20831 83RD AVE W.PDF111111111111
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20831 83RD AVE W
CITY OF EDMONDS
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PUBLIC WORKS DEPARTMENT
'RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction
22,831 03 AV 11 Pleat 0 1-61-0,69,14
0 Owner: TJcshlricj�-on Na,�,uzal M@):-3 Co
Name
3(15 15-6 Aq7 NE
Mailing Address
Oollavnn, t1nnh,�nq-ton 900 7
Clty� State, Zip Code
0 Contractor:- 0 a� `0 P�,13 Ib OVC
Name
Permit No.
Issue Date
9 Permit Issued To: " )�_) A!� 11 1
0 Type of Work to be Done:
9 Work in Connection With:
• Sub or Plat D—Single Family
• Comml. / Ind. 0 Apt. Condo.
Pavement Cut: 0 Yes El No
Mailing Address - � - , I . .. . � t, . State License Number
Z
< City, State, Zip Code Telephone Number
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NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by �is signature to this application, agrees to hold the City of Edmonds harmless
from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
against the City of Edmonds, or any of it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
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Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
0
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand that this Pe
I
Signature: 1 V
Own�r or A
avai� the jo)ylite for inspection purposes at all times.
te Ocl-_ :E72�,
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Void after —days
Special Conditions:
Ammendments:
0
Permit Fee:_4� .- 0 r
Security Deposit:
Receipt No.:
Fund I I I Fee:
Street Cut Dimensions
� X
* * NO WORK TO BEGIN.PRI,OR TO PERMIT ISSUANCE .* *
Eng. Div. December 1978
FIELD INSPECTION NOTES (Fund 111 - Route conv to Street Dept.
Comments:
Diagram:
Contractor called for inspection Yes No
Work Disapproved By: Date: g12 Bv: Date -
Work Approved By:__ --Date:
Inspector:
Ena. Div. December 1978
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I UVION
APPLICATION
for
The City of Edmond I s. S11DE SEWER PERMIT EASEMENT N
0 . ................. ........ ..............
NEW CONSTRUCTION REPAIRS 0
PrF� Nt-4 Y--, %-apmc— V=L-UMVS%t-4 C=,
OWNER .............................................................................................................. CONTRACTOR 0-417F . ..................................................................... PERMIT
......... ..................
ADDRESS............................. ............................................................................ LEGAL DESCRIPTION: LOT No . ..... ......................................... BLOCK No . ............................................
R4=*5F-=�-V f=—. th-MC) �40.2-
NAMEOF ADDITION .........................................................................................................................................
III
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tsTweb
Approved:
A ..... 0
DATE
NOTICE:
-N o wa rra nty. oT -accUtd�'Y
The information on t.he attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edm.qnds does not wa.rrant the
accuracy of anything set forth on these
map(�_). Any person or entity -requesting a
copy should conduct an indep-endent
inquiry regarding the inform-ation shown on
I
tFe'map(s), including, but not limited to,
th-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 "ity of Edmonds nor its
k__1
ernplfo-yee-s o-r offi-ce.rs -sh-a-11.1 be 11a.b.-I.,e for the
information given on this map(s), nor for
ion provided based
any one representat'
upon said map(s).
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER-SEVEM DEPARTMENT
PERMIT
Call 77 -2525 for side sewer inspections BEFORE covering any Portion of the construction.
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections)
ADDRESS LOCATION OF CONSTRUCTION ------ 20a-31 .... 7 alrd..A�tenua..Ma-Z I
PROPERTY LEGAL DESCRIPTION ---
--------------
...................... . .......................... . .......... . .......... . ........................................................................................ . .................................. . ..................................................
................................................................ O-VVNERA3M,1OR BUILDER ........ FRANX .. ... PT Tr
L. _LE ... . .................................. . .......................................................
CONTRACTOWSNAr4E&AII)DRESS-..''ni.-�-,=,,I..Dl-,,ml,in� 9. �Znt.j
—7. -------------------
Permission is granted ........... . .. 19 ... 7.3, for repair and/or connection of a side sewer to the city sanitary sewer
--- ------------ . ..............
system in accordance with City of Edmonds ordinances.
AT_7TION IS CALT D TO THE FOLLOWING:
N( 10. 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 constr'uct
side sewer in street a-rea. Do not cover any portion of sewer before it has been inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invasion Of Right-Of-WaY Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Tolp 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. 5—Trenches in street must be water settled ajid 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--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 appurtenances except to -in-
sert the pipe into the wye.
DISAPPROVED Date--- BY ------_------- Date .............. ........ :7 ........ By ------------_- Date ............... . ................... By ----------------
APPROVED Date_
/& �' J, .................. By ... . ...... P.*! . . .. . . .... . . ................... A\
ks: .....
Remar AKOE' LNQ� '3 8189
........... ...... ....... ......................................... ................................................................................................................................
..................................................................... ......................................................................................... _1 -
................................ . .......................................................
BOTH Permit Copie T Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
. J5"� '�I - -
Iod.. ...... ......
of C�-- �-g . Perf - or . ming --- Con . str . u . ctio - n hereby certify that the side sewer installation constructed under this permit
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wp—*-xstalled in ccordance with all governing ordinances of the City of Edmonds.
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Dated this ........... 7 ............ day of ............ .. . ..........
.. . ...... ..... ....................
-j V Check BEFORE you dig for: Water C], Gas El, Telephone E], Power 0, Sewer 0, Other 0 %1 V
Tho City of Edmonds
APPLICATION
for
SIDE SEVVER
NEW CONSTRUCTION ;�""ffREPAIRS 0
OWNER... . ........... .................
ADDRESS ...24F.Al .. . ... 6?,3X.�d ------ ae,-e
.. ........ t .... �u ..................
EASEMENT No.
CONTRACTOR .. . .... PERMIT No.
LEGAL DESCRIPTION: LOT No. ............ ................ BIA)CK No . ............................................
......................................
NAME OF ADDITION ...... oe . . .... ;",� ..........
RECOVED
NOV 2 1913
Approved:
DATE----------- .................................... By -----------------------------------
U)
Aj
OP
01L"1=
CD
CD
Frank L4 Leptick and/or Rosella A. leptickp their successors or assigns
here -in -after referred to as the grpntorp grants to James W. Clarke
and/or Bonnie Js Clarke, their successors or ;ssigns here -in -after
referred to as the grantees for the suM of $10.00 and otbMw valuable
consi�eration the following described perpetual epsement to be used
for underground sanitary sewer line rurposes:
The north 5 feet less the east 58 feet of Lot #33 of Plat Robert
E. Tboras Addition #2 filed at Snohomish County Court Fouse in
Everettj Washington.
In additions the grnntor and the grantee will constructs reconstruct
and maJntaln the said sewer line jointly.
Followir* said constructions recoAstruction or Tmaintenance the grounds
a .
will be restored to original condition and work will be performed
neatly and promptly.
Date:
GrantoC2�z NO SALES TAX
-'Z REQUIRED
NOV 11973
Grantee
VERNE SHERS, S"Sh.AVUM;'
;iaz��a�D UtY
STATE OF WASHINGTON
)ss
COUNTY OF SNOHOMISH
SUBSCRIBED AND SWORN TO before me this 30th day of OctobMi 1%73.'-'�
tZL
ARY PUB.111C In-7a,xiord, to f
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no nohomish County, Wit0hIngton,
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.11'reoiding Jn Edmonds.
Mum
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REGARDING: 20831 - 83rd
Avenue West
67C&O
Ta-d Tr—e
R E C
0 R D 0 F C 0 N
T A C T S
DATE
NAME, PHONE NO., &
ADDRESS of CALLER
COMMENTS
5/l/74
Frank Liptick
Certified
Letter No. 406326 sent
requiring
hook-up within 60 days.
7/1/74
Certified
Letter No. 406572 sent
requiring
response by July 12.
7/74
-Discovered Unit&d Plumbing had
obtained permit #4524 ll/S/73.
Pan
ComeQtig_n_coWletQd.
11/7/73.
PC
ACTION TAKEN
Letter received.
Letter received.
INITIALS
TE
TE
TE
SENDER:� h
e sirre fo-follj
0/� insf ructions on ofher side
A E�N
V
'8H Zn� 12�,
�LE FLI
LEASE FLIR�NISH SERVICE(S)ANDiCATED BY CHECKED BLC)Ck�
z -�es re,72iiie
.(A,dd tion-al ch�r d fpr these scrvic6), S)
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how 'S
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�L_j "Wheee0eliv6rea D I*
tloellver QNLY RECEIPT FOR CERTIFIED MAIL-30�
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dress.ee gstage)
RPT
TCEIPT
Receive 421-07400
d'46 numbe OSTMA
I�ILKW "U. red arficle dds*ciibed�below bl?,D�TVE�
Q0 LEPTICK, FRANK
SilliNATURE-OR L
F ADDRESSEE (must /way R, "I , ,
s bolilled In)
20831 63RD AVE. W.
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EDMONDS, WASHINGTON
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A, I I 1 1: �SEFS AGENT, IF 20
2 ANY 980
SIGN 98020
INSURED No., OPT 015 S
DNAL FEE
NAL FEES
RETUR 7
N 10 Whom and date delivered ...........
With delivery to addressee only ............. 650.
R 7E
CIE PT
TE VIC :h.:-
�N
RECEIPT Ws to whom, date and where delieed
_SHG SERVICES With de
_-UtLJVLREQ.�-_W.2 lkiL COUCSte D L I� With livery to addressee only
dJ?icLudcZ1,P_Co 1350
acl— E VER TO ADD Z-,� t L UNLT L
..... .. ....
SENDER 8,,
e.surefc foil
insfructi
crIs on other sida
e�,LEAISE FUkNiSH SERViCQS)
ANDICATED, BY CHECK
LOCK(S)
�Addih.onaz,�harr�is eq2a�ed' ED B
for.these,
'S address: services)
ver ONLY
whoe%r�fe delivered tDeli
ddressee
R
Receiveq the Aulhibered c"ficle de
REG CST—ERED —No., scribed below'.
SIGNATURE UR HAME OF -ADD
-RE-Irt (must always beff led ir�)
IG OF ADD
RES, E' A EN IF ANY
I URED NO.
"':'DATE DELIVERED
SH
JO WHERE- E
VERED,
(Qnlyif ciuested; an
Rd
3
---------------------
� .... — textra tee required) .................. —1
PS Form 1
3800 NO INSURANCE COVERAGE PROVIDED— (See other side)
Apr. 1971 NOT FOR INTERNATIONAL MAIL Gpo:
RECEIPT FOR CERTIFIED MAIL-300 (plus
SENT To -------- postage)
POSTMARK
OR DATE
Apr. 19-7-1 3800 F40 INSURANCE COVERAGE PROVIDE (See other sid,,)
NOT FOR INTERNATIONAL MAIL GPO: 1970 0-297-45.