21001 84TH AVE W.PDF111111111111
7891
21001 84TH AVE W
NOTICE:
aw a r r a n
7.4
A
The -Information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, Its Employees and Consultants.
Th,' e City of 'Edmonds does not ' warrant the
a curacy of anything set for.th on these
map(�_)- Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform-ation shown on
_tFe -m a p (s) . including, but not limited to,
th-e lociation of any sewer stub shown. Sucl-
sewer stubs may or may, not exist and may
or may not exist at the location shown.
Neither the -;ty of Edmo-nds nor its
%-� I
empl-o-yee,s o'r office-rs -sh-a-1-1 be [11a.b.-IFe for 1[he
s rnap(s), nor for
information given on thi,
ion provided based
any one representat*
upon . said map(s).
r--1
L--j
0
APPLICATION
for
The City of Edmonds EASEMENT NO . ............................................
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS Fj LID NO . .................. ASMT. NO. ...............
OWNER.............. ------------------------------------------------------------------------------- CONTRACTOR ---------------------- PERMIT NO . ....................
JOB ADDRESS ---- — - LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO.
'L4YV4 --------------------------- ------- ....................................
7? F--= ��. +V,,,�
... ...........................................................................................................................................................
NAMEOF ADDITION ------ - ---------------------------------------------------------------------------------------------------------
ed:
DATE ...... I.Z ......... By ------------------
DM N 10 "VIT'
YOFE S: .,.E':`SEWEZ:,PtRfM,
OT
WATER- MEN
SEWER DEPART T'
A: .
PERMIT
Fo" ,any portion, of the '�onsfyu,ctlon:N.
.'j,,CaIW,,j.75�2525. for- side se�ver ln'spktlons. -RF
kl[nspe�lion will*:be, provided, within'2�.hours- after, or* holiday Inspections.];-
N
AD ESS
.. . .... .. .. ......... ........
.................... P ......................................................
7
..............................................
PROPERTY, Li96A1.DESCR1PTTON:.; ...... ............... 1,he`E-.:l60' Of _xra6t 7. Bloc', , 1. 'AlderwobdIm
........... ..................................... : ...... ; ..................................................................
..............................
r
exc
't 2 7.0
........ I .............. .................................. ...................................... thereof
................................................... .......
........................................
WAWKM�- HMS -
.... ................................. ................
................................................................ OMWER AND/OR.BUILDER ................. . ..... .............................
OWSMAME
CONTRACT I�ADDRiSs ................................. .......
v....... . ............................... 7 ........ .......................... ..........................................................
4rson, s, gran .. . ............ thei;cl
--tils I' I epair. and/6r'i6onneetl6n- c;f'*a s1de,.;sew.ert6' ty,044i4tiry'sewer
uEdmonds ordlnanc;e&,
saiiw ty
�M IC
a, if In, ab
jV R
0
..,;%!TTENTION'IS �'XID,'TO'THE'FOLLOWING:
NOTE No. I—The,-Low,ne'rs;,of�,tfie�*pro�er�y,!miLy obtafn,a- P��e'r"�mit':tb,,,�go-n�st-i��et.,sewer�rin�ld rtyAlh licensed- Side Sewer-'Co�iiaci6r,�',,i�"t'��be��eii�ik�i�4iio�.,-,'c�nstruct
. pipro�6 e�A
side- sewer I . n street area:. 1)6�. not�,;�o�er a�y.portlon,'tof gewer before -it hasibee�i inspe9ted.
NOTE, N 2 formed In city,rigk-*pi
MI Work per ;:,�Wky. requires "I fhvaslon of l�Jght-of-Wa:y-Pe�mit:�bfEdh-able-fr<)m'th�!,Ctiy En.lnzer'. office. 4'
o. h
a; prm
_NOTE',,No� 3-�-Obialn full' information, regaxding.O'idinanbj) Tl�M.630;14 R6g6lati6ni.,governlini��st4e�i4iwers-�v t.�
— of.slde� sewer -must have *at ches� c A, o
Top, Ieaa0"30f.tn` at �property '12*,,Tii�h6a,lineldek,p�6pert�,, n .4,
NOTE. No. 4 grad�e??,,,of��2.-%��o a a in, igr
-than % will, be permitted ade
..sharper'
NO �No -'5--TrenchesAn. street, must betwater settle f,str�k, restored original-,6ondition. Contractors,,shall: ia�'�reiponslbl fo uJiure ue to,Amproper
TE &�and, surface.,o
work'�phich may develop. within,one year of.-comPIet!.qp.1.
NOTE) No. 6,-, It As, unlawful to alter or do any other work Ahan, J� ��ro�ided- 'for, in. the �Permjt, or,�to.;do:.i�ny; k on the, ma.1 W -, c, e so to, in-
wqr M,sewer�or. "a t
sert the'pipe into the wye.
DISAPPROVED. �'E): Date ... . ............. ... .......
y -B'k ................ . Date; .................. !,�'Ry
.... ..... ............... .... I ...........
APPROVED Date
, . ................... . ............... ............ .......... .......
..............
.,Remarks: .6-Unit, aDartineftt
................. 7 ............................................. .................. 7 .......................... t . ..................... ................ ........
.......................... 7, .................
..................................................................... ................ ................ ....................
............................................................. ......................... ........ ...... .........
1�,rf 'i -, 60��6tructi
BOTH Permit Copies MUST'Be Signed' By Owner, of 'Yirm� e orm. ngi on IVRIOR.To-Zeque9t For Inspec on
...... ertify.4.pat 1he Wdb� seWer installation, construiiied:underthiw permit
0
17-Fifming. donstruction,)�
PL
0
wa&*Installeal',lacecordance, �vlth. all -governing or�dinances;,of the City of"Edmon0b.
t Wthl&. A�Ak ',of;
e ........ ................. .................................... ...................
AZ
e �Icl,.
6heckoB''EFORE -you digj4?r:,WWate'r,.,0,;, Ve16ph6fii0E3;' Power. E],, .�S6W rtj, Othe� .'