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20607 81 ST AVE W
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STREET FILE
C I T Y 0 F E D M 0 N D S
- SEWER DEPARTMENT -
STOPPAGE OF SANITARY SEWER MAIN REPORT
DATE: TIME CALL RECEIVED: -1:0-50
LOCATION OF STOPPAGE: -SELM ArrrArL.41190 0"W1104-.
TIME OF ARRIVAL ON THE JOB SITE: .1'. 46 p ." ( -I, I I.- -ILo )
TIME NORMAL FLOW OF SANITARY SEWER REESTABLISHED: 1-11--lLp 9:0o A. -
CAUSE OF STOPPAGE: L41-r--aA%-. 8W9.r=f-J a`,? AL-14h.
QT-Y C)F= 0-0Mcw-J0S- Def)A(2,rA&ev--jor
ACTION REQUIRED TO CLEAR MAIN AND/OR LATERAL: --Che;. L-�t> LAMO-4-L. A'r
LZX.&f-14pLj W�Aelze lue- New.
W&Tee tV-JTEaSe4C-r6 JlAe tX1'-5nt1JG 4=14
o6ewseL.41s.-rea&t. aG PL-A.(-F- 2. eac>4eNj e�rww se -n Le w ir 14
1 'F
.z NFEW 4.11 ZIP Swa -ri La. (,bee "mA% a. it.-&
CITY CREW ON STOPPAGE CALL OUT (Personnel Involved): 1-11-16 JINAJewSSW vVIV4
-1, 1 *X - *7LO C-AIZY CA%? MC>-J D4 J I IN -A J4Et,,J6SQ,, rC=q-eY OA,#,J SL-> V-J
LOCATION OF RESIDENCE AFFECTED: 2�oipo-i- sov'r &NJI W.
KAJ,E, ADDRESS, AND PHONE NUMBER OF PROPERTY OWNER: '1>oTrY DL.31Z6=C-1E'
14;0� 2-7 t!-r \Aj.
W&J - (z2:)0-L0 --
DESCRIBE DAMAGE TO PRIVATE PROPERTY: 0. TO
E4=)L.S1PLA�LJT- U-SelD T-0 �4�V-e aec)&AaoE,#.
At-4c> st S, -tt :V; *t 240 -,-t .4
1016?1-119 .19.S 4ej'c/-/-
NEW IWO '41 - W AT S Z tA A. W
ST. �S-W-�
'11
CLAIM, FOR DAMAGES
NOTICE �.U. 0 1976
I r
Cla,im MUST be presented to the City Ccuncil and filedfvA-t4 wiilr�� 120", -''s
from the date of Accident or Accrual of Damages. C;,y C)F LIDNIOND""
..........
TO THE CITY COUNCIL OF THE CITY OF EDMONDS: [;y ...... ..........
ri.Y CLJ�!K
PLEASE TAKE NOTICE, THAT
f-if marriedi' give husband's name)
WHO NOW RESIDES AT
(State present actual address by street, number and city)
AND WHO FOR SIX MONTHS PRIOR TO DATE OF ACCIDENT HAS RESIDED AT
40-6
(Give residence by street, number a-nd city)
CLAIMS DAMAGES OF AND FROM THE CITY OF EDMONDS IN THE SUM OF
a -rising out of the following circumstances:
Describe Claim, giving
DATE and TIME inju ' ry or
da.mage occurred, PLACE
and full particulars.
Accurately locate and
describe defects caus-
ing injury or damage
and all acts of negli-
gence claimed.
.Accurately describe
injuries or damage
r
/2 3,
r
(61C
State items of damage
claimed. Itemize all
expenses and losses.
ILA I i P:
V V�
(Claim must be sworn to by claimant)
J
(Signatu�C- of Claimaqt).
F. ___AIBZD AND SWORN TO
before me this (Y day Of r6Z "'Y/l/ Y, 19 ;7(
dL
Notary PubAic in and e:the,S7tte of
Washingtofi, residing
et
J Old Cust. D New Cust. 0 WORK ORDER Charge 0 Cash 0
Plumbin
F%CPAIR
SEIPWICIE
Lee'sPlumblong
774"'.133t
P--,.aO,�! BOX 1-;.58.,�-- -,.LYN NWOO.Dl-. VIASH.'__9803
.6
7 DAY 24 HOUR SERVICE
f
Job Name Send Aiii T.
' ' " 'I
DATE - — I — 7
PROMISED
A.M.
DATE P. M.
Job Location
7
Address
City
City
Phone
Apt.
Phone
C3 Day Work 0 Contract [:3 Extra
Description
of Work:
n
Total Material
Total Labor
Pe Imits
Sub Total
Sales Tax
.1 i
TOTAL
PAYMENT IN CASH ONLY unless approved by office PLEASE PAY FROM THIS INVOICE
TO OUR CUSTOMERS: Service bills ore due and payable upon completion of work and serviceman Is ou-
I horized to receive payment for some. if service is not satisfactory in any way; please phone our office
Im.0 d io I ely.
Work performed on or about plumbing fixtures, su pply lines, d'o'nogfe oncr.h.eafn?rsys,e-,, sawe�s, etc., is not,guaronreod against stoppages,
domag 0 in the rem ovol of foreign objects, backups. floodinn breakage, .". 0 oozing. Now fixture insto olions ore guaranteed against
t foully rnoto , lot 6 or workmenship for a pe r lad of ONE YE R from dole olinsfollotion.
I Highest legal rote of interest charged offer maturity, If, however, this occounlisnolpoiclas agreed l(wo)ogree to pay in addition to the fore�
I going, a reasonable attorney's fee. or If this account is placed in the hands of a collection agency, I (vvehocl,nowleclua that you will be domayed
th:to dam
y a the extend of the collection charge against you and I (we) therefore ogres 10 Pay to you, as quidated ages, on amount equo to
th.00mount ad you on sold collection by said collection agency, not exceediW,, however, fifig percent of the amount un
,e .. =g
n _poid thereon. and
a a torney's to*. At the opfio of the holder hereof, the venue aid suit may e laid in the county seat, of the holder of this
In trumool.
I hereby acknowledge the satisfactory completion of the above - described work.
1,z.
Customer's Signature 1111� N. nnp,,'14.—.
I
f
Work Ordered By
Date Completed
Order Taken by
4-
7 6
APPLICATION
for
y of Edm SIDE SEWER PERMIT
onds IL LYNN PLANT
I V� PC pit yl "0' Vf f EASEMENT No . ..........................................
N EW -C ONSTRUCTION E] REPAIRS
.............. .... ...........
OWNER ..... . ...... I -CONTRACTOR ... PERMIT I..
........ .... LEGAL DESCRIPTION: LOT No . ............................................. BLOCK No. ..............................
....................
........................ ...................................
NAME OF ADDITION ... 4Z
er'
to
7-" 7.
4
Phi,
Ag, :,rk"
00 -t� "WIpprove 64�
L
--------- - — ----- ----
DATE! . .......... ............ .. ....... .....
7
NOTICE:
The information *shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edrnonds does not warrant the
accuracy of anything set forth on these
map(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information sho.wn on
t -map(s), including, but not limited to,
th I e 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
e rn pl- o-y e e-s o -r o ffi C e r's) S h a 11 1 b e [i a. b-'Fe f o r +L h e
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS
Call PRospect 6-1107 when work
CIVIC CENTER — WATER -SEWER DEPARTMEI-Pr is ready for Inspection. (No InsPec-
tions Saturday, Sunday or holidays.) N2 1598
SIDE SEWER PERMIT
ADDRESS........ ....... 2-0.6-0.7 ... . ... alsit..Avenue .... WeAt ....... ...............................................................................................................
OWNER ....... JAMS ---- C..___F0W1er ..................................... "TOR .................... ........ �
.......... CON'JrRAC .......................
Perndssion is granted ............... ]Lq�? .... for ...................... days, to REPAHL or CONNECT a side sewer
with City Sewers in accordance with application on file and governing ordinances.
A T`TENTION IS CALLED TO THE FOLLOWING:
NOTE No. 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—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side -sewers when you get permit.
NOTE No. 3—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 % will be permitted.
0 No. 4—Trenches In street must be water settled and surface of street restored to original condition. Contractors shall be responsible for
failure due to Improper work which may develop within one year of completion.
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-
purtenances except to Insert the pipe Into the wye.
0
CITY CLERK
CITY OF EDMONDS
III STH AVENUE NO.
IAWONbS. WA .98020
CONFORMED COPY
200304160288 1 PG
04-16-2003 09:32am $19.00
SNOHOMISH COUNTY, WASHINGTON
STATEMENT ON ACCESSORY DWELLING UNITS
GRANTOR: GRANTEE:
Property Address: 2_0�,0_7 '9PT_ &
Edmonds, Washington
Legal Description: o., NO 2- & r- oo-,-) b -06 —(-0-H (..
Assessor's Parcel Number: eQ V// "'10 0 0 0 A 0
I have read the requirements.for accessory dwelling units contained in Chapter 20.21'of
the Edmonds Community Development Code (ECDC) and understand that an accessory
dwelling unit, including a'second kitchen, as defined in kCDC . Section 21.05.015 is
prohibited until an Accessory Dwelling Unit Permit is approved.
I also understand that an Accessory Dwelling Unit Permit cannot be approved -unless all
the criteria in Chapter 20.21 are met, and all the necessary items are submitted,
including an affidavit of occupancy and a covenant to be filed with the Snohomish
County regarding the regulations imposed on Accessory Dwelling Units.
Property Owner Signature:'
Propi�rty Owner Name (prijo
Date: H-1(3
STATE OF WASHINGTON
COUNTY OF SNOHOMISH)
.1 certify that I know or have satisfactory evi d-ence that
ct for the uses and
signed this instrument and acknowledge, it to be his/her_f�ree �and vol nt�aryyact Am.
purposes mentioned in this instrument.
Notarys
must be smudeed.
&&"';� F I
01,
Signature of
Notary�p
ubli
LU
r).*AZ'
L 15 �14
Dated: `14
7
Residing at: A
My Appointment
Expires:
THIS DOCUMENTM'UST BE RECORDED WITH THE SNOHOMISH COUNTY AUDITOR.
CITY CLERK
OTY OF EDMONDS
III GTH AVENUE NO.
111MONDS, WA .98020
CONFORMED COPY
200304160288 1 PG
04-16-2003COO9Uh32a'm $19.00
SNOHOMISH TY3 WASHINGTON
STATEMENT ON ACCESSORY DWEI . LING UNITS
GRANTOR: t) 6*\ % , � a �
GRANTEE: C
Property Address: Z-0 (, 0 -7 'S 4L
Edmonds, Washington
Legal Description: _Cd-cs�^ 0., No 2- 6L r- 00-^� 0 -06
Assessor's Parcel Number: 0 0.// � &40 0 0 0 16 0 0
I have read the requirements for accessory dwelling units . contained in Ch pter 20.2l'of
the Edmonds Com . . a
munity Development Code (ECDC) and understand that an accessory
dwelling unit, including asecond kitchen, as defined in kCDC Section 21.05.015 is
prohibited until an Accessory Dwelling Unit Permit is approved.
I also understand that an Accessory Dwelling Unit Permit cannot be approved uinless all
the criteria in Chapter 20.21 are met, and all the necessary items are submitted,
including an affidavit of occupancy and a covenant to be filed with the Snohomish
County regarding the regulations imposed on Accessory Dwelling Units.
Property Owner Signature:
Property Owner Name (prijr
Date: 3
STATE OP WASHINGTON
COLft'ITYOF SNOHOMISH)
I certify that I know or have satisfactory evidence that
signed this instrument and acknowle e
'�ry act for the uses and
dg . it to be his/her—frieee �and Voll n*tary ac.
purposes mentioned in this instrument.
Notary, s eals must be smudged. Dated:
ga�&\\( F I Tz� Signature of
*4'0 Notary Publim—
z'-"' -
0S
Residing at:
MY Appointment
150
Expires: 4
nil
THIS DOCUMENT MUST ]BE RECORD91) WITH THE SNOHOMISH COU
NTY AUDITOR.