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205 HIGHLAND DR
CITY OF EDMONDS
PUBLIC WCM - EMINEERRU
ACTION REPOR,
N 9 5677
SUSPENSE DATE:
Date: I'F,(a Time: LO '- j- File #
I Attachments:
=Yes
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SUBJECT: - L, 0 w uj Abe, K- I ooc-e!�>:5ul-lf
REQUESTOR: NAME: K-:5 eAd d 0 14
ADDRESS: wf'Q h Aq ,I &-ak- -
PHONE: J- e,!5 4-1
REQUEST RECEIVED BY:
TELEPHCNE
CONTACT IN OFFICE
OTHER:_ r---j
RECEIVED BY: Ny; n;�
.A"Tr yn
ACTION:
A-- )Wf
All Concerned Notified
,?,o —'r-6 Action Completed/File
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT _9`�
V 0 46A
Call 7.76-1107 for side sewer inspections BEFORE covering axiy portion of the construction.)
Inspection will be provided within 24 hours- after request. NO Sat., Sun., or holiday inspections.)
IN- Nighland Drive
ADDRESS LOCA17ON OF CONSTRUCTION ............ ------------ * ............... ....................... * ...... * ............ * ---- --------------- * ........ * ------- --------------
PROPERTY LEGAL DESCRIPTION ......... Lot 18, Emerald Hills
.............................................................................................................................................................................
.................................................. . ................ : ..... . ........................................................................................ . .................................. . ..................................................
.................................................. ............. OIKWERi"D/OR BUILDER ........ Phil Skoog ------ - ---------------------------------- - ------------------------------------- * -----------------
..... .......... * ... .....
Los's Side Sewer Contracting, 1555 ME 172nd, Seattle, Uash. 931*'-.5
C*IACTOR'S NAME & ADDRESS .... .................................................................................I Z ...........................................................................................
Permission Is granted ------------ Juix --- U ........... . .. . ............ 19 ... 73, 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:
NON o. 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 RIght-of-Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 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
,E work which may develop within one year of completion.
N&TEI 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 E] Date.... By ................ Date ... ...... B,�f . ... ..... Date ............... . ................... By ................
Z -7-5-
... .......... By ------ . ...
.. ................. .................. ........ ...................
--------------
APPROVED ks� Date.. 4
Re ........ .... j ...............................................................................................................................
�1_ 7 ............... ----- - --------------------------------------
..................................................................... . ............................................................................................................................ . ............................................. .........
�p.
BOTH Permit ies T Be Signed B Owner of Firm Performing Construction PRIOR To Request For Inspection
I, ... . ... . .................. .... hereby certify that the side sewer installation constructed under this permit
(Pwne]r tra ng Firm Perfcr g Conetruction)
v0steall d in ac rd n all governing ordinances of the City of Edmonds.
Dated this ....... Z:Zk ......... day of ......
.....................................
Check BEFORE you dig for: Water [], Gas E], Telephone E]q Power F], Sew;r I-], Other E] V
0
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER. -tv 0-3 0 006 o I y c
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: — DETERMINATION: F1 Conditional Waiver E] Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE: 1�m YAW Phu.16 LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #: � L4
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED: 5 Jq
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STREET FILE
RECEIVED
NOV 13 2006
BUILDING DEPARTMENT
CITY OF EDMONDS
REVISIONS
CONTENTS
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RECEIVEM
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CL NOV 13 2006
BUILDING DEPARI'MENT
CITY OF EDMONDS
15
7
APPLICATION
for
The City of Edmonds SIDE SEWER PERAHT EASEMENT No . ..........................................
NEW CONSTRUCTION E) REPAIRS 0
PHIL- -441<:)
OVY'NOR, .............................................................................................................. CONTRACTOR kn!�-!t --- �J.4i .... C . J ....... PERMIT No . ......................
ADDRESS ......... ..... M*277... LEGAL DESCRIPTION: LOT No . ............ leZ ........................ BLOCK No . ............................................. -
NAME OF ADDITION ....... "A-WE'l
..............................................................
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Approved:
DA
......... B
...........
APPLICATION
for
The City of 19dmands SWE SEWER PMMT EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS
....................................... ------ - -----------------------
OWNER ... ...... e ---- CONTRACTOR ............ ------ % ............. PERMIT No.
LEGAL DESCRIPTION: LOT No - ------- V ---------- ....... --------- BLOCK No . ................................
.... 1-'i2w ---------------------------------------------------
ADDRESS ....... ly ?- //" d? ?, -
NAMEOF ADDITION -------------- -------- ..............................................................................
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11
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)73
Approved:
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DATE---------------------------------- ------------- By .................................................................
9. pie . 1 121 41 1
Address
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Street Right -of -Way Existing Z. REQD
Access Easements Existing
Utility Easement Existing. I U 0 0 REQD
Lot per Subdivision Plat �6 Assessor Map
Site Plan Checked for Accuracy.
Underground Wiring Reqd.
Check Accuracy of Legal Description
Environmentally Sensitive -Area
Environmental Checklist Reqd.
Flood.Hazard Zone
"I
Shoreline Management Area Vtl(*X-
Z Slope, Soil, Vegetation
Stream, Creek, Dra inage Basin I -A
Existing Zoning Per Code
An-cnities Design Board Approval Reqd. ADB # Approval
Board of Adjustment Approval Reqd.
Review By- Date:'
Existing Water 11,1ain Size
Water Main Reqd.
Se rvice Line Reqd.
Hydrant Size Existing CIr
Hydrant Reqd. Per Fire Code X,�W Size
Detector Check Meter Reqd.
Cross Connection Inspectic
Water Meter Charge Reqd.
Review by: W/S Date: -Z//3,/-74FF
oepuic iaru-, uesipi Approvea
Septic Tank Permit Reqd.
Sanitary Sewer Availability
te:
Permi t Db.
Proi .
Drawing No. File No.
Side Sewer Availability
W Sanitary Sewer Con�ection Fee Reqd.1
Review By: _W_,Is Date: -7 Ll 317A
— — — — — — — — — — —
q)en Ditch
Culvcrt Reqd. Size
c4 Catch Basin Reqd.- Indicate on Site Plan
Shoulder drainage n-nin ection on si4ale open runoff,
1-1-u-diole rcqd. Indicate on S*te Plan
Soil Conditions ;:uy��round Water Field Checked
Street Paving Keqd.
Curb and Cutter Reqd.
Sidewalk"'Reqd. Z/1
t4 qu.:�b. Cut for Driveway Req d.
YC
re. Rig)it-of-Way Construction Pe q
Bond Reqd. for Public Inpr ts
Street Nanie Sign Reqd.
Other Signing Read.
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Pre P.ermit Site Inspection r�Lade on
0
BY: SB,.IER
U.
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EN1G=.RL%-7G
am� 3x 1.& = ME 1K X -.Clr
Special Rcqi-Liru-,-tmLs li sted in mew to Conm=iuy Dcvelopn-ent Departmcnt,
Building I)i
BY V,-S,-o Date
0 All items filled in on Building Permit Application
BY Date
Drawings Stapped and Notations �kide
BY Ddte
Approved by Riblic 'Porks DcparriTmt
Revised: 1v 10-1977