20828 HILLCREST PL.PDFIIIIIIIIIIIIII
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20828 HILLCREST
PL
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RIGHT-OF-WAY CONSTRUCTION
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PERMIT, Permit Number.
Issue Date: tz
A. Address or Vicinity of Construction: - 20,828 Hillirest Place (9406122)
1B. Type of Work (be specific): Install New Service
C. Contractor: -Washington Natural Gas Compan
MailingAddress: 815 Mercer Street
State License #: Seattle WA 98111
D. Building Permit # (if applicable):
Contact: Frank Swan
Phone: 224-2278
Liability Insurance: Bond:$
Side Sewer Permit # (if applicable):
E. F1 Commercial 0 Subdivision El City Project 5a Utility (PUD, GTE, MING, CABLE, WATER)
n Multi -Family E] Single Family E] Other
INSPECTOR: INSPECTOR:
F. Pavement or Concrete Cut 0 Yes 0No G. Size of Cut: x H. Chargq�_$
APPLICANT TO READ AND SIGN
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INDEMNITY.- Applicant understands and by his signature to this application, agrees to, 6bldllta City ofEdmonds Lrmle: fanom Gli t?
ye§, Vm ges, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be ma the City of Edmonds, o any 6f it dep6rtMents or
employees, including or not limited to the defense of any legalproceedings including defense costs, and attorney fees by reas n ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE.FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
�? , )� "z - )"t - 9jr
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 apbrdved material prior to the rpd of the working day;
NO EXCEPTIONS.
Ihave read the above statements andunderstand thepermit requirements and thepink copyof thepermit willbe
available on site at all t' for inspection puVoses.
Signature: . 4 ' Date: Der-eMber 27, 1993
�v(Mwn`irlacto�r _0r_TgZ_n'U'
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: & A-2 1--m. , RIGHT OF WAY DEPOSIT
TIME AUTHORIZED VOID AFTER DAYS
SPECIAL CONDITIONS:
COMMENTS:
DISRUPTION FEE/FUND Ill -
RESTORATION FEE:
PERMIT FEE:
TOTAL FEE: *3a- -4
7'_
RECEIPT FEE:
DATE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Engrg. I)iv. 1991
FIELD INSPECTION NOTES
Comments:
Diagram.:
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by
Work Disapproved By:
FINAL APPROVAL BY:
P.W.:
(Fund 111 - Route copy to Street Dept.)
El YES NO
Date:
Date:
Addendum to City of Edmonds
of Way
Permit Applicaiion
-.Pubmitted by: M-ITCHELL S.-LANKFORD
Engineering Aide
Oz 4-C) ( ;52 ra-L Washington Natural Gas
# -'-521-�5246
kj
Q/A WNG to window
r-
0��ain depth
gas main
Key:
-w-
water
-g-
gas
-ss-
sewer
-E)-
water hydrant
C).water
valve
81-5 Mc".- -�z (I;). WA )811
IC 'INURKS DEPAM= CHECn* Date
STREET FL?""BUILDING PER= REVIEW
A . ........ --I -A-A A -
My I 4L"Nr_M hM- J1
SO
i Street Right -of -Way Existing REQD
Access Easements Existing REQD
Utility Easement Existing REQD
lot per Subdivision Plat Assessor Map
Site Plan Checked for Accuracy
Z
Underground Wiring Reqd.
941 Check Accuracy of Legal Description
14 Environmentally Sensitive Area I how
Envirortmental Checklist - Reqd. K VA
Flood Hazard Zone
1_" Shoreline Management Area AJV4.
Z Slope, Soil, Vegetation aim
Stream, Creek, Drainage Basin NV
Existing ZoningTer Code OS/2
Amenities Design Board Approval Reqd. a-4) ADB # Approval
Board of Adjustment Ampproval Reqd. &:0'
Review By: �4�j 1 Date:
Existing Water Main Size
Water Main Reqd.
Service Line Reqd.
Hydrant Size Existing
Hydrant Reqd. Per Fire Code
-:V. Detector Check Meter Reqd.
Cross Connection Inspection
Fire Department Comments
Water Meter Charge Reqd.
Review by:
15eptic -i-anK Design Aprrc
Septic Tank Permit R * .
Sanitary Sewer Availabdil-
Drawing No.
Side Sewer Availability
Sanitary Sewer Connection
Review By:
Size
Date:
Date:
Permit No.
le No.
1E
Reqd.
Date:
%-AAA
Open Ditch Existing, V-- Reqd.
Culvert Reqd.
k Size
P� Catch Basin Reqd. Indicate on Site Plan.
0
Shoulder drainage niailitaii-i collec on bi,7ale open runoff
P t/11
M�u-diole reqd. Indicate on Site Plan
Soil Conditions and Groui.id Water Field Cliecked
Revie�%7 by Ulte
!qStreet Paving Reqd.
Curb and Gutter Reqd.
Sidewalk Reqd.
Curb Cut . for Driveway Reqd.\,
P� Right -of -Way Construction Pe
Bond Reqd. for Public ImproverDe s
IStreet Nami- Sign Reqd._
a
Other Signin, Reqd.
3Pre'Perniit Site Inspection mde on
(D
BY: SEI.TER
WATER
STREET
ENGINEERING
5SPecial Requireme—nts listed in iiieim to Communi�y Development Department,
DIBuilding Division
BY Date
o All item filled in on Building Permit Application
BY Date.
f P4
'4 Dra�,Tings Sta and Notations Made
BY g5;::' Date
lApproved by Public 'Norks Deparment
Revised: Iv 10-1977
EASEMENT No - ------------------------------------------
LJ.QWNER ------------------ CONTRACTOR ---------------- au).d.ce - ----------------------- .................................... PERMIT No.
DDRESS ;�.lr... LEGAL DESCRIPTION: LOT No - -- ------------------------------------------- BLOCK No . ......... ----------- ----------------------
----------------
NAMEOF ADDITION .........................................................................................................................................
a
Approved:
DATE .... .... 070 --- ----------- By
W
CITY OF EDMONDS
CwIc:-:-CENTER — WATER -SEWER- DEPART]" T' 'Pall PROSPect 6-1107 when work
N is ready for inspection. (No Inspee-
tions Saturday, Sujjday,,O�holldmys.),
:N2 3503
SIDE- tSEWER PERMIT
41?DRIPS ...... Place
OUNER Lawrence J. Kleiner .. ...............................................
...................................... ..................... * ........... * ...... CONTRACTOR .............
. .......................................................
P
eirinission is granted ................... octob-'er ... 2.7, for .....
WI.th City:Sewers In accordance wit ...... days to REPAIR or CONNECT a side sewer
h application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the Pioperty may obtain a permit to construct sewer inside Property line. A
be employed to.constru-dt side sewer In street area. licensed Side Sewer Contractor must
NOTE No. 2�Obtain DO not cover any Portion of sewer before it has been Inspected.
full information regarding Ordinance 11.16.030 and Reg . ulations 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 'A will be Permitted.
NOTE No. 4--Trenc'hes 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. 6-1�t 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.
71