20622 77TH PL W.PDFiiiiiiii lill
6554
20622 77TH PL W
City of Edmonds
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number.
W.ue Date:
.1. STREET FILE'
A. Address or Vicinity of Construction: 20622 77 PI W. (9404600)
890 C� B. Type of Wo . rk (be specific): @nstall New Service
C. Contractor: Washington NatiirAl Gag Company Contact: Frank Rwan
MailingAddress: 815 Marcer..Rt, �qpat-_ 1— LIA Phone: 224-2278
State License #: 98111 Liability Insurance: Bond:$
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. Commercial E) Subdivision El City Project Q Utility (PUD, GTE, WNG, CABLE, WATER)
Multi -Family E] Single Family Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut: 91 Yes 5dNo G. Size of Cut: X_ H. Chargq�,$
0 C
APPLICANT TO READ AND SYGN
INDEMNITY. Applicant understands and by his signature to this application, agrees t the City of Edmonds harmless fro*niL2riV, damages, or
- t
b i
claims of any kind or description whatsoever, foreseen or unforeseen, that may e m. Vgainst the City of Edmonds,,;", �4'f iis;�partments or
employees, including or not limited to the defense ofany legalproceedings including defense costs, and attorney fees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP,AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THEWORK ESTIMATED RESTORATIOPAFF�RV.LLL BE HELD UNTIL T1�E_FJML;4REET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISS 'k,�,XPrPhICANT.
Construction drawing of proposea work required with permit application.
A 24 hour notice is required for i'nspection; Pleasei,call the Engineering Division, 771-0220.
Work and material is to be inspected during progres's and at completion.
Restoration is'to be in accordance with City"Codeis. 1:
Street sh4ll be kept clean at all times.
7'raffic-Control and Public Safety shall be in accordancewith Qjty �egulations as required by the City Engineer.
All street cut ditches shall be patclred-with asphalt-oroCfty apprWv"e"d material prior to the end bit_1kTbr16Kg day;
NO EXCEPTIONS.
I have read'(Ce above statements and understand thepermit requirements and the pink copy of thepermit will be
available on site at a�ll �ft for i . nspeiti . on purposes.
Signature: — &�� . Date: December 7, 1993
'�—(N_ntlractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER RJ6 2-5- DAYS DISRUPTION FEE/FUND Ill:-',
SPECIAL CONDITIONS: RESTORATION FEE:
PERMIT -FEE:,
J*
TOTAL FEE:
COMMENTS: ,,RECEIPT FEE:�
a
0!
R"
DATE: ISSUED BY: 194,c
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund 111 Route copy to Street Dept.)
Comments:
Diagraw
CONTRACTOR CALLED FOR INSPECTION El YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
FEIMI
NakjrQ Gas
Addendum to Cit of Edmonds
Right of Way
Permit Application
2Submitted by: MITCHELL S.-LANKFORD
Engineering Aide
Washington Natural Gas
# -'-521---"�5246
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101,21
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WNG to window
W — in depth Key:
rZtno_ro_w�n -w- water
-9- gas
gas main -ss- sewer
-19- water hydrant
0 water, -valve
815 M=a St' (P 0' Box 1869)- SuOk, WA 98111 (206) 67.2.6767
APPLICATION
for
The City of Edmonds Ew SEDE SEWER PERMIT
ET FILXW CONSTRUCTION E] REPAIRS F-1
Q-161-
OWNER .. .. ...... i ... .....
ADDRESS ... ... .. 3.10 ....... ;zy --- a-�....
.... I. .) ..................
-7
0
0
0
/--2 3,P-'
PL&L,
EASEMENT No . ..........................................
CONTRACTOR PERMIT No.
LEGAL DESCRIPTION: LOT ........................ BLOCK No . .................. .........................
NAME OF ADDITION.. . .. .. .... ..........
-/--j ......................................................
Approved:
APPROVED
MAY 3 11967
DATE ... 6.—.47n.6.? ................... B,
CITY OF EDMONDS
CIVIC CENTER — WATER -SEWER DEPARTMENT Call PROSPect 6-1107 .he. work
Is ready for inspection. (No inspee-
tions Saturday, Sunday or holidays.) N? 2304
SIDE SEWER PERMIT
- -------------------------------------------------------------------------------
.....................................................
OWNE*_—'V)jj� .... /Je� .....
110,W&,C ------ CONTRACTOR_.1_y_,JW ......
Permission is granted ..... M&y- -_--_----- �31 ....... 19k.7., for ------- ---------------- days to REPAIR or CONNECT a side sewer
with City Sewers in accordancqwith 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 Contractor must
be employed to construct side sewer in street area. Do not cover any portion of sewer before It has been inspected.
TE No. 2—Obtaln 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.
NOTE 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 appur-
) tenances except to insert the pipe into the wye.
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 Hab-le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).