20612 77TH PL W.PDFIIIIIIIIIIII
6552
20612 77TH PL W
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 officers shall be lia-b-l-e for the
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 DEPARTMENT is ready for Inspection. (No Inspee,
SIDESEWER PERMIT tions Saturday, Sunday or holidays.) N? 2302
ADDRESS---
----------------------------------- ..................................... . ......................................................... ------------------
OWNER_- mi.?Le ... ------ CONTRACTOR
NV ----
Perniission is granted --- ------------- 1 19.01.7-, for -----------_---------- days to REPAIR or CONNECT a side sewer
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION 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 Contraetor must
be employed to construct side sewer In street area. Do nut cover any portion of sewer before it has been Inspected.
V -U No. 2—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
_4' 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 'A will be permitted.
NOTE No. 4—Trenches In street must he 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 appur-
tenances except to insert the pipe into the wye.
APPL ICATION
.MOEN
IPOR
'T"'ET
FILE
SIDE SEWER PERMIT
OUTSIDE 0 INSIDE REPAIRS[]
LYNN PLANT CARD Iq - ---------------------------------------
;EAMEAKENT No ....................................
OWNER, <;;r .......... .. ... .. . .... ..... . ...... . ......... ---- CONTRACTOR— ...... .... . ............ o rl I ;k
Z4.-L ..PIMBM
STREET
HOUSE No ............. :�lte a-V--e--4K .... ........................... AVENUE LOT ..................................... ...... �Bll�A� No ...................................................................
7
......... . .... . .
NAME ADD ....... . ... ---------- . ............. . ......................................................................
7?. aj
0
.10
".5
BACK� WORK ORDER ISSUED..
SEWER
Form .2
APPROVED
mAy 3 1.1867
5-0
DATE Approved:
................................. DEPOSIT, $ ........ ........................
................................. DATE, ... 6-:71 ..... 6.2 ... . ................... ..... ------ 7
RONALD SEWER DISTRICT
APPLICATION FOR
SIDE SEWER PERMIT
he undersigned hereby applies for permission to construct a side sewer as indicated on reverse of this sheet.
he undersigned hereby agrees to construct a side sewer
T as above applied for subject to the following stipulations:
1. That all regulations and requirements set forth by Resolution No. 94, as amended, of the Ronald Sewer District,
be complied with fully and completely. Resolution No. 94 is by this reference,'included in its entirety .as a part of this
side -sewer permit application and the issuance of this permit and acceptance by the Owner, or his agent, will be construed
as prima facie evidence that the Owner, or his agent have read same and agree to its terms and stipulations in their
entirety, particularly Sec. 19.
2. The Owner hereby agrees to maintain the side sewer constructed under this permit in accordance with the rules
and regulations of the Ronald Sewer District and furthur will permit access with entry by authorized representatives of the
Ronald Sewer District on the property described in thi's permit at any reasonable time for the purpose of inspection for
compliance with all Sewer District regulations.
3. The Owner is hereby notified that the Ronald Sewer District sewerage system is of the sanitary type system and
he agrees that he will not at any time connect storm water drainage from any source to the District's system'; this in-
cludes, but is not limited to the following:
(a) Roof Downspouts.
(b) Building Footing Drains.
(c) Springs on the Property.
(d) Any Outside Ground -Water Drains.
4. The Owner and his Contractor hereby agree to accept full responsibility, and to hold Ronald Stwer District harm-
less, for any li I ability, damage and/or costs which may accrue from prosecution of side -sewer work under this permit.
5. The Owner and/or his Contractor hereby agree to safeguard the work done under this permit in such a manner
as to prevent injury and/or damage to the public. Such precautions shall include ihe employment of all necessary ditch
safeguards such as lanterns, barricades and safe access or egress through the working area.
6. The Owner and/or his Agent agree to employ a side -sewer contractor approved by the District- and covered
with adequate and satisfactory liability insurance, licensed by King County, and/or the City of Seattle, as the - case may
be, for all work to be prosecuted on public roads and R/W's.
7. The Owner and his Contractor agree to install the side -sewer covered by this permit in full compliance with
the Sketch entitled "Side-Sewcr Requirements", which includes, but is not limited to the following:
(a) Cover on Sewer Pipe at Property Line to be at least 36" below road grade.
(b) Cover on Sewer Pipe on private property to be at least 18".
(c) Minimum grade to be 2
(d) No bends to be sharper than V8 bend will be permitted without a cleanout.
8. No backfilling will be allowed until the work has been inspected and approved by the District's authorized, in-
spector. All backfill shall be tamped and/or water settled.
9. The Ownei and his Contractor agree that all street cleanup and road restoration will be made to the satisfaction
of the governing authority, i.e., City, County, or State Highway, etc.
lo. The Owner and Contractor� agree to obtain, at no cost or liability to the District, all other necessary permits
for construction work to be accompii'shed under this permit.
11. The Owner and/or Contractor must call for inspection upon completion of any portion of side -sewer.
OWNER'S SIGNATURE:
Date:
OWNER'S AUTHORIZED AGENT: (SIGN AT URE)
AUTHORIZATION: (DFSCR I PT ION)
Date:
CONTkACTOR'S SIGNATURE:
Date:
4 ftwv
0 'it 140t��
City If -Eidmonds
RIGHT OF -WAY CONSTRUCTION.
PERMIT 7
Permit Number.
Issue Date:
A. Address or Vicinity of Construction: - 70619 77 pl W (9620925)
141ANow— C3
9 0 1 9 C) Type of Work.(be specific): Install Service
C. Contractor: - Warhing�nn Na'tijrgl Qqit Contact: MariAmnp Kinhhury
Mailing Address: '1122 75 St Sw RyArAtt Phone: 356-7500 X7596
State License #: 1" 98203 Liability Insurance: Bond:$
D. Building Permit # (if applicable):
'Side Sewer Permit # (if applicable):
E. 0 Commercial 0 Subdivision El City Project IM Utility (PUD, GTE, WNG, CABLE, WATER)
E] Multi -Family El Single Family Other
INSPECTOR: 114SPECTOR:
F. Pavement or C'oncr�te Cut: 0 Yes IgNo G. Size of Cut: H. Chargq�,$
APPLICANT TO READ AN N
INDEMNITY: Applicant understands and by his signature to this applicati n, agrees to hold the Cilty ofEdmondg harmles's frqm injuries, -damages, or
10
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its d4paFtments or
employees, including or not . limited to the defense ofany legalproceeding8 including defense costs, 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 A&EPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT, WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
Construction drawing 6f 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 copy of thepermit will be
available.on site at all imes for inspection purp oses.
9-6-96
Signature: Date:
Mxontract& or_Ag_�nt)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY:
TIME . AUTHORIZED- VOID AFTER FA DAYS
SPECIAL CONDITIONS:
COMMENTS:
DATE:
RIGHT Of WAY'DEPOSIT
DISRUPTION FEE/FUND Ill:
RESTORATION'FEE:
PERMIT �FEE:
TOTAL FEE:
RECEIPT FEE
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994
FIELD INSPECTIONNOTES
Comments:
Diaaram.:
(Fund 111 - Route copy to Street Dept.)
CONTRACTOR CALLED FOR INSPECTION 0 YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
El NO
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NakarilGas
AVAylwxjk)n EreWCCnPMV Addendum to: City of Edmonds
Right of Way
Permit Application'
Submitted by: Mariamne Kingsbury,
Engineering Aide
Washington Natural Gas
1356-7500 X7596
C� Moe
PL-V.,)
Key:
-W- Water
Watermstin depth QQ �QDICA-r�bh3 -G- Gas
-SS- Sever
-& Water hydrant
gas main Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331
WIldik
9 G; ;
AVAVI*XfiDnErVWCCnVffV Addendum to: City of Edmonds
Right of Way
Permit Application'
Submitted by: Mariamne Kingsbury.
Engineering Aide
Washington Natural Gas
0356-7500 X7596
Vuo,#4
ISO
C��-- ,
A
t.—L CZ0 woe
C A-4-7
Key: -w- Water
Watermain depth vjO �Q.DICAI�-bA3 -CV- Gas
-SS- Sever
-& Water hydrant
gas main 0 Water valve
Washington Natural Gas Company
1122 75th Street S.W., Everett, Washington 98203, (206) 355-3331