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20411 80TH AVE W
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APPLICATION
or
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The City of Edmonds SEWER PERNaT
EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS
OWNER ------- ...................................................
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ADDRESS oc>al ... I ...... W ...........
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is
CONTRACTOR 4
................................... ................................................... PERMIT No . .............
LEGAL DESCRIPTION: LOT No . ............ .......................... BLOCK No . ........... ................................
WAMR OV AnnTTMV
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DATE v
'000epAP!r
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The City of Edmonds
APPLICATION
for
SEDE SEWER PERMIT
EASEMENT No . ..........................................
NEW CONSTRUCTION 0 REPAIRS
/- - X'-/- Y I- -
OV*rNER ......... . ..............
....................................
ADDRESS .... ��.07 ...... / ........... ............ .......
.................
1-140 1%59""
................................. E MI
CONTRACTOR ...... ......... P R T No.
LEGAL DESCRIPTION: LOT No . ........ Y ................................... BL40CK No . ............................................
NAME OF ADDITION ...... 4 .........
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- / — -
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Approved:
DATE................................................ By ......................................................................
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
employees or officers -,--)hall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).,
L
CITY OF EDMONDS'-- SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 7.76-1107 for side wer inspections BEFORE covering any portion of the oonstruction.N
Inspection will be provided. within 24 hours� after request. NO Sat., Sun., or holiday inspections.1
ADDRESS LOCATION OF coNsTRucTION .............. 20411 - 80th Avenue West'
................................................................................................ . .......................................................
PROPERTY LEGAL. DESCRIPTION .................. 111* -------- Lo I t -1, 8 Wo * qdyalp ... NArth, ------------------------------------------------------------------------------------------------
.................................................. . ...................... . ........................................................................................ . ............................ -------------------- * .......
................................................................ 01*4WERANDJOR BUIIDER ....... �jjck Homes
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CONTRACTOR'S NAME & ADDRESS .... Sea-Tac Excavators, 3802 South 384th. Puvallug� Wash.
----------------------- ....................... . ................................. . ..................... . ....... .... ......................... 9-83.7-1 ................
__"%usslon Is granted ----------- - --- J.u.ne ---- 28 ........... . ............ 19 ... 73., for repair and/or connection of a side sewer to the city sanitary.sewer
in
.,em accordance with City of Edmonds ordinances.
A7 TION IS CALLED TO THE FOLLOWING:
NL .-To. I —The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer In street area. Do not cover any portion of sewer before it has been inspected .
NOTE No. 2—All work performed in city right-of-way requires an Invasion of RJght-Gf-Way Permit obtain -able from the City Engineer's office.
NOTE No. 3—Obtain full Information regarding Ordin I ance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at Property line and 12 Inches inside property line; minimum grade of 2%. No bends in grade
sharper than 'A will be permitted.
NOTE No. 5--Trenches in street must be water -settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
workwhich 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.
DISAPPROVED0 Date ... . ....... ....................... By ................ Date ........ ........ — B-z . . ........... Date .............. . ................... By ................
APPROVED Da
* . .................................................................
....... ............................
Remarks: .... .. . .................... .......... ......................... . ...........................................................................................................
.......... ........................................................... ....................... I .................................................................................................... . .......................................................
Permit CopiesiMUST Signed By Owl�e"�_ o *Firm � Performing Construction PRIOR To Request For Inspection
'Si
........... ........... : ...... .... . hereb
y certify that the side sewer installation constructed under this permit
Twner of Contracting Firm Performing Construction)
w"�stalled in accordance with all governing ordinances of the City of Edmonds.
of ..... �.W.T!SFL - ------------
Dated this--- Ne!�Q ............. day ........................... 3L9
V Check BEFORE you dig -for:'Water Gas Telephone 0, Power 0, Sewer 0, Other [3 V V