21306 95TH AVE W.PDF9266
21306 95TH AVE W
PUBLIC 'WORKS DEPARIM9 CHECKLIST
BUILDING PERMIT REVIEW
(address)
STRFET FlLe""
_-2
Street Right -of -Way Existing
REQD
Z
Access Easements Existing 0
N
___jEQD
p4
Utility Easement Exist
Lot Per Subdivision Plat
Assessor
Site Plan Checked for Accur acy__�
1,LZ_1
Z
Underground Wiring Reqd.
Ar
H
Check Accuracy of Legal.Description
.Z
Review by
Date
2,?.1 -78
Existing Water Main Size
r Main Required
Service , e Required
Hydrant Size tuig
i�4
Hydrant Reqd Per Fire de
—Size
Detector Check 14eter Reqd
Cross Comection ection
Fire t ConTnents
Water 14eter a: iarge Reqd.
Review by.
Date
Ic T
eptic Tank Design Approved
e p t si" p rov e
Date
S e c T Pe
Sep ic Tank Permit'Reqd.
p Req d._
P
Perm�t
ermit
_t
Sa I ewe Ava ability—
Sanit Sewer Avail -ability
n S il
<
D b wm 0 -
r - g No.
ile
File
i _ty
Side Sewer Aval il3i ty._
P4
S S Conn
Sanitary Sewer e on Fee Reqd.
�3:
Review by.
Date
Open Ditch Existing,
_Req d.
Culvert Reqd.
Size
P4
Catch Basin
In te
on Site Plan
0
r -�iif
ShoulL>der au'tage maintain collection on
swale open
f
Mtgole reqd.
Indicate on
Site Pi_�
Soil Conditions and Ground Water Field Checked
Review by
Date
Revised: 1vl0-1977
PaL7e 2
'u-
0
4
StTeet Paving Reqd.
Curb and r Reqd.
Sidewalk Reqd.
Curb Cut for Driveway Reqd.
V
P4 Right -of -Way Construction -Permit Reqd.
Bond Reqd'. for Public Impr
Street Name Sign Reqd._
rn
Other Signing Reqd.
e
z ' Pre�Pe Sa *7 Inspection made on
0
BY: SEWER
WATER
P4
STREET
ENGINEERING
1-1 Special Requirements listed in memo to'Commmity Development Department,
<4 Building Division
> BY ID Date
o All items. filled in on Building Permit Application
'Z2�
r4 BY Date
I
P" Drawings Stamped and Notations Made
P4 BY - . k' -T\ J Date
"�' jApproved by Public Works Department I
Fievised: 1v 10-1977
APPLICATION
for
The City of Edmonds SIDE SEWER PERNaT
NEW CONSTRUCTION [:] REPAIRS [3 EASEMENT No . ..........................................
111-07700
OWNER........... Le.sli.e ... T....-H.ans.o-n ......................................................... CONTRACTOR ........................................................ . .
.... .. ....... .. .. . . ...................................... PERMIT No . ......................
ADDRESS ....... 213.06 .. . ... 95th ... An...J! ................................................ LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
0
NAME OF ADDITION
Dye Tested Oii Sewer 1972
Approved:
DATE................................................ By ......................................................................
9
NOTICE,.,
w a .,y ... n.. -a
at*on . 'shown on the a-ttached
The Inform I
piled for use by the CitY 01
map(s) was com. I
Edmonds/ its Empl,oyees and Consultants.
Th,.e City of 'Edm.onds does. not. warrant the
accuracy of anything set for.th on t * hese
rn a p (.S-'-). A n . V person or entity -requesting a
copy should conduct an independent
inquiry regarding the infbrm-ation shown*c
_t -M a P (S) -, including, but not J,m'ted to,
'c ion of any sewer stub shown. SU(
thelo'at
sewer stubs may or may- not e.xist and ma�,
or may not exist at the location shown,
r-ity of Edmoinds nor its
Neitheir the I,--, i -c e,r s s h- a, I I b e 1.1 a. b].,e f 0 r t1h.-
empl-oyee-s 0-r off.
information given on this map(5)] nor for
ovided based
any one representation pr
Upon'said map(s).