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20610 85TH PL W.PDF111111111111 8086 20610 85TH PL W Alp E DiMI, EWVPEIZ�PERM T�:,,; S MATER;-.SEWER'1QE `7 M1,11 PER YNO'. ]i5l[�ORF; -coverfing' ,any. portlo��',of'jhe construct .,_.(fC_ajl!-T76L1,1b7, for-' side: sewer,,,lq�Recttonsk B 10 n.),,, Inspe ction, will,.be.1-prqyide'd!�withi�,�24 hours,After',requsst.�. NQI,Sat..;..Isun;,�,".,,or.'h(?IidLy,-Jn 6etions: P�, 4� 8�1;tht- P'l a ce,%�'W' % .20610 e 5 t. ..................... ............................... .......... ...... ................. ................................................................. Y, E OWL:. D E SCRIPn .......... 0, "'iPROP, Pine.,k ja MAT 01V ... ............................................ ............. . ....... ......... ................................. ..................................... ........ ......................................................................................... ............... .............................................. ...... ...................... ............. .................................... .............. ....... ................................... .............. %M MWER. AND/09 BUIL DER ........... LAD V .................... ......... ............ ................... C YS YO ............ ................. ................... U S: s _jo*i�'6h 'Sewdr &­V1- aib.j ri`� 1`60 CONTRACT-ow's�IN$AMIE:,&.,'ADDRES .................................................. U _Moad6W0'6 ................ ....... ....... ....... ............................ .............. ............. ..... ..................... se wer Penid'ssion, Nil 'ted -1 ............. ...... ...... ofi, of: a;,side 0, ar..'sewer NTIONLIS.,CA-LtIEDTO� THE FOLLOWIN�G - No. I The ownersYlof Ahe properti m'ay ob* tain! a' p�rmi-t'I't-o'�co'n's"t'r"u'ct sewer inside,property,line. A licensed Side Sewer Con tiact:br- muse �bc empiloyed,:to construct slde;�,sewer in street area., Do not cover any, �portion of'- siwerl.before it hadbeen irfspected� NOTE':No., 2­.A,11� work per formed�!in city, rIght-of-way requires -an', Invasionu of'LRight -of-Way, Perral t,o ta rrable, from the City Engineei!s,.offlce..� -informatio m regaxcling: Ordinance, J.jL 'I NOTE`-IN�oi 3--�-Giitaimfu_117 6.030�;pA- Regulations' governing side,'seweis iYhen.you -get permit. NOTE No: 4�—ToIY�ofl side� sewer, ni'u'si-have afl�ast 30 inches, c6verkje,id-piope�ty, 11ru es minirm1m7, gride',*of .2%. -�No,113ends'ln'-grad'e e anA� i2:indh inside 'property line sharbei-than- %,'will be permitted... No. &�Trenches in -street must be, water settled, and'surface of stre6f'r'estored to origindl conditi6n.- Contractors shall be respon�i�!e for,failure d e,*to�_lmproper u w6rk.,which- may,develo ­ P, within 0 ne year of completion.' NOTE 'No. ��It 1s; unla�v ' ful, to,alter, or do �any other work lhan­is�p:rovided for in -,the p&rmit,' or,to Ao, any"work on -the- maim er �or., its appurtenances 'except �to. in'- serV the, piipe'into, the wye. sew DISATPROVEDDate .......................................... By ...... ............ DAbb ............................. . L,.-.­RY ................. D*At� .............. B" .......... ...................... Y. APPROVE ................ .... . .. ....................................... ............. D*' T ...... B Y ........... �` ------ %:­. Zama;rks': . ................ ................................... .......... ................ ......... ................ .. ........ ........................... ............. ........................................... ....... ........... ... .............................. ... ........ L ....................... ....... ....................... ........ ............ ;­ .............................................................................. 114TH Yei#it Copie&',M,U',S'T- lfe'�. ned- By.,OWner �6f':Firffi P6rf6rhnirfj:ConitructiOn PRIOR to Requbst For Inspe6tion hereby !certifSr .. . ......... . ...... ...................... ..... .... th�i�-'the side,�ewerinstalliitioii'co:p§tr-u'dt'edl-iinder,,thi§, permit --ne f-. ont et ciforming Constru rn� P cti n was,instOl�d imaccordance, th-all governing',prdinan6 s�bflth,OCity of Mdmorfds., .. .... ... 6'aited iffl­ of .............................. Cfi6ek, BEFORE'�otf dig'for: Mi �Seiy.er E1 El. N/1 V, at&' .!G Telc�hofie-' El, er 0 ,2 a C / ,) - SNOHOMISH HEALTH DISTRICT DIVISION OF SANITATION STREET FILERockefeller Avenue, Everett, Washington APPLICATION FOR A SEWAGE DISPOSAL SYSTEM PERMIT (Submit 3 Copies) Permit to be issued to: --- ... ... ........... 4ff"s ..... ------------ For installation at: (street address) -------- . ........ ........... ......... . ....................................................................... ..... .. ....... Addition or Subdivision. - _- ------------------------------------------------------ Lot._1�7�_ Block ---------------- Type of Building: New ... X --- Existing .... ------- Single family residence ---- Number of bedrooms....;?, ..' .......... 11 ........ Other: (specify type or use) ------- ............................ ............................. ....... ------------------------------------------------------------------------------ Builder --- ... --------- .. ....... A d d r e s s 'ol - o:�17_ 4'e 4�� - -- -- --------------- Address-,/ ... ... ---- Designers.14 ----- Z01 �_ Soil Log Hole No. '00 ------- - ------------------- Soil Log Hole No. ......................... ---------- -------------------------------------------------- Elevation of Water Table, if encountered. (Distance from ground surface) --------- ---_---------- ------_------_--- Corrections t o control surface water if needed'404�__e'::�."_.. --------------- .......................................................................................................................................................................................................... Specify if any removing or gradd* g of to ,oil, in field area./���� -------- o' . .......... . .. ..... 4 ---------------------------------------------------------------------------------------------- --------- ...... Percolation: Test Hole No. 1 — Average Rate -------- er ------ ------------------------------ I -------- (Fall in minutes/inch-bottorn 6" test hole) Test Hole No. 2 — Average Rate ------- �? --------------------------------------------- (Fall in minutes/inch-bottom. 6" test hole) Test Hole No. 3 — Average Rate ----- 7 --------------------------------------------- (Fall in minutes/inch-bottorn 6" test hole) Average percolation rate on which to base drain field design .... ..... -------------------------------- Septic tank requirements based on present rules and regulations: Septic Tank Size/ ---------- gallons. Amount of Square Feet of isposal Field 4��o Signature — Designe,�;e'04/ ---- ----------------------- Date..� ------_--------_- DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency) Permit issued (date)_ ... ............ ---------_-------- Permit Number ............ 1.3_K.5_� ------ ------ Remarks: ....................... __ ------------------------------------------------------------ ................................................................................................................... ------------------ I ------------------------------------------------------------------- BROWN 0 SCALE Is 9 f T Rull"'K A .4 PLOT AM WAShIMTON DESIGUR j2hn A. Crawvcrd 1220 N. 205th Seattlo 33, Wash. pp, 0-1911 - PH 8-310t 456 77�1 Pt /6" 1 /,9 Arl, GEL ra;ALt Tcmt k FiL Drala TIN A. Min. Wad To Wa 9 or"Ifificid Not To Ex=d Shzded Ajoa The City of Edmonds I;L;L - -0,29�6 0 APPLICATWH STRaT FLE for SWE SEWRR PXXMT A~ NEW CONSTRUCTION Z3.� RW 99��� EASEXOM No. OWNER ...... S ........ I v . ............................ CONTRACTOR . ...... ....................... Prit3m No- ADDRMM LOT No__ . ....... . ........... ----------------- LWAL DESCRIMON: ............................. BLA)CK No . ............................................ NAME OF AMMON ..... .............................................. F�ECEiVED i- APR -;) '%-"72 w , f I L,,&�,L I p/Uj 4f t ( t�� ks4:'r,�'t 4040 Vo MA Tot ApprovW: DATE... '-**� ........... ---- ........ ..... . 7 NOTICE: U_rarr -N'0­wa rra n y o -cc 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.onds does not . wa rra nt the accuracy of anything set for.th on these entity -requesting a map(s"). Any person or n*ndependent copy should conduct a i shown on inquiry regarding the information IMIted to t-Fe *m a p (s); including, but not H -er stub shown. Such the lociation ofan'ysew ',or may- not exist and may sewer stubs may or may not exist at the location shown. the r-ity of Edmonds nor its Ne'thel %�_� e M P.I. 0-Y e e-S 0 0 ff i -c e r s -s h- a- I. I b e a. b.-IF-e f o r h e information given on this map(s), nor for any one representation provided based upon said map(s).