20602 77TH PL W.PDFIIIIIIIIIIII
6551
20602 77TH PL W
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number -
STREET FILE Issue Date:
-law,
A. Address or Vicinity of Construction: - 20602 77 P1 W
8 9 0 1 9 C) B. Type of Work (be specific): Repair Leak
C. Contractor: Washington Nati - 1ral rans Company -
Mailing Address: gl 9 Mprnpr St, -IRA-attle. WA
State License #: 98111
D. Building Permit # (if applicable):
Contact: Frank -qwan
Phone:
Liability Insurance: _ Bond: $
Side Sewer Permit # (if applicable):
E. E] Commercial F t 0 City Project @ Utility (PUD, GTE, WNG, CABLE, WATER)
] Subdivision
Multi -Family 0 Single Family 0 Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: 0 Yes G. Size of Cut: /X' H. Chargq�_$
AN
APPLICANT TO READ ZD, IGN
0
OF
INDEMNITY: Applicant understands and by his signature to this application, agrees t d t �)City ofEdmonds harmlVsTaln n
yurte mages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be mad 'dgainst the City of Edmonds, or an o its e artments or
employees, including or not limited to the defense of any legal proceedings including defo Al dc6sts'and attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATEDRESTORATIO SR,91WILL BE HELD UNTIL TI[F
%INA L STREET PATCH
is COMPLET Y CITY FORCES, A T WHICH TIME A DEBIT OR Cl EPdO!��k-�SED FOR ISSUANCE VO HAUPISICANT.
Construction drawing 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 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 thepermit requirements and thepink copyof thepermit will be
available on site at all s or rposes.
5>,V�s C
Signature: ;�� Date: nerembpr 16, 1993
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: 'I
TIME AUTHORIZED': VOID AFTER DAYS
SPECIAL CONDITIONS:
TOTALYEE: A5
COMMENTS:, RECEIPT, FEE:
DATE: ISSUED, BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. Div. 1991
FIELD INSPECTION NOTES
Comments:
Diagram.:
I . . - i", ,
CONTRACTOR CALLED FOR INSPECTION
(Fund 111 - Route copy to Street Dept.)
YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
�V- — — 'aw
The City of Edmonds
lz 0 — 69�91
APPLICATION
for
UP39" FILE SICIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS 0
OWNER......... �- --- -------------------------------------
ESSI� .. .... lq,� C'� "pv�
ADDR.................................................. .........................
'le) & o .2 — *7'lrm I
9
CONTRACTOR
�8�ENT No . ..........................................
1 IS-6
.................
- 4v
........................
LEGAL DESCRIPTION:
LOT No. ...... BLOCK No . ............... .........
NAME OF ADDITION .......
—7
... .. . . . 7
____ _�4
_j - -
DATE .... 3
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
the 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 off icers sha-11 be Ha-b-le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
- -1 - C�
CITY OF EDMONDS
C][VIC CENTER — WATER -SEWER DEPARnIENT
SIDE SEWER PERMIT
Can PROsPect &1107 when work
18 ready far Inspectlou. (No imp
Mug Saturday, Sun4ft, or hon ec-
days.) N2 1568
ADDRESS ...................... 295
.............. 24t A
....... h.. n
OWNER........... _..Staljd� F . ...........................................................................................................
... My ..................................... .............. CONTRACTOR� ...
PernlissiOn is granted ----- FebruaLry ... a ....... .... Ly ��qqd ..............
with Ci ........ 1967 ... for ...
--- days, to REPAIR or CONNECT a side sewer
and governing ordinances.
V Sewers in accordance with aPplicatim on file ...............
ATTENTION IS CALLED To THE FOLLOWING:
NOTE No. I —The owners of the
be —Ployed to constff,0,P%`d`e may obtain a Permit to construct sewer Inside property line A licensed Side Sewer Contractor must
sewer in street area. DO not cover any Portion Of sewer be*
'E No. 2--obtain full Information regarding Ordinance 11.16.030 d R g ation fore It has been inspected.
OE No. 3—Top Of side sewer must have at least 30 1 an e ul a governing side sewers when you get permit.
nches coverage at Property line and 12 Inches Inside property line; minimum grade Of 2%.
No bends in grade shaxper than % will be permitted.
NOTE No. 4—Trenches in street must be water settled and surface of street restored original condition. Contractors shall be respo
compl tion.
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 ap-
to
failure due to Improper work which may develop within one year of e nsible for
Purtenazces except to Insert the Pipe Into the wye.
L