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-013LIC PORKS DEPARr,= CHEMIS-. Date-,
FILEC BUILDING PERMIT REVIEW
pA- pf)c:�T. �)tj L_y ddress
STREET
.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
Underground Wiring Reqd.
Check Accuracy of Legal Description
Environmentally Sensitive Area
Environmental Checklist Reqd.
;Tlood Hazard Zone
Shoreline.Management Area
Slope, Soil, Vegetation
Stream, Creek, Drainage Basin
Existing Zoning Per Code
Amenities Design Board Approval Reqd. ADB # Approval
Board of Adjustment Approval Reqd.
Review By: X ZVV\A Q_ Date:
Existing Water Main Size
�Iatze,r Main Reqd.
Service
Hydrant Size Existj�nR
Hydrant Reqd. Per Fire
Detector Check Meter Reqd.
Cross Connection Inspect��
Fire Department ts
ent
Water Meter. ge Reqd.
Septi ik Permit Reqd.
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Sanit:71Sewpe
ty
Drawing No.
Side Sewer Availability
Sanitary Sewer Connection Fee
Review By:
Size
Date:
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Date:
Permit No.
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Date:'__�
WAV S-8-81. WAS NA A.A.A.A.MA A
itch Existing Reqd.
CCulvert, Req Size
P4 Catch,Basin Reqd. 11 --Jrx b7cate on Site Plan
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Shoulder drainage mvij.nuiii-i collec 01-1 bWale"opcn rLdioff
I-111hole reqd.'I_ InCT11 n Site Plan
S 'I _q and Ground Water Field Clieciced
Re,,ricT.,7 hy., 1XI te
IgStreet Pa i Reqd.
Curb and Cutter Req
Sidewalk Reqd.
Curb Cut for 7ay Reqd.
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7ay R�eqd
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-o -Iqay Construction Permit Reqd.
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Bond Reqd. for Public Tmprovem—ents
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,Street Nam, Sign Reqd.
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Other Signing Reqd.
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r iit Site Inspection made on
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BY: MIER
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P-4 ENGINTEEPJING
5speci,al Require-Ti-encs listed in memo to Commmity Developmen't DepartiTent,
ZBuilcing Division
641
BY
—Date
o All items filled in on Building Pern-Lit Application
BY Date
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PA Drawings Stan-ped and Notations Made
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BY Date
-oved by Public 1,7orks DeparLiTo-iL
Revised: IV 10-1977
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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 for ' th on these
map(�-). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
-fh-e -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
emp-l-o-yee-s o-r officer,-) shall be hlab-11-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
The City of Edmonds
o , AEET
APPLICATION
for
FILE SIDE SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS 0
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OWNER............... ...................................................... — .................
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ADDRESS............................... ;� ....... .......... ) ...... — .................
1501,17
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LYNN PLANT
E S
EMENT No . ..........................................
i- / 1) - 13 c)
001�TTRACTOR .......
lea -=7 Of -'� . . ............... .................... . PERMIT No.
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LrEG9'A'-L'DI.E�S.C.rRrI"P(-TION: !��No . ............................................. BLOCK No . ............
NAME OF ADDITION
.......... ........................ .................................................
a ce-, 7`/7
V
04
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.??ROVED
APR 17 1561
Approved:
DATE... . ..... .... ....... By .... ................ i ..... �./ ...........................
ITY OF EDMONDS
Call PRospect 6�110 wb6n work
CIVIC CENTER WATER -SEWER DEPARTMENT
is ready.for inspection. (No �inspec_
tions Saturday, Sunday or holidam) -No 2037
SIDE- SEWER PERMIT
ADDRESS .................. 310 21st Avenue South
. ............................................................................................................................................ ................................. .......
OWNER ..................... Charles A. Duncan Russell Johnson
.................................... ................... ............. ... CONTRACTOR
Permission Is granted ........ �..Apri_l --- 19 .... 6.7, for ........................ days to REPAIR or CONNECT a side sewer
with City,Sewers In accordance with application on file'and governing ordinances.
�kTTENTION 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 bef re it has been inspected.
NOTE No. 2—Obtain full Information regarding Ordinance 11'.16.030 and Regulations governIng side sewors 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 20/..
No bends in grade sharper than.% will be permitted.
1v No. 4—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for
failure d ue 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.