20914 HILLCREST PL.PDF11111111 lill 11
11676
20914 HILLCREST
PL
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER MENT
PERMIT
Call 7,76-1107 for side sewer inspections BEFORE covering any portion of the construction.N
Inspection will be provided within 24 hours after request. NO Sat., Sun., or holiday inspections.1
ADDRESS LOCATION OF CONSTRUCTION .............. 20914 Hfllcrest- Pla-c
................... .............................. -
---- ........................................ . .......................................................
tll'est 90.01� of S 1120' of H 650' , Lot 7, Ald6rv!d Mnr
PROPERTY LEGAL DESCRIPTION ......... .................................................... * ............................................................................... .
..........................................
..................................................................................................................................................................... . ......................................................................................
I aris
................................................................ O`WNERi%ND/OR BUILDER ........ 0- C� M .... * ------------------------------ * - ----------------------------------------------- * .......
............. * ........... * ......
I!,ss Johnson, 16009 N. Aoadowdale Rd. , Edmonds, llash. -DT�RU
CONTRACTOWS NAME & ADDRESS ............................................. -------------------- 7 .............................................. ........ . ............ : .................... 11 1 -
.......................
Permission is granted ...... June 11 ......... 119 .7.3.., for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with';6ii�"O'i"E-d,mo�is-,or'dinances.
A'gftTION IS CALLED TO THE FOLLOWING:
NWo. 1—The owners of the property may obtain a permit tooconstruct sewer Inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion f sewer before it has been inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invazion of RJght-of-Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regaxding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
140TE No. 4—Top of side sewer must have at leazt 30 inches coverage at property line and 12 inches inside property line; minimum grade of 20/,. No bends in grade
sharper than 1/s will be permitted.
NOTE No. 5—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. 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 maln sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVEDE) Date ... . ................................... By ................. Date ............ 4 .................... B ..... .......... Date ............... . ................... . Vy ................
APPROVED 1K Dat ............ i�4.,Yztf_ .......... By ....... '00000�_
. ..................
ap ... . ..... .....
Remarks: ....... /vp- ..... 10%mg4s ------- ..... . . .... ......
.................................. _ ............ . ... ............ . ....... I ........................
... . .......................................................
Be Signed By Owner of Firm Performing, Construction PRIOR To Request For Inspection
l4.1�11_1v/.. hereby certify that the side sewer
e-e 'COM ra P�� I n__ g- ... C_ -o- n__s_ t--r- u__ct_ I o--n- -) --- I
nce ng ordinances of the City of Ediii6nds.
Dated this .......... /.( ............ day of-;.
constructed under this permit
...... / ....................... 19 .........
. -� V Check BEFORE you dig for: Water E], Gas E], Telephone E], Power
Sewer E], Other E] V j
�T—
-i"IR
City of Edmonds
RIGHT-OF-WAY c0NSTRucj§;5EET FILE
PERMIT
A. Address or Vicinity of Construction:
KerM1L VIUMUer.
Wue Date: 117- 2�-
20914 HILLCREST PLACE
15, 9 0 9C) B. Type of Work (be specific): GTE TO PLACE BURdED SERVIC.E WIRE FROM
TERM # 7929 TO CUSTOMER, PLOWING 350-FT. PLEASE SEE ATTACHED'SKETCH.—
C. Contractor: GTE NORTHWEST INCORPORATED Contact: BARB :.488-1642
MailingAddress: 22118 20TH-AVE, sE SUITE 1_T&one:
State License #: BOTHELL, WA 98021 Liability Insurance: Bond:$
D. Building Permit # (if applicable):
i�
Side Sewer Permit # (if applicable):
E. n Commercial Subdivision .0 City-ppiect N Utility (PUD, GTE, WNG, CABLE,� WA TER)
F1 Multi -Family E] Single Family 0 Other:'.� -'W 0. # 2'1'O0-9i60'*1'DB' 242316
INSPECTOR:
INSPECTOR; .% k
F. Pavement or Concrete Cut: - 0 Yes MNo G. Size of Cut: x H. Chargq�_$
APPLICANT TO READ AND 4S
S
INDEMNITY. Applicant understands and by his signature to this application, agrees to h City ofEdmonds ha n7l f da ages, or
it h r' UT'
-t . q
claims of any kind or description whatsoever, foreseen or unforeseen, that may be mad 'a tthe City of Ed nd r fiMartments or
's
employees, including or not limited to the defense of any legal proceedings including defense. tsJand attorney fees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS:��R '?E'AIOD 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 -�ff Y CITY FORCES, AT WHICH TIMDA DEBIT OR CREDIT WILL BF PROCESSED FOR JSSU.�NCE� TO THEAPPLICANT.
Construction drawing of proposed work required with permit applic'at"ion. �"3
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.
T'raffic 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 approy�d material prior to the end,Qf the working day;
NO EXCEPTIONS.
Ihave read the'abdve'§tatements and understand'thepermit requirements and thepink cop.yof fhepermit will be
a 1. vailable on'site at all titnes for inspection, purposes.
Signature: Date: 12-9'
(Contractor or Age9f)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
I FOR CITY USE ONLY
APPROVED BY: I-XILACA-A RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER DAYS DISRUPTION FEE/TUND,111:
SPECIAL CONDITIONS: RESTORATION FEE:
PERMIT FEE:
11
COMMENTS:
DATE: r
TOTAL FEE:
RECEIPT FEE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Enug: Nv. 1991
FIELD INSPECTION NOTES
Comments:
Diagram.:
CONTRACTOR CALLED FOR INSPECTION
Partial Work Inspection by P.W.:
Work Disapproved By:
FINAL APPROVAL BY:
(Fund 111 - Route copy to Street Dept.)
1:1 YES
Date:
Date:
El NO
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APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS 0 EASEMENT No . ..........................................
MZ7-- OCDS"L C> LID Ida-1
OWNER.... ........................................................ CONTRACTOR
............................................... PERMIT No.45.al.o.
ADDRESS .0451-41`4 ...... ........ I .................. LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ......................
A..... . .............. . .............. ....
W. 4DO-401, ap am. IFECD, C�lvw N. cmew:z,
NAME OF ADDITION 1.90T .... 77 ...... .... W.,tirala
Mb&4-0.;.w2 ----- H.c>-,� .. C-:b
0
0
0
The City of Edmonds
APPLICATION
for
SEDE SEWIM PXRm
NEW CONSTRUCTION REPAIRS
OWNER -.�j ........
. ................ I ---------
EASEMENT No . ..........................................
Z, /. Z), & / C-4;:O�e?
CONTRACTOR 4 ..... (
---------- \J.r le of
--- ------ ....... pER311T No...7-�—
LEGAL DESCRIPTION: LOT No - ---------------------------------------------- BLOCK No . ............................................
NAME OF ADDITION ........ .. ... . .... . ... .. .. . . . ....... .................
DATE- --------------------- -_ ............ --- By ....................................................... ..............
JAN 3 1 2012
EET F
EDMONDS CITY CLERK
2 P6S
12/281220"1'1"10: 16amfi 00
SNOHOMISH COUNTY, SHNGTON
r
Return Address:
City Clerk
City of Edmonds
NO EXCISE TAX
121 - 5th Ave. N.
REQUIRED
Edmonds, WA 98020
DEC 28 2011
UTILITY EASEMENT KIRKE SIEVERS, Snohorniih Counly Treasurer
Property Address: None
By KIRKE SIEVERS -
Assessor's Property Tax Parcel Nos.: 00373600500713, 00373600500714, 00373600500715
IN CONSIDERATION of benefits to accrue to the grantors herein, the undersigned, Shegy B. Weave ,
hereby grant to the CITY OF EDMONDS, a Municipal Corporation, a permanent easement for the installation,
construction, operation, maintenance, repair, reconstruction or replacement of a waterline conveyance Dim and
necessary appurtenances over, across, through, and below the following described property, and the further right
to remove trees, bushes, undergrowth and other obstructions thereon interfering with the location, construction,
operation, maintenance, repair, reconstruction or replacement of said waterline conveyance pipe and necessary
appurtenances together with the right of access to the easement at any time for the stated purpose.
The easement hereby granted is located in the COUNTY OF SNOHOMISH, STATE OF
WASHINGTON, described as follows:
THAT CERTAIN PRIVATE ROAD OVER LOT 7, BLOCK 5, ALDERWOOD MANOR NO. 9 DESCRIBED AS
THE SOUTH 50 FEET OF THE EAST 135 FEET OF THE NORTH 330 FEET, AND THE WEST 50 FEET OF
THE EAST 135 FEET, EXCEPT THE NORTH 280 FEET THEREOF.
The easement area is depicted in the drawing attached as Exhibit A.
THE CITY agrees to restore to substantially the original condition such improvements as are disturbed
during the construction, maintenance, and repair of said utility or utilities, provided the grantors, their heirs, or
assigns shall not construct any permanent structure over, upon, or within the permanent easement.
t
DATED THIS QF
20-L
Sherry B. ehv��
STATE OF WASHINGTON)
)ss
COUNTY OF SNOHOMISH)
On this day personally appeared before me ShgM B. Weaver, to me known to be the individual described
in and who executed the within and foregoing instrument and acknowledged that they signed the same as their free
and voluntary act and deed, for the uses and purposes therein mentioned
UNDER MY HAND,� M,"WK!,4L SEAL THIS F
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01 %$.F AZ
op
for the
nit at
N. LUKE
EXHIBIT A
MAIN ST
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Lot 7, Alderwood 20901,
Manor No. 9
20914
c s �em e n�t
21105
21109
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RECEIVED
'JAN 3 1 2012
I&S�74 PI
EDMONDS CITY CLERK
Return Address:
City Clerk
City of Edmonds
121 - 5th Ave. N.
Edmonds, WA 98020
Property Address: None
201112280356 2 PGS
12/28/2011 10:16ajSH3100
-SNOHOMISH COUNTY, NGTON
STREET FILENO EXCISE TAX
REQUIRED,
DEC 28 2011
UTILITY EASEMENT KIRKE SIEVERS, Snoho6sh C.ounly Treasurer
B y KIRKE SIEVERS
Assessor's Property Tax Parcel Nos.: 00373600500713, 00373600500714, 00373600500715
IN CONSIDERATION of benefits to accrue to the grantors herein, the undersigned, Sher!�� B. Weaver
hereby grant to the CITY OF EDMONDS, a Municipal Corporation, a permanent easement for the installation,
construction, operation, maintenance, repair, reconstruction or replacement of a waterline conveyance pipe and
necessarV appurtenances, over, across, through, and below the following described property, and the further right
to remove trees, bushes, undergrowth and other obstructions thereon interfering with the location, construction,
operation, maintenance, repair, reconstruction or replacement of said waterline conveyance vive and necessary
appurtenances, together with the right of access to the easement at any time for the stated purpose.
The easement hereby granted is located in the COUNTY OF SNOHOMISH, STATE OF
WASHINGTON, described as follows:
THAT CERTAIN PRIVATE ROAD OVER LOT 7, BLOCK 5, ALDERWOOD MANOR NO. 9 DESCRIBED AS
THE SOUTH 50 FEET OF THE EAST 135 FEET OF THE NORTH 330 FEET, AND THE WEST 50 FEET OF
THE EAST 135 FEET, EXCEPT THE NORTH 280 FEET THEREOF.
The easement area is depicted in the drawing attached as Exhibit A.
THE CITY agrees to restore to substantially the original condition such improvements as are disturbed
during the construction, maintenance, and repair of said utility or utilities, provided the grantors, their heirs, or
assigns shall not construct any permanent structure over, upon, or within the permanent easement.
DATED THIS
STATE OF WASHINGTON)
) ss
COUNTY OF SNOHOMISH)
On this day personally appeared before me She= B. Weaver, to me known to be the individual described
in and who executed the within and foregoing instrument and acknowledged that they signed the same as their free
and voluntary act and deed, for the uses and purposes therein mentioned.
,,�,q/_f
UNDER MY HAND,��"WQAL SEAL THIS Z,2'4_D-A-Y_QF 20
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f4F"*A '%N, I NOITFARZY PU I for the
it - 0 - W
S 5-State of Washington, residin at
Ito, V816�
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N. LUKE
EXHIBIT A
MAIN ST
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Lot 7, Alderwood 20901?
Manor No. 9
20914
Easement
21105
21mg
21113