.3
OATA PRINT-OUT:
AREA(ACRES) PERVIOUS IMPERVIOUS TC(KINUTES)
A CN A CN
.4 .4 81.0 10 98.0 25.3
PEAK-Q(CFS) T-PEAK(HRS) VOL(CU-FT)
.03 8.00 811
ENTER (d:](path)fiIename(.ext) FOR STORAGE OF COMPUTED HYDROGRAPH:
ANOEREX.10
S.C.S. TYPE-1A RAINFALL DISTRIBUTION loo -
ENTER: FREQ(YEAR), DURATION(HOUR), PRECIP(INCHES)
100 24 3.0
---------------------------------------------------------------------
S.C.S. TYPE -IA DISTRIBUTION
100-YEAR 24-HOUR STORK **** 3.0011 TOTAL PRECIP.
S.C.S. TYPE-lA RAINFALL DISTRIBUTION 10-
ENTER: FREQ(YEAR), OURATION(HOUR), PRECIP(INCHES)
10 24 2.0
------------------------------------------------ n, ---------------------
S.C.S. TYPE -IA DISTRIBUTION
10-YEAR 24-HOUR STORM **** 2.00" TOTAL PRECIP.
------------- ---------------------------------------------- 7 -------
ENTER: A(PERV), CN(PERV), A(IMPERV), CN(IMPERV), TC FOR BASIN NO. 1
0.242 86 0.129 94.6 tX 0.6
DATA PRINT-OUT:
AREA(ACRES) PERVIOUS IMPERVIOUS TC(MINUTES)
A CN A CN
4 .2 86.0 .1 94.6 .6
PEAK-Q(CFS) T-PEAK(HRS) VOL(CU-FT)
.13 7.61 1424
ENTER [d:][path)filename[.ext) FOR STORAGE OF COMPUTED HYDROGRAPH:
A6ERDEV.10
S.'C.S. TYPE-1A RAINFALL DISTRIBUTION I 0c)
ENTER: FREQ(YEAR), DURATION(HOOR), PRECIP(INCHES)
100 24 3 .0
-------------------------- -------------------------------------------
S.C.S. TYPE -IA DISTRIBUTION
100-YEAR 24-HOUR STORM **** 3.0011 TOTAL PRECIP.
-------------------------------------------- ------------------------- --- ----------------------------------------------------------------
ENTER: A(PERV), CN(PERV), A(INPERV), CN(IMPERV), TC FOR BASIN NO. 1 ENTER: A(PERV), CN(PERV), A(INPERV), CN(INPERV), TC FOR BASIN NO. 1
0.311 81 0.00 98 25.3 0.242 86 0.129 94.6 0.6
DATA PRINT-OUT: DATA PRINT-OUT:
AREA(ACRES) PERVIOUS IMPERVIOUS TC(MINUTES)
A CH A CH
.4 .4 81.0 .0 98.0 25.3
PEAK-Q(CFS) T-PEAK(HRS) VOL(CU-FT)
.08 7.83 1759
ENTER (d:)(path]filename(.ext) FOR STORAGE OF COMPUTED HYDROGRAPH:
ANDEREX.100
AREA(ACRES) PERVIOUS IMPERVIOUS TC(AINUTES)
A A CN
.4 :.2 86.0 .1 94.6 6
PEAK-Q(CFS)' T-PEAK(HRS) VOL(CU-FT)
.24 7.61 2589
ENTER (d:](path]fil9a.ame(.extj FOR STORAGE OF COMPUTED HYOROGRAPH:
ANDERDEV.100
RIO FACILITY DESIGN ROUTINE
PERFORMANCE: INFLOW TARGET -OUTFLOW ACTUAL -OUTFLOW PK-STAGE STORAGE
SPECIFY TYPE OF RID FACILITY:
DESIGN HYD:' .24, .08 2.50 386
TEST NYC 1: .13 .03 ;03 1.23 180
I - POND 4 - INFILTRATION POND
2 - TANK 5 - INFILTRATION TANK
3 - VAULT 6 - GRAVEL TRENCH/BED
STRUCTURE DATA: R/O TANK (FLAT GRADE)
2
RISER-HEAO TANK-DIAN STOR-OEPTH TANK -LENGTH STORAGE-VOLUNE
ENTER: TANK DIAMETER (ft), EFFECTIVE STORAGE DEPTH (ft)
2.50 FT 2.50 FT 2.50 FT 78.7 FT 386 CU-FT
2.5 2.5
see 0�e (oui
DOUBLE ORIFICE RESTRICTOR: DIA(INCHES) HT(FEET) Q-KAX(CFS)
ENTER (d:][path]filename[.ext] Of PRIMARY DESIGN INFLOW HYDROGRAPH:
BOTTOM ORIFICE: 1.00 .00 .043
Anderdev.100
TOP ORIFICE: 1.12 1.30 .037
PRIMARY DESIGN INFLOW PEAK -- .24 CFS
ROUTING DATA:
ENTER PRIMARY DESIGN RELEASE RATE(cfs):
0.08
STAGE(FT) DISCHAR6E(CFS) STORASE(CU-FT) PERK-AREA(SQ-FT)
.00 .00 .0 .0
ENTER NUMBER OF INFLO14 HYDROGRAPHS TO BE TESTED FOR PERFORMANCE (5 MAXIMUM):
1 .25 .01 20.1 .0
.50 .02 55.0 .0
.75 .02 97.5 .0
ENTER [d:)[path]fiIoname[,exQ OF HYDROGRAPH 1:
1.00 .03 144.4 .0
Anderdev.10
l.'25 .03 193.3 .0
ENTER TARGET RELEASE RATE(cfs):
I ' 30 .03 203.1 .0
0.03
1.50 .05 242.2 .0
1.75, .06 289.0 .0
ENTER: NUMBER Of ORIFICES, RISER-HEAD(ft), RISER41ANETER(in) "1;
2.00 .07 331.5 .0
2 2.5 8
2.25. .07 36G.4 .0
SUMMARY OF INPUT ITEMS
2.50 .08 38616 10
2.60 .29 386.6 .0
2.70 .67 386.6 .0
2.80 1.01 386.6 .0
1) TYPE OF FACILITY: TANK
2. 90 1.15 386.6 .0
2) TANK DIANETER(ft), STORAGE DEPTH(ft): 2.50, 2.50
'
3) VERTICAL PERREABILITY(min/in): .00
3.00 1.28 386.6 .0
4) PRIMARY DESIGN HYOROGRAPH FILENAME: Anderdev.100
�-AVERA6E'VERTICA L PERNEABIL I I TY .0 MINUTES/INCH
5) PRIMARY RELEASE RATE(cfs): .08
SPECIFY: f - FILE.., N - NEWJOB, P - PRINT IF/OF, R - REVISE, S - STOP
6) NUMBER OF TEST HYDROGRAPHS: I
TEST HYD I FILENANE: Anderdev.10 TARGET RELEASE(efs): .03
ENTER jd:)[pathjfilenamvj.ex*tj FOR STORAGE Of ROUTING DATA:
7) NUMBER -OF -ORIFICES, RISER-HEAD(ft), RISER-OIAM(in): 2, 2.50, .8
AnderDet.dta
INITIAL STORAGE VALUE FOR ITERATION PURPOSES:
V e-4�eA+(v'K Ve k �Zc' c C( 31R; C
BOTTOM ORIFICE: ENTER Q-MAX(efs)
-
7
Volovve (rou eck
0.043 Ole
'7 A I- F 3 c c--
DIA.-- 1.00 INCHES
TOP ORIFICE: ENTER HE16HT(ft)
F ;t A 6 c
1.3
Dc- I
OIA.- 1.12 INCHES
15569 A,3
EXPIRES
ct 7
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ENGINEERING DETAILS - SD25/33
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ON OMEMMEN son ENOS no
Pump/Motor Unit
Submersible
Pump Models
SD25AI
SD33Al
Horsepower
1/4
1/3
Full Load Amps
8.0
10.0
Motor Type
Shaded Palo (4 pole)
R.PJA.
1550
Phase 0
1
Voltage
115
Hertz
60
Operation
Intermittent
Temperature
1201 Ambient
NEMA Design
A
Insulation
Class A
Discharge Size
1-1/2- NPT
Solids Handling
1/2ff
Unit Weight
30 lbs.
Power Cord
18/3, SJTW, 10' std.
(20' optional)
...... . . . . .
MEMO
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unless cerfified
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3-1p 4. Mansions and we%hts am
Materials*r. Constr ctidni.i�' approw4malfte
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produds and t6k
4-1/2
Motor Housing
specifications %ifliout flotise
Cast Iron
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Shaft Steel
Mechanical Seal Faces: Carbon/Cercunk
Shaft Secd Seal Body: Anodized Steel
Spri Stainless Steel
n
Bellows: Buna-N 11-1/8
Impeller
Thermoplastic 17-7/8
PUMP
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Upper Bearing Bronze Sleeve Bearing OISCHARGE
HEIGHT
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Single Row Bull Bearing
Strainer/Base Plastic
Fasteners Stainless Steel
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S T p F f L E'
oCA FrLE NO.
Critical Areas Checklist
----------------- --------------------------------------------
Site Information (soi /topography/
6Fgyl vegetation)
1. Site Address/ Location:
2. Property Tax Account Number: /?Z 70 40 _0% 000'T
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? _ yes; X no.
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
Hilly: slopes present on site of more than 15 % and less than 30 % ( a vertical
rise of 10-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over
a horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing wgM VW Depth:
V I Ur I*
7. Site contains areas of seasonal standing water: *__9
, Approx. Depth:
What season(s) of the year?
8. Site is in the floodway—*14-- floodplain of a water course.
Site contains a creek or an area where water flows across the grounds surface? Flows are
year-round? . Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow shrubs mixed
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: k0tJ 9 11RUP 01-INI
.. ...... .. Sffr77
-----------For City Staff. Use Only — - — --------- - — ---- — ------ — ------
1. Site is Zoned?'
2. SCS mapped soil type(s),?.
Weila*ndmventQry or C*.A. map indicates wetland present on e?
sit
Critical Areas inventory or CA. map indicates. . C.Irid.c . al'A Pe . a. I qnsite?
Site within designate*d' earth suibsidence landsh d*e hazard areO
6. Site, designated on the Environmental.ly Sensitive, Areas Ma p?.
DETERMINATION
^c&_cWdoc; Rev 02/11/97
City of Edmonds .
7///7/f 7
litw.CRITICAL AREA . SCHECKLIST
The Critical Areas Checklist contained on this form is
to be filled out by any person preparing a
Development Permit Application for the City of
Edmonds prior to his/her submittal of a development
permit to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The
information needed to complete the Checklist should
be easily available from observations of the site or
data available at City Hall (Critical Areas inventories,
maps, or soil surveys).
An applicant, or his/her representative, must fill out
the checklist, sign and date it, and submit it to the
City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map along with the signed
copy of this form to assist City staff in finding and
locating the specific piece of property. described on
this form. In addition, the applicant shall include
other pertinent information (e.g., site plan, topography
map, etc.) or studies in conjun ction with this Checklist
to assist staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applican
Name
7,012 4 3
Street Address
City State Zip
tocz -) -�(110 --
Applicant Representative:
Name
Street Address
city State
Telephone
Signature
7-
Date Date
Zip
(over)
c:recepdWjana\caddoc
--T
2.020
042-
- — 2 . 040
2-043
I oleL
C'I A- 9 �':2 - 02 5
Z-4* 2-110
2-107
4 12-//31
2-024,
200PI ST b. W. 9 (08 Z401 41
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2-067 12-U- N,
202nd. ST
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2-080
2-081
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b.Wn. 6,jve.,T,.,j 367-7040 &TIRI# UIK
ZOA# t4G. - "CO
K
PLANNING DATA
NAME:
SITEADDRESS:_ 155�1'9-141DATE:
ZONING: PLAN CHK#:-
PROJECT DESCRIPTION: ht,191-/ 5 /fi- ,
CORNER LOT IVU -(Yes/No) FLAG LOT V-P-5 . (Yes/No)
SETBACKS:
Required Setbacks:
Front: 10 Left Side: Right Side: JO Rear: /0
Actual Setbacks:
Front: Left Side: Right Side: A Rear: /6
7
Street map checked for additional setback required?= - (Yes/No)
I/ - , -
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED '__ (Y/N)
LOT COVERAGE: -3 5 � I Actual:
Maximum Allowed:
BUILDING HEIGHT: 15 -/
Maximum Allowed:— ---Actual Height:
DatumPoint:#,(- ef 0'00 Datum Elevation: '60
A.D.U. CREATED?: A/
D 4,:r" z
SUBDIVISION:
CRITICAL AREAS #: I I- a - IA/A / ye'l-
SEPA DETERMINATION:- t-,Xvq'p-�
LOT AR
OTHER:
Plan Review By:—
cAf11es\permit%Ap1andaLdoc
September 4, 1997
Mr. Jamal Mahoud, P.E., Engineering Inspector
City of Edmonds
Engineering Division
121 - 5th Avenue
Edmonds, Washington 98020
Re: DWA Construction
Edmonds Project
20320 85th Pl. West
Dear Mr. Mahoud:
SEP 10 1997
n-rr% 11 N"
a I MEET FU:
I have been asked by Doug Anderson of DWA to review the drainage submittal for the above
referenced project. The orifice on the outlet control is sized according to the predevelopment
runoff, which requires a 7/8" orifice size and is constant throughout the analysis. The volume
of the detention portion of the system is calculated by a lineal equation that can be increased
over 5000 sq. ft. by the percentage of increase of impermeable surface area. As the original
system was thought to be sized for up to 5,000 sq. ft., the 5600 sq ft. represents a 12%
increase in the required volume. 5000 sq.ft. of impermeable surface requires 25 lineal feet of
30" CM[P., increased by 12% to 28 lineal feet. Because the pipe comes in 5 feet section, a
length of 30 lineal feet is used. The outfall infiltration was sized based on the discharge from
a 7/8" orifice and was based on predevelopment runoff rate which is not affected by any
increase; therefore, infiltration surface would not change. Increasing the length of the
infiltration trench is simply an added safety factor.
if the detention volume is increased by a factor of 1.12 and there is no change in the
discharge rate of the 7/8" orifice, increasing the length of the required 30" detention pipe from
25 lineal feet to 28 lineal feet or more, the system will work quite well.
Please call me at 632-2664 if you have any questions.
Ve truly yours,
'y yo rs'
I Raynard, P.E.
ZXPIRM 8131/
1111V1Q7
11
CA FILE NO.
Critical Areas Checklist
--------------------------------------------------------------
Site Information (soi�4topo 4 graphy/ �*gy/ vegetation)
1. Site Address/ Location:
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet): 73�2
4. Is this site currently developed? — yes; **)< no. V
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a
horizontal distance of 66-feet).
Hilly: slopes present on site of more than 15 % and less than 30 % ( a vertical
rise of 10-feet over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over
a horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: Approx. Depth:
7. Site contains areas of seasonal standing water: �Jo Approx. Depth:
What season(s) of the year?
8. Site is in the floodway—*,4---floodplain of a water course.
Al)e- Site contains a creek or an area where water flows across the grounds surface? Flows are
year-round? Flows are seasonal? (What time of year?
10. Site is primarily: forested meadow shrubs n-dxed X
urban landscaped (lawn,shrubs etc)
11. Obvious wetland is present on site: k)OIJ 9
For City Staff. Use
20* a�
1. Site *is ne .
2. SCS mapped soil typeks)? W5
3. Wetla.nd inventory or C.A. map indicates wetland prese I nt on site?
4. Critical Areas inventory or C.A. map indicates Critical Area on site?
5 . Site wid-tin designate d eart . h subsidence landslide hazard ar eia� P45
6:9.. Site designated on the Environmen
tally Sensitive Areas Map?
EP nner
Y
CONDITIONAL WAIVER
4ca—chkAoc, Rev 02/11/97
City of Edmonds 1171?7
N�W CRITICAL AREASCHECKLIST
The Critical Areas Checklist contained on this form is
to be filled out by any person preparing a
Development Permit Application for the City of
Edmonds prior to his/her submittal of a development
permit to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The
information needed to complete the Checklist should
be easily available from observations of the site or
data available at City Hall (Critical Areas inventories,
maps, or soil surveys).
An applicant, or his/her representative, must fill out
the checklist, sign and date it, and submit it to the
City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application. .
Please submit a vicinity map along with the signed
copy of this form to assist City staff in finding and
locating the specific piece of property described on
this form. In addition, the applicant shall include
other pertinent information (e.g., site plan, topography
map, etc.) or studies in conjunction with this Checklist
to assist staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate cohinin below).
Owner/Applican
Name
Street Address
%4-1—ce I c
City State Zip
0 cc � ' � (-1�4 � -- I
) W.1
61�
Signaturd'
7- /7-?7
Date
Applicant Representative:
Name
Street Address
City State Zip
Telephone
Signature
Date
c:reception\janakaddoc
(over)
2-0/9 43
,Ogg 12 14
8
12 (5 9
2.020 IP02)10'
Z.18 2-
-03 5
2-110
2041 2-1 1 09
2-IL
:2 042. 2-040 :�VU 12-0y'2-10812.-W FZ-114- '12-//31
-75-001
2OOtK ST W.
L-r
2-OtAl 11 '.
.05�.12-CM Lp—.. 0
2. O�Z LTA A611
Lo 2 LD.!�5 5 1 2-00
2,IXI r
2-09') 1
2- 074
2 -M!5 —T T—
Q,
2-077
vol
202 nd. ST
2-08 2-080 17
2 16
2-090 2-081
2 2-089
ui j LAJ 15
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2420 Q)
QZ 5 13
10�-D 4
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9-091 6 00
9 5 5 7
1 4-095 CL Q
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S/80 ? 6
2-LI92 6 9
7 6 Q-
NO 2 (57�14)
2-0-4
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114 Sec Cor
D. CL., FeA,'7ff
rvey. it is a parcel mao
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202 nd. ST
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114 See. Cor
2041h. IST S.W
tey. it is a parcel ma�
&57 7- ? �048 S, uj
[IN
PLANNING DATA
NAME: �A&M_�o�j
SITE ADDRESS: DATE:
ZONING: PLANCHK#:
CORNERLOT NO (Yes/No) FLAG LOT- NQ (Yes/No)
SETBACKS:
Required Setbacks:
Front: a Left Side: Right Side: 7 Rear:
Actual Setbacks: qx., t�d
Front: '* Left Side: Right Side: Rear: LP' *0d, 4'a
Street map checked for additional setback required? —(Yes/No)
LEGAL NONCONFORMING LAND USE DETERMINATION ISSUED (Y/N)
LOT COVERAGE:
Maximum Allowed:, 1�6 Actual:
BUILDING HEIGHT:
Maximum Allowed:_S Actual Height:
Datum Point:
/L-2- 1) Datum Elevation:
A.D.U. CREATEW: Q4
SUBDIVISION
CRITICAL AREAS #:
�14;hMAL4449hTil M"W0611;
LOT AREA:
OTHER:
USE
CITY OF EDMONDS ZONE PERMIT
NUMBER
CONSTRUCTION PERMIT APPLICATION 1 000
U
Zo
SE
N
ITION
Jo
ADD 0 3
ADS SUITE/APT #
NAME/NAME OF BUSIN DIDRESS yz
'0 S'zl
L LEG CHECKI SUBDIVISION NO. LID NO.
I-) E vsotj EGAL DESCRIPTION
WMAILING ADDRESS
4
PUBLIC RIGHT,0F WAY PER OFFICIAL STREET MAP. TESCP Approved 13
'01�y ZIP TELEPHONE NUMBER
RW Permit Required 11
-bAh--mE: �316'6- 3 70 10 EXISTING 2 (�? REQUIRED DEDICATION Street Use Permit Req'd
PROPOSED — 20 Inspection Required
Sidewalk Required A I
M SIZIff NO.OFFITURES I PRV E UIRED W
% 1�71 L I
ZIP ITELEPHONE NUMBER
T AME 0 /\) SUL T
ADDRESS
7-0 12,4 ME
VTYN tZIP
,!�5 1 TJP�JE IJUMBEF
76 - floe
STATE LICENSE NUMB*,,, 03 b P EXPIRtTI(
7) UA Z 0
Legal Pgacription of PCqperty - include all easements/,
U&,P Xv V4-kCt--( F-
F
!INEERIN9,MEMO DATED
1. L-1 VARIANCE OR CU
.. . , t',
. A I SERA REVIEW
COMPLETE I EXEMPT
EX
LOT COVERAGE
ALLOWED PROPOSED
R 01 � Ivr 7 06 MO _S 76'e-
W 3,)" 17
_j operty
Pr I
Tax Account LOTAREA
Parcel No. 704 -.,ff
NEW RM�7
IeXj RESIDENTIAL PLUMBINGIMECH
COMPLIANCE OR
ADDITION COMMERCIAL CHANGE OF USE
EIREMODEL APT. BLDG. SIGN
DFENCE HECKED BY IT"
REPAIR CYDS. If - X —FMT)
D.— WOODSTOVE SWIM POOL
5 NO 0
L
e C_ (" Lu
Z
0
e P.—C 61
ADS
SIGN AREA
ALLOWED I PROPOSED
FRONT SIDE REAR
NN IN G IEW B7
SHORELINE It
HEIGHT
ALLOWED PROPOSED
Z
IROPOSED SETBACKS (FT
FRONT UR SIDE REAR
7V
Z
UJI
0
0
C 0
L _j INSERT HOT TUB/SPA
GARAGE RETAINING WALL/
CARPORT ROCKERY RENEWAL
�K 1
SPECIAL INSPECTOR
REQUIRED
El YES
Q �tA
OcCUPAw
LOAD
REMARKS
PROGRESS INSPECTIONS PER UBC 108
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
a /,�� I.. � - X
NUMBER
OF
2.
STORIES
NUMBER OF
DWELLING
1 UNITS
IT
R ICALqj
JAREAS
NUMBER
DESCRIBE WORK TO BE DONE (ATTACH PLOT PLAN)
com mo c,7 mew IS wy-(_e-
FINAL INSPECTION
REQUIRED
VALUATION
FEE
0
PLAN CHECK FEE
BUILDING
��07521
14z-7
HEAT SOURCE-
AA Gr 43
GLAZING
/;7 'Zo
PLUMBING.��4,1.1,5
MECHANICAL
WWI
Plan Check No. / "YO
This Permit covers work to be done on privafe property ONLY.
Any construction on the public, domain (curbs, sidewelks,
GRADING/FILL
STATE SURCHARGE
1,.5 L/
driveways, marquees, etc.) willfequi(e separate permission.
Permit Application: 180 Days
Permit Limit: I Year - Provided Work Is S�rted Within 180 Days
STORM DRAINAGE FEE
30-
n
2
2
<
X
0
0
x
"Applicant', on behalf of his or her spouse, heirs, assigns and
successors in interest, agrees to indemnify, defend and hold
harmless the City of Edmonds, Washington, its officials,
employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the Issuance
of this permiL Issuance of this permit shall not be deemed to
modify, waive or reduce any requirement of any city ordinance
nor I.imit i,n any way the City's ability to enforce any ordinance
provision. I
ENG. INSPECTION FEE
30
PLAN CHECK DEPOSIT
TOTAL AMOUNT DUE
ZC 1 ;'�'9
_I hereby acknowledge that I have read this application; that the
information given is correct; and that I am the owner, or th i e . duly ATTENTION APPLICATION APPROVAL
authorized agent of the owner. I agree to comply with city and THIS PERMIT
state laws regul fli construction; and in doing the work authoriz- AUTHORIZES This application is not a permit until
ed thereby, no per h,,will be employed In violation of the Labor signed by the Building Official or his/her
0 ONLY THE
Code of thq-State o a§I:iIng1l in relating to Workmen's Compensa- WORK NOTED Deputy; and fees are paid, and receipt is
1�wc W 1 -t\ acknowledged in space provided.
�ltion lnsurabc�.aria '&27 INSPECTION
IGNATURE (0 Nit 0�1 I DATE DEPARTMENT
OF I, TE
CITY OF
VFCI ;A, �SIG�N�
EDMONDS
S By Z r 0,
CALL FOR AELEA§ BY: 0 DATt
ATTENTION INSPECTION
IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE (T.
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR OR ) IGINAL File
771-0220
— YELLOW — inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. UBC
SECTION 109
U12.11171 PINK — Owner GOLD — Assessor
m�
K__
,�%_ I , 1> e--% —2- e-"A-
STREET LIGHTS
ALL S I KEE I LIGHT CONDUCTOR
TO BE INSTALLED IN 1" PVC.
STREET LIGHTING SOURCE VOLTAGE
is I 'ZO V.
Lo C-N-T A o N
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1351
REV. 7184
PUBLIC UTILITY DISTRICT No. 1 of Snohomish County Area
LOCATION 104 4h _=�-r 'c:-, i,,l k PL- W' DATE I ?) 54 W. 0. NO.
POLE NO. f-5. 1��j 1/4 S jz:� - T -Z7 R 4 DWG. NO. 4-A 4--7
REASONFORWORK f='FrIr-�FZ-r' _. __ ENGINEER U. G. FILE NO. ��9
C- H F=—L- I - C-- 12—_ FA C-- H!S'r. DRAFTER E_ P_ SCALE
ili r;;_ Pi t--i r-- F�3'i c> &, F_, t--4 E_= APPROVALS
DATE WORK COMPLETE I — 1-770SI RY 1--C—C—N ;:npF:M,APJ
SUBSTATION
CIRCUIT NO.
ENVIRONMENTAL ANALYSIS
-B�EXEMPT 0 NO'T EXEMPT
PARA. ITEM
FEES REQUIRED YES NO El
PRIMARY OVERHEAD:
LEO #
FT. =
O.H. U.G. CON?. -7. KV
ADD _4dC�_'cKT. FT. PH.
REMV. CKT. FT. PH.
NE1 4= CKT. FT.
REVISIONS
APPR.
NO.
DATE
DESCRIPTION
XXO #
O.H. U.G. COND. — KV
'0 $—/FT. =
ADD — CKT. FT. — PH.
REMV. — CKT. FT. PH.
NET CKT. FT.
SECONDARY OVERHEAD:
$—/FT: = S—
PERMITS
METER POLE S
DATE
TYPE GRANTED
0 TREE TRIMMING
0 STATE
[J COUNTY
,I&CITy rF_t�q-jor-4t>—_,)
PRIMARY UNDERGROUND: (RESIDENTIAL)
BASIC FEE $
LEU #
o 10 $—/FT.
xxU #
$—/FT.
0
SECONDARY UNDERGROUND:
EASEMENTS
7�'REOUIRED El NOT REOUIRED
BASIC FEE $
—0 $_1 FT.
UNDERGROUND PLAT:
BASIC FEE $
It FT. a $ /tFT.
STREET LIGHTING:
(LF7.c s_/(LFT.=slt,70
DATE RELEASED -54
FOREIGN CONTACTS
D GTNW JPN NO.
0 CATV JPN NO.
'9� JOINT TRENCH GTE & CATV
PRIMARY UNDERGROUND: (COMMERCIAL)
BASIC FEE $
1.
$_1 FT.
n-
OHIUG SUBDIVISIONS (5 YR. REFUNDING)
ESTIMATED COST $
NUMBER OF LOTS
POLE STENCILING
FROM TO
TAKE OFF POLE
MISCELLANEOUS FEES:
PRE-CONST. REOUIREMENTS
0 TREE TRIMMING XPUD LOCATOR
0 ONE CALL 0 BACKHOE
0 OTHER
IDENTIFY
c;,
$_
$
LOGS POSTED
G.E.
C.E.
$
TRANSF CARDS
U-MAPS
TOTALDUE- $
POLE DEPT.
CIRCUITS
DATE PAID:
NEW SVC. APPLICATION #
LOCATION
MAP PAGE
DISPATCHER POSTED
DWG. NO.
4
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