21412 98TH AVE W.PDF9644
21412 98TH AVE W
0
ADDRESS: �>2 /-<A�z- 9 &e . M ),
TAX ACCOUNTIPARCEL NUMBER: 063 c2-50 0 10147
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: E] Conditional Waiver E] Study Required 0 Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER): WJ4/VD —
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:-
10 0
SIDE SEWER PERMIT(S) #: 5EG)� 12
GEOTECH REPORT DATED:
STREET USE / ENCROAC14MENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
LATEMP\DS'l7s\Fonns\Street File Checklist.doc
NOTIC�:'
t. Y ... 0 T
N'o---w- 'a 'r-� aln-
The-infor . mation'shown on the attached
for use by the UtY 01
map(s) was Com ' piled
Edmonds/ its Empl.oyees and Consultants.
Th,.e CItY ofEdm.onds does * n ot. warrant the
these
accuracy of anything set for.th on
r entity *requesting a
Map(s). Any person o I
copy should conduct an independent
rm-at'on shown-c
inquiry regarding the infoi
-m a p including, but not Jimited to,
the lociation of any sew-er stub shown. Su(,
sewer stubs M<-3y or may- not exist and rna�,
-he location shown.
or may not exist at t
t
Neitheir the r-ity of Ec.1mondI.S1 nor i-S
h- b e 1--J a. Hf,e f o r t h
empjoyee-s or Offrce-rs
information given' on this map(5)) nor for
e-ntation provided based
anyone repres
upon said. m a p
0
0
APPLICATION
The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS LID NO . .................. ASMT. NO. --- ..........
OWNER ----- .......................... CONTRACTOR ------ ......... PERMIT NO.
JOB ADDRESS ... - -------------------------- LEGAL DESCRIPTION: LOT NO - ------- ------------------------------ BLOCK NO - ------------------ .................
NAMEOF ADDITION ....... ................................................................................
Approved:
...................
DATE --�7c .... - �- ...
!M
CITY
WATER-SEWER�PEPARTME T
2
the 1�constructjoW'
775-2525 for side: sewez� inspections'_ BEFORE covering any po
Ca I I poL
Insp tion -will. be provided within, 24' hours after requst.
�,Sun,
OPC`NY��iii'spections:),
N
ADDRES&LOCATIO CTION'....
................................. .......... .. ...... . .................................... .
...................
PROPERTY LIE '�%D- ESCRIPTION ........
.............................. ......... ..................................................................................
.......................... ...............
................... . ........ ............ ...................................................
...............
........................
..... OWNER AN-13/0R. BUILDE& ...... ........... ......
................... ..................... .
-61V-STNIAMEN'
I -a .......... L.f ...........
T L&ADDRESS ................ ................ I
CONTRAC 4T.# ...........
........................................
r
a Se
41�ermlssionls,granted ....... 7 1 fo']rejloair-and/6i, ��nnec'ifohl U' side wer to tiAzityx, I Se e
System in. accordance,witi"C'ity -of Edmonds ordinances.
A—AITTION -IS,;CAILLED, TO, THE; FOLLOW-ING:
NOTE No. I c 0
the�)proper�y,�may obtain a permit itb,,cohst'ruct -sewer� inside prop&t�;Alrfe�. A llcensed� Side c
—The owners of �Sewm�Contractor��muit!be- emp)loy d to on
-dide,iiewer, in, stree -area;. Do� not: cover any portion �of,' iew.er'before It has. been. I , n6ec6d!
work p
,NOTE No; '2—A, erforme& In city, r., ght-of-way requires an! Invasion, of. R.Ight-of-Way'Permit obtain -able, from the City Engineer's offlcc�.
NOTE No'
�—Obtlaliv, full information regarding Ordinance 11. 16.030.,"d Regulations governing;mskole sewer& when,you �get permit.
NOTE No. 4—Top of,, lde'sewer� must,have at least.30, Inch,es coverage, af,,proiperfy llnoi and 12illrich6s, inside, property iine;,� riiihimum "grade).of 2"' en in
'than %, will be, permitted
sharpeys
NOTE No.. &--Trenches, in, atreei,.- must be water settled and* surface of, street' restored' to orlglnal� con-ditio'n., Contractors shall be -responsible -for I I ailu ue ro, er
work wilich, may,dOielop, -within one year of c6nnpletion�
'At
—It is u'iawful�'to alter or do &ny other work than -is providedi for in the 1permit,, or: to. d o any work on the main sewer orits appurtena ces NIP
NOTE No. 6 n n
sert 'thoi-.pipe Into, the- wye�
DISAPPROVJ�D'-':[]�, Mate".- . . ........... ....... %Dat I e;;..
7 ..................... .................. Date ..... .......................... ...... .
y .. ..........
-y7 ........... I ........................................................ ....... .- ..................
VED .. . ....................................................................
.. 1JIr
APPRW
t1A e--1
..................... e,� .......... ...
01
. .............................................................. :-.
........................... .......................................................................................... ... :.,.7
— — 11 ... 7� ................................
BOTH. P! irmit,Copiesj MU ST'Bb Signed, By. -Own�r of Firrn,perform ir,,iej-Cbnstrudtion PRIOR,"T ci� Request� For�lnspectioh,-
A
................................. ...... ........ cet,.tif,�r',thd.t�t.h6.9id�,�sewer.install'ation�cofist�,uttedt%uridi5rtr4.,hi8�',,Permit
(Owner -of Contract Ing, Firm Performing C o n struction f
,nstalledl. in faccordance With I%U� g9verning,ordinantes of the.City
9f:Edmonds.
Dated, -this! ..... ........................ Aay. of .............. ...................... .................... 19 .........
V�`% Ch6ck" BEFORE,you dig for Water E], Ga& Telepfi -,,Power E], S er-EJ Otller,E]�
Ell
9E PERMIT
ONE NUMBER
.BUILDING. DEPARTMEN 7' 0022
j1h, 1, Applicant Fill
,d Heavy Lines Joe
PERMIT APPLICAT101W I n,, e
ADDRESS
NAME (OR NAME OF BUSINESS)
LEGAL LOT LOT A IVISION NO.
-JI ES N
MAILING ADDRESS
I ADS NO.
z VARIANCE OR
COND.Usc NO.
__TFELEPHOr�C NUMBER
G CITY PROPOSED YARDS
al S 160 -54 2 yo -^ 2 -
Pco"'OV'D FRONT'?4? SIDE REARjgE_.� z
NAME A LOWADI-E ROP Vi
DIED
SIGN AREA SIGN AREA �Vj IL
ADDRESS
OTHER
REOU'_ -T
_� V � 12
U
ir CITY VLEPAarlt: NUMBER D�T.
PLANN
jj�HG�;, APPROVAL 1.
t&ck — '] S�
5 i I'AEET 'w
10's ?(G'0-jC REET R/W(10/(10 IT. D.F..IE..Y THIS PROPLPTY
EXISTING ST
0 ADDRESS
COMP. PLAN ST. R/W C10/00 FT. FT.
REMARKS
'M CITY TILL.I.Q. NUM64ER
I_ �x Driveway sicpe-, not to oxceed t:hcs!E
X: irdiwt-ro ion -Standard Dwig I'll- 11,114 — x
0 W
U CITY LICENTE NU"�i.ER
z
SF UTRUET AND/011 UTILITY 171 1! CS W
Legal Description of Property Show Below or Attach Four Ccpie U
AN 0 R K R C O'D NO
UNDERGROUND 0 YES
WIRING FEVP
0
-PC CONN FCTION V�Rl JXO
11i7RI
ER
U YES Ot R'V 113 U M B w
SEPTIC SYSTEM '40 11
APPVD BY CITY ENG. W
REMARKS 7
PAC Z
REMAT-S
AS
New RESIDENTIAL _L C 0
E] S:N1 FIRE ZONE TYPE OF CONSTR ON
... T.ALj GN L73
0 ... RETAINING SPECIAL. INSPECTOR �A OCCUPANCY JOCCUPANT.
DEMOLISH WALL REQUIRED COZ GROUP LOAD
EXCAVATE FENCE 0 YES S�
ALTER L ITE IS LOC
El OR FI L X—F" PLAN Cl :ATED IN THE
Or- EDMONDS. LOCAL SALES TAX 0
REPAIR PR-..11. [:]swim SHOULD-89 CODED 3L04- 0
POOL
R
P STORIES NUMBER OF
D '.V '�
NUMBER 0 ELLING 2T-10"— 7
UNITS Is
NATURE OF WORK TO BE DOME
VALUATIOF. rEE
PROPOSED USE !';.AN CHMCK
to No.
2
PLJOT PLAN 'INDICATIC BUILDI G SETBACKS,
G M
ABU'rTIN STREETS) BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POCL
I heMby Rano-19dir, that I have TtAd this sppliCation; that the In. TOTAL AMOUNT DUE
forran 91T 12 Correct: and that I Arn the O—r. or the duly author -
I. Igl�ont of 'the O.D.r. I agre.�O covIply With City and State I&W- "gU-
latter construction: and in doing the work Isuthorl"d thereby, no Person ATTENTION APPLICATION APPROVAL
will be employed to -'solatlon of the Labor Code of the State Of WLAhIJ391tOa THIS PERMIT
nilittag to Workmen*x Comptntat!on Insurance. AUTHORIZES This application Is not a permit until
NOT �': Permit Umit One Year (EXCept DrMOLITIONS -hIC.h ONLY THE eigned by the BuildinT Official or his Dep-
shall �;CoMeleted In ninety days: MOVED -IN BUILDINGS shall be corn. W ORK NOTED uty; and fees are paid, and receipt Is ac-
pleted In $tX Months.) knowledged in space provided.
INSPECTION
SIG P (OWNER OR AGENT) _]VATE SIGNED DEPARTMENT Or7'S GNAJTU
�1_7 CITY OF k
EDMONDS DATE
NOTE Applicanr Subject to Plan Chcck rer 775-2525
This Permit covers work to be done on privatj nroperty ONLY.
Any Construction On the public domain Jcurbs, sidew3 Its, driveways, ORIGINAL - Fdc YELLOW - In
marquees, etc.) will require separate permission. PINK - 0ier GOLD - A,scs��r
0
PERMIT NO: 10020
City of Edmonds
.Q1'nF.QFWFR PFUMIT PERMIT EXPIRES—V*S
-'-'C. 1-6-7
Address of Construction: Alk W- LYD #
Property Tax Account Parcel No.- ';70 S-00 10 qQ00
Attach copies of all access and utility easements Verified and Approved by
Owner and/or Contractor:
Contractor License #: Building Permit #: -.
)� Single Family
F� Multi-FaImily (No. of Units
F� Commercial (No. of Units
Public
Invasion into City *Right -of Way: El Yes XN 0
*RW Construction Permit #
Cross other "Private Property: Yes M;No
"Attach legal description and copy of recorded easement.
-5.2,05-
diw��ner t c r * ature and acknowle gement statement: Date
By signing for this er it I certify that I have read the City's public handout entitled
�C_ � I
ide Sewer Spec* ns, and shall comply with all City requirements outlined therein.
W CAI�JL D�AL-A-DIG (1-800-4:-M,-5555) BEFORE ANY EXCAVATION W
�_� FOR INSPECTION CALL 425-771-0220 extensio
24 HOUR NOTICE REOUIR'ED FOR ALL INSPECTION REOUESTS
NOTE: IF JOB SITE IS NOT READY FOR INSPECT16N WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARG:'E",D".',,'..."�'.*'.','�
Job Site Ready YES NO —Date: Initiali
Partial Inspection:
Partial Inspection:
Date: Initial:
Date: Initial:
FINAL INSPECTION APPROVED: Date:
`45 Initial.: zZ As -built to Street File:
t� PERMIT MUST 13� POSTED ON JOB SITE t-
White Copy: File -Green Copy: Inspector Buff Copy: Applicant
L-,temp;bldg;forms;sspennitjlg4/00
I
EXEMPTION FIAM CONTRACTOR R]MISTRATION
VERIFICATION FORM
The undersigned property owner or contractor has applied for a building permit from the City of
Odmonds and claims that he/she/it are exempt from providing contractor registration in accordance with
the provisions of RCW 18.27. The property owner, by their signature below hereby verifies to the City of
Edmonds that:
0 Value of work under $500.00. The aggregate contract price of labor and materials
and all other items required for the project is less than $500.00 and is not part of a larger
opertation to be undertaken on the property. The person employed to do this work has not
advertised nor otherwise put himself forward to the permittee to be a contractor or
qualified to engage in the business of a contract. RCW 18.27.090(9).
Work performed personally on own property. The undersigned verifies that all work
done under this permit will be done by the permittee personally on his/her own property
and that the improvements constructed on the property are not being undertaken with the
intention and purpose of selling the improved property.
0 Commercial property exemption. The permittee is the owner of commercial property
and the owner's own employees will perfonn all maintenance, repair and alteration work
on the property. No work will be done by contract under the permit. RCW 18.27.090(13).
0 Licensed architect, engineer, electrician or plumber. All work performed under this
permit will be performed by an architect, civil or professional engineer, licensed electrician
or licensed plumber operating within the scope of his or her license. RCW 18.27.090(14).
0 General Contractor. The owner is the General Contractor for the project and is required
to hire a minimum of two licensed subcontractors (unrelated building trades or crafts). The
general contractor is responsible to verify all State licenses of subcontractor. RCW
18.27.010
THE UNDERSIGNED PROPERTY OWNER HEREBY VERIFIES THAT ALL
INFORMATION PROVIDED ON THIS FORM IS TRUE AND ACCURATE TO THE BEST OF HIS
OR HER KNOWLEDGE AND ACKNOWLEDGES THAT IF ANY OF THE INFORMATION
PROVIDED ON THIS FORM IS FALSE, HE OR SHE UNDERSTANDS THAT THE BUILDING
PERMIT WILL BE IMMEDIATELY REVOKED AND ALL FEES PAID FORFEITED.
Dated this day of 2005—
PROPERTY OWNER/PERMITTEE
LATEMP\BU1LD[NG\F0RMS\ex,ernp contractor regis verif form.doc03/28/01
COP
Filed for Record at the Request Of:
PMA Development Services, LLC
19400 33" Avenue W., Suite 200
Lynnwood, Washington 98036
Notice of Easement
Grantors: PMA Development Services, LLC, a Washington limited liability company
Grantee: Willard 0. Magnuson and Mary V. Magnuson, husband and wife
Legal Description: In NW1/4, NE 1/4, Section 25, Township 27 North, Range 3 East, W.M.
Assessors Tax Parcel ID Nos. 27032500104600 and 27032500104700
Notice is hereby given that in consideration of mutual benefits to be derived, PMA Development Services,
LLC, a Washington limited liability company, owners of the following described property, situate in the City
of Edmonds, County of Snohomish, State of Washington, to wit:
That portion of the northwest quarter of the northeast quarter of Section 25, Township 27
North, Range 3 East, W.M., described as follows:
Beginning at the southwest corner of said northwest quarter of the northeast quarter;
running thence east 30 feet to the easterly line of a road;
thence north parallel to the west line of said subdivision 584 feet to the True Point of
Beginning, said True Point of Beginning being 30 feet east of the southwest corner tract
conveyed by Chester H. Kiehl and Selma L. Kiehl, husband and wife, to C.E. Lawson by
Warranty Deed recorded in Volume 98 of Deeds, on page 19, under Auditor's File No.
108082, records of Snohomish County, Washington, as measured along the south line
thereof;
.thence South 88*52'27" East, a distance of 293.77 feet;
thence South 0*31'30" East, a distance of 43.71 feet;
thence South 1*44'06" East, a distance of 56.37 feet;
thence South 88*52'27" East, a distance of 0.51 feet;
thence South 0*31'55" West, a distance of 46.00 feet to the northeast corner of tract
conveyed by Guy M. Street and Alice H. Street, husband and wife, to Grove C. Gaier and
Eva 1. Gaier, husband and wife, by deed recorded in Volume 255 of Deeds, on page 516,
under File No. 494609, records of Snohomish County, Washington;
thence North 88*52'27" West, a distance of 297.27 feet to the east line of the road;
thence north 146 feet to the True Point of Beginning.
and Willard 0. Magnuson and Mary V. Magnuson, husband and wife, owners of the following described
property, situate in the City of Edmonds, County of Snohomish, State of Washington, to wit:
The west 147.43 feet of that portion of the northwest quarter of the northeast quarter of
Section 25, Township 27 North, Range 3 East, W.M., described as follows:
Page 1 of 4
Beginning at the southwest corner of said northwest quarter of the northeast quarter;
thence South 88*52'27" East, 327.09 feet;
thence north 484 feet to the True Point of Beginning of this description;
thence continue north 100 feet;
thence east 297.33 feet to the west line of the county road;
thence south along the west line of said county road to a point east of the point of
beginning;
thence west to the point of beginning.
Together with that portion of the northwest quarter of the northeast quarter of Section
25, Township 27 North, Range 3 East, W.M., described as follows:
Beginning at the southwest corner of said northwest quarter of the northeast quarter;
running thence east 30 feet to the easterly line of a road;
thence north parallel to the west line of said subdivision 584 feet to a point 30 feet east
of the southwest corner tract conveyed by Chester H. Kiehl and Selma L. Kiehl, husband
and wife, to C.E. Lawson by Warranty Deed recorded in Volume 98 of Deeds, on page
19, under Auditor's File No. 108082, records of Snohomish County, Washington, as
measured along the south line thereof;
thence South 88*52'27" East, a distance of 293.77 feet to the True Point of Beginning;
thence continuing South 88*52'27" East, a distance of 3.55 feet;
thence South 0*31'55" West, a distance of 100.00 feet;
thence North 88*52'27" West, a distance of 0.51 feet;
thence North 1 *44'06" West, a distance of 56.37 feet;
thence North 0*31'30" West, a distance of 43.71 feet to the True Point of Beginning.
0 do hereby reserve and convey unto the present and future owners, their heirs successors and assigns of
the hereinabove described properties orportions thereof, a permanent easement for the installation,
operation and maintenance of a sanitary sewer pipeline and appurtenances over, under, across and
through upon the following described portion of the first hereinabove described property, to wit:
That portion of the northwest quarter of the northeast quarter of Section 25, Township 27
North, Range 3 East, W.M., being a strip of land lying 5.00 feet on either side of the
following described centerline:
Beginning at the southwest corner of said northwest quarter of the northeast quarter;
thence running east 30 feet to the easterly line of a road-,
thence north parallel to the west line of said subdivision 565.70 feet to the True Point of
Beginning of the herein described centerline;
thence S 88*52'27" E, a distance of 151.16 feet;
thence S 41 *40'05" E, a distance of 78.62 feet;
thence S 88*52'27" E, a distance of 91.88 feet to the terminus of the herein described
centerline.
Maintenance, repair and/or reconstruction of any sanitary sewer and appurtenances constructed upon or
within the easement right of way hereinabove reserved and conveyed, shall be the responsibility of and
0 Page 2 of 4
the cost of said maintenance, repair and/or reconstruction and shall be borne jointly and equally by the
owners, their heirs successors and assigns of the hereinabove described properties or portions thereof;
except that no owner shall be responsible for any portion of a commonly utility system above or beyond
their point of connection to same.
This instrument shall be a covenant running with the lands hereinabove described and is binding upon the
owners of such lands, their heirs, successors and assigns, forever.
IN WITNESS WHEREOF we hereunto set our hands and seals this day of _, 2004.
PMA Development Sercices, LLC
by:
C. Michael Arnim, Me�nge-r
Willard d—Magnuso M�� V.Aagnuson'
State of Washington )
)ss.
County of Snohomish)
I certify that I know or have satisfactory evidence that C. Michael Arnim, Member of PMA Development
Services, LLC, a Washington limited liability company, signed this instrument, on oath stated that he was
authorized to execute the instrument and acknowledged it to be the free and voluntary act of such party
for the uses and purposes mentioned in the instrument.
Dated:
Notary public in and for the state of
Washington, residing at
My appointment expires
0
Page 3 of 4
State of Washington )
)ss.
County of Snohomish)
I certify that I know or have satisfactory evidence that Willard 0. Magnuson and Mary V. Magnuson,
husband and wife are the persons who appeared before me, and said persons acknowledged that they
signed this instrument and acknowledged it to be free and voluntary
act for the uses and purposes mentioned in this instrument.
Dated:—Iz—/Ij 10(i
I JEFFREY E. JOHNSON
�) �&t'y E Pso NotarY Public
Notary public in and for the statfff State ot Washington
Washington, residing at lel wh my commission Expires
My appointment expires 7WLPI/^ juiy 06, 2W8
Page 4 of 4
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0 F E.D* CITY OF EDMONDS SIDE SEWER AS. BUILT
,to
,�'i "t,
'IV 1. x:::5 ADDRESS HOMEOWNER
CO I Q'I - 21412 98th AVE W Magnuson
ift, [CONTRACTOR SCALE
dl NTS
DATE DRAWN PERMIT
5/26/2005 By Nima M.Moghaddam NO. 10020
0
0
SKETCH (L;iKL;Lt UIVL:)
CITY OF EDMONDS SIDE SEWER WATER AS— BUILT
ADDRESS Ayis HOMEOWNER
CONTRACTOR SCALE
DAT,E, D"N PERMIT
BY NO./W,?
Mr
ell
11
(toJd -lftg(IV
link
City of Edmonds
RI,GHT-OF-WAY CONSTRUCTION PERMIT
Permit No:za.P5-,0/z8
Issue Date:
A. Address or Vicinity of Construction: :0 1 q I a �J 8 "—' om e UJ (- S-� Ld M ry-n d S ) CK)G_ 9 8��p 0
B. Type of Work (be *specific): n e 5',du _',� 9.,_o ex-, CW.9,- 0J,_/ C TPI (+ 0 Ict _5 (,C,6 e.(-
C. Contractor: x)ao � ok i i I � Tmo Contact: iLwe. um(i
Mailing Address: 1,903 Tp!;)raEhA Phone: eCtl (90to 5-/�) qqgs
dN, 9d
State License #: 15WI--bo,0985 MC, Liability Insurance: Bond: $
'City Business License #:
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable): -A+- 1 ()0
I
E. F� Commercial El Subdivision F] City Project 0 EUC (PUD, VERIZON, PSE, COMCAST, OVWSD)
F-1 Multi -Family Single Family Other
I I I -
INSPECTOR: /_WC
F. PAVEMENT CUT: [-I YES ERNO G. SIZE OF CUT x
CONCRETE CUT: El YES ONO
G. El Mail Approved Permit 5�Call for Pickup
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands by.his/her signature to this application helshe holds the City of Edmonds harmless from
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 its departments or employees, including but not limited to the defense of any legal proceedings including defense
costs and attorneyfees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD 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 BYCITYFORCES, AT WHICH TIMEA DERITOR CREDIT WILL BEPROCESSED FORISSUANCE TO THEAPPLICANT.
Traffic control and public safety shall be in accordancewith City regulations as required by the City Engineer. Every
flagger must be trained as required by (WAC) 296-155-305 and must have certification verifying co mpletion of the
required training in their possession.
Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City -
approved material prior to the end of the workday - NO EXCEPTIONS.
Three sets of construction drawings of proposed work are required with the permit application.
CALL DIAL -A -DIG (1-800-424-5555) PRIOR TO BEGINNING WORK
I HA VE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THATIMUST MAKE THE PINK COPY OF THE PERMITA VAILABLE ONSITE ATALL TIMES FOR INSPECTIONS
f)-'7
An rd, we
Signature. Date:
(donfractor or AgenV V
REQUIRED INSPECTIONS:
.
Call 425- 771-0220, Ext. 1326for a 24-hour voice -recorded insp�ction request line.
FINAL APPROVAL OF PERMITTED WORK: DATE:
, lnspecio-ri
CADocumcnts and Settings\CunisNy Documents\Fomis\Engnrng\ROWpermit_.doc Revised 10/01/03
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14- 12-
le
APPROVED AS NOTED
BY ENGINE ING
Uate:
Date July 14, 1976
Memo to: Director of.Maintenance & Operation RECEIVED
Public Works
From:. City Engineer
Public of S U-Pl.
Subject: Sewer Connection Charges
Legal Description: See attached
Commonly known as: 21412 98th Avenue W.
.Z.F.F. Calculation:
Minimum Fee( Z.F.F. x
Lateral X
Unit x $25
a 6� � 7// 117 4
CC:
Owner: Nor West Construction
$ 300.00 Connection.Fee
$ Lateral Charge
$ 2-5.00 Trunk Charge
$ In _ ()n —Permit
$ 335.00 TOTAL
2108
Aulbofiud Signalory
THE WEST 10.43 FEET OF THAT PORTION OF THE NORTHWEST QUARTER OFJHE
NORTHEAST QUARTER OF SECTION 2-5, TOWNSHIP 27 NORTH, RAINCE 3 EAST,
DESCRIBED AS FOLLOWS:
BEGINNING AT THE SOUTHWEST CORNER OF SAID NORMWEST QUARTER OF NORTH—
EAST QUARTER; THENCE SOUTH 88052'27" EAST 327.09 FEET; THENCE NORTH
484 FEET TO THE 'TPUE POINT OF BEGINNI.NG OF TH,ls DESCRIPTION,: THENCE
CONTINUE NORTH-100 FEET; THENCE EAST 297-33 F,17'ET TO.THE WEST LANE OF
THE COUNTY ROAD; THEME SOUTH ALONG THE WEST LINE OF SAID COUNT-) . .. .
ROA D TO A. POINT EAST' OF THE POINT OF BEGINNINC; THIENCE.WEST TO THE
POINT OF BEGINNING�
TOGETHER WITH EASEMENT OVER THE i']ORTH 15 FEET O.F THE FOLLOWING DESCRIBE!
TRACT FOR INGRESS., EGRESS AND UTILITY PURPOSES:
BEGINNING. AT THE SOUTWEST CORNER OF SAID NORTHWEST QUARTER. OF THE
NOR-rHEAST -52'.27" EAST � .09 FEET: THENCE
. QUARTER; THENCE SOUTH 88 -27
NORTH 484 FEET TO THE TRUE POINT OF BEGINNING OF THIS DESCPIPTION;
THENCE CONTINUE NORTH.100 FEET; THENCE EAST 297-33 FEET' TO THE WEST
�E OF SAID
LINE OF COUNTY ROAD; THENCE. SOUTH ALONG THE WEST LI
COU�TY ROAD- -1 TO A POINT EAST OF THE POINT OF BLEIGINNING; THENCE WEST TO
THE POINT OF BEGINNING;
EXCEPT THE WEST 147.43 FEET THEREOF.
C CONT I NUED
NOTE: Invej.-igainn ibould tv made io determine il thure are any jervice, iijitallation, maintenance, or eonfiruction.chargef for iswer, wa�� or elec.ricil.-,;
4
Memo to:
STREET FILE
Date
Director of Maintenance & Operation
Public Works
From: City Engineer
Subject: Sewer Connection Charges
Legal Description:
Ste attached
July 14, 1976
Commonly known as: 21412 98th Avenue W. owner: Nor West Construction
.Z.F.F. Calculation:
Minimum Fee Z.F.F. X
Lateral X
Unit x
CC:
$ 300.00 Connection Fee
Lateral Charge
$25 $ 25.00 trunk Charge
$ 10.00 Permit
335.00 TOTAL
2108
%0
"I 71ed— znalory
THE WEST 147 43 F E E T OF THAT PORTION OF T1,1E NOPTHWE51'. QUAPTFR OF THE
NORTHEAST QUARTEV,'. OF. SECTION 25,, TOWNSHIP 2'7 NORTH, RALNGE - EAST, W.M.
DESCRIBED AS FOLIJ)WS:
BEGINNIN'f� AT THE 5011JTlA'*'-v'FSl' CORMER OF SAID NORTHWEST QUARIER OF NORTH—
EAST QUARTER; THL;,''J_ SOUTH 88052'- HENCE. NORTH
27" E.AST 327 . 09 FEFT; T
.484 FEET TO THE POINT OF BECIHN)iNG OF THIS DE ' SCRIPTION THENCE
CONT-INUE NORT�:- I. -_EFT;- THENCE i-/-\,ST 297-�3 Fl-�E_r TOTHE WEST LINE OF
L.. . ) � T I
THE COUNTY ROAD; SOUTH Al-ONG WL�'l LINIE (")F SAID COUNTY
E VIEST TO -THE
POMT OF BEGINNINC; THENCE
ROAD TO A POT-NT FASI OF THI
POINT OF BEGININI�4G.
TOGE'THER WITH EASE11,ENT OVFR THE NORTI-1 1r) FEET OF JHE FOLLOWING DESCRIK*
TRACT FOR INGRESS, EGRESS /\ND UTILITY PURPOSES:
-1 'V11 E r T[ w 5 R C)
BEGINf4lNG AT THE SOU T CORNEP OF SAID NOR) *E T QuARTE F THE
NOR-rHEAST QUAR-rEp THENCE SOUTH 89"52'.27" FAST 327,09.FEET,: THENCE
T T 0 IHE _fRUE POINT OF BE -GINNING OF THIS DESCRIPTION;
NORTH 4814 FEE
THENCE CONTINUE NORTH, 100 FEET; THENCE EAST . 297.3-:) FE-EJ TO THE VIEST
7_
LINE OF COUNTY ROAD,: "THENCE SOUTH ALO(�(; THE ��EST L ' INE OF -A D
COUNTY ROAD TO A P-01.NT EAST OF THE P.QINT OF [3)"G[NNING; THENCE WEST 1*10
THE PO.INT OF BEGINNING
EXCEPT THE WEST 147.1.1-' FEET THEREOF.
CONT I NUED
.NOTE: Inveviga,'inx ibouid I r madelo deterinine here are any jervi(c, jMjlallll;011, Maintenance, or i.on ftr;jCl;0�1. chargef for iswur, tvaier or elec.r;cii.:
CITY OF EDMONDS
STREET FILE ENGINEERING DEPARTMENT
505 BELL STREET
EDMONDS, WASHINGTON 98020
APPLICATION FOR INVASION OF RIGHT-OF-WAY
I (Submit In Duplicate)
Permit to be issued to: x �ot jd-�—:s
For work at: (address or vicinity)
Type of work to be done:
(Attach Drawing when Applicable)
Owner: /� /10/ Z, ��-75 e�ll
Name
17�`a 'yo., 20 7
Mailing Address
city State
Contractor:.
Name
Mailing Address
Telephone Number
City State Telephone Number
Signature:
Owner or Agent Date Signed
DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit Number UK
Permit Issued (date).
Remarks:
A
=0 '� A ,A � I I i
'ENGINEER'S APPROV I)ATt
AL V
INOTICE:
Upon issuance of this piii�tt the contractor is responsible Work subject to inspection and restoration in accordence
for workmanship and mai�eirials for a period of one year ith city code. A 24 hour notice is required for inspection.
following inspection of . the restoration by the Engineering �Iall 775-2525
Dept.
0
0
CITY OF EDI-IONDS
DEPARTMENT
ENGINEERING'
InsDate ............ .... By ...................... --------------------- -------------
.p -.Pemtrlkb;; .......
InspDate. .................. By ........................ Remarks ............................................... . .......................................
InspDate ................. 1Y ........................ Romarks ............. ..........................................................................
Insp-Date .... . . ......... By ........................ Remark's ....... ... ..................................................... . ...................
Rem'arks
Fina .. ...... 1� .............................. . .............
. 101-M . .. ... ..
- 7 - a 0
483 SF
(A,!:', JND, 9-0030202-14)
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