21415 92ND AVE W.PDF111111111111
8905
21415 92ND AVE W
NOTICE:
-a r-ra nty ... 0 t -a CC-u-
ched
The -information shown on the atta
piled for use by the City Of
Map(s) was cOm. I
Edmonds, its Ernpl-oyees and Consultants.
Th,..e City of *Edm.onds does. not. warrant the
accuracy of anything set for.th on these
Map(s). An . y person or entity -requesting a
copy should conduct an independent
orm ation shown or
Inquiry regarding the infi
tFe -map(s), including, but not hrn'ted to,
the location of any sevver stub shown. Sud
sewer stubs may or may not e.xist and may
or may not exist at the location shown.
Neitheir the city of Edmo-ncJs nor its
emp-1.0-yee,s o*r office-rs -s-hal] be !Jab -'Fe for -41-he
information given on this map(5), nor for
'ded based
any one representation provi
upon said map(s).
APPLICATION
's"?*491FREET FILE for
The City of Edmon SIDE SEWER PERMT
/ / /) --� /--7 1- /, 7-1 OUTSIDE 1�� INSIDE E] REPAIRS
OWNER
HOUSE No.
9
Date
BACKFILL WORK ORDER ISSUED ..........
SEWER WORK ORDER ISSUED .................
CARD No . ...............
EASEMENT No . ...............
CONTRACTO .. ..... a .... ....................................... ............... PERMIT No.
STREET
J,C- 3
AVENUE LO No . ...................................................................... BLOCK No. —'Pot .. 0 --------------------------------
----- - ---- --
NAME ADD. ..... *? ................................................
73
13
w
Approved:
DEPOSIT, $ .............................................
DATE
11ZI .....
APPROVED
JUN 18 1964
By.... .. .. .. .................. . .. 1
a
'CITY'OF.EDMONDS
Call-, PROsPect 6-1107 when work
CIVIC 'CENTER'— WATER -SEWER DEPARTMENT
Is ready for inspection. (No inspec-.
tions Saturday, Sox I iday or -holidays.) N2 1078
SIDE �'SEWER PERMIT
AljDR RonApy
ESSr ........ ................................. .... ..................... ................. ........................................................ .....................................
...... Jim ... Rale .... Cans.t.ructlark ................
owN,Fm ..... 2.4-1. ....iath ... kvenue S.W LL I . . ........................... CONTRACTOR.
Pe milssion is granted , ........ June ... ................ 1954.., for ...................... days, to R EPAIR or CONNECT a side. sewer
wl I th City Sewers in,acco rdance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE N6. 1—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 before it has been inspected.
NOTE No. 2—Obtain full Information regarding Ordinance 11.16.030 and Regulations. -governing side se wers 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 2
No -bends in grade sharper than 'A will be permitted.
NOTE No. 4—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. 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 ap-
purtenances except to insert the pipe -into the wye.
STREET ADDRESS FILE
C1 Y OF EDMONDS
7110-210TH ST.S.W. - EDMONDS, WA 98026 - (206) 771-0235 - FAX (206) 744-6057
COMMUNITY SERVICES DEPARTMENT - PUBLIC WORKS DIVISION
t IS9
September 19, 1996
Mr. Franklin P. Shines
21415 - 92nd Ave. W.
Edmonds, WA 98020
Dear Mr. Shines:
BARBARA FAHEY
MAYOR
I have reviewed your account and will allow a credit in accordance with our City policy.
The policy'states that the customer will be billed at the retail rate based upon the'average
water consumption for the same period during the previous year. In addition, the excess
water -lost from the leak will be billed to customer at the City's wholesale rate with a 15%
surcharge added for administrative cost. Only one leak credit will be granted in any three
year period.
Should you have any additional questions after you receive your new billing, please
contact Ilene Larson, Utility Billing Clerk, at 771-0241.
Sincerely,
Scott Highland
Acting Water/Sewer Supervisor
RH/lk
cc: Ilene Larson
Utility Billing Clerk
wordaWwaterkredit96\209925 * Incorporated August 11, 1890 0
Sister Cities International — Hekinan, Japan
-# 2-099 2- 5-
21415 - 92nd Ave W
Edmonds, WA 98020
August 27, 1996
Ron Holland
City of Edmonds
501 Bell St
Edmonds, WA 98020-2008
Dear Mr. Holland:
4UG 9
-'Usuc WO'7'�' 996
I was instructed to direct this letter to you regarding my water bill. Yesterday, August 26, 1996,
when I arrived at home at approximately 5:45 PM I found water flowing across my drive way.
After trying to turn the water off, which I was unsuccessful in doing, I called 911 and they sent
out the person on call and he turned off the water. I dug down and found that a root from the
cedar tree had pushed the pipe to the extent that it had broke the pipe.
I got it repaired today and have enclosed a copy of the bill to verify that indeed the pipe was
broken. I understand that it may be possible to get some relief from the increase in my water bill
due to this pipe being broken.
I appreciate your consideration in this matter.
Sincerely,
Franklin P. Shines, Sr
j:Lje:wcj 'pLb,&%sa ADIuST- T3,4E 151L-L 0" THtS Agr-C7-- T-0
TRC- A,\;6kAG6 FOR- 1-1-"S T-10.%C- Fr"'K6- 'BILL -r"C- EXCG-5-5
WN-Mk USNGe Ar- OUM- W�Adt-C-ZTALC- COST .
-T-"Aw tc s,
tci-a-'93 40
S.'7-9S' 39
37
12
14
14
2.s-
S-94, 3S
'116
DXL
CONTRAMO. 1 "610 i'_'. 0
ALL WAYS PLUMBING
Tn- M ft= SE -
Evereff, WA 90M
CM) 743.1= * 353,..SM
ALLWAP*081K9
PLUMBING-HEAnNG-SEWERS
WATER HEATEF,S AND MORE...
F] CASH [] CHECK
1:1 CHARGE APPROVED BY
SOLD 70. JO.B-ADDRIM:
HOME PHONE 7 7Zo AOME PHONE T�
TECHNICIAN:
WORK PHONE WORKPHONE
NAME
NAME AhcIza MI
78M - CASH Wel-ten (10) d
1plf� U pe A�
ADDRESS 2 A[ wpoj account Oslo
Wg� AIL WIN 11�. In to am# of delad
pc"md of any amount due 1here wl be an
aff/MTEMP_,\,/�&&.?- 4-1-09 AZAL AL—_6W
f5TA P_
chow equal to the kad wcp*mxn alowed, C
adr d of b tie Cod of coledion in
d231 fees, =,xand cot
by law 0 Irom
Is
N!LE
I wujnm
-'Af
N
"*T
mom wrrH macsypossamsomoN the wxir*
jned, am owner/outatzed representMm of te
0- M W' �
I he%iouthmize 1;T1. deern mMsobkL A rnonthly senice
1 06 DOTI algmmmo to p Is! and co� coslsl,,,
I to 3yr-----
rt WO be to $1 00midl I : I P
v* on unpaid OSI. ADD. WBU11:11!11111!!!I!!IIFD and c'm
T f=dd
the event of vwcm Mh"' r"Hiecicbmimsj —be kbefor*3 ftes 40 canourd ofthe checlill 111111, 00
I how *belvow a copy of fts ftNaft W Owner on figimil I,
a". —You'o procee�# 00 work at aj#, W�,,ce 4.
WOW AUTHORIZAM& AumiazooN To mocEED wrrH sma mcommENDED - L #m w'Wm*- pW��;arn- owner/authortzed represenk" of the prerrises
of which the work mentioned herein is to be done. I =a=e perlo" Smice, Recarvirrmded dawn odWsable. A nwnd* service
be added after 10 tnoy$l=. 2VZO $1,000.00. .:;x_Xoftmej(s =01fh="of
ir onunpaid tam moenses. and coud
action in Ve an 3h =ug r c bounces, I could be kd* for 3 =Pa0nYXrKeM0t' of the check or $100.00 wNdmw is ff lore, plus to face valm of
Zdkixel
and court costs I haw.read and received a copy of fts contract and a copy of the Nofice to Owner on reverse skis.
I hereby authorke you to proceed w0h the work at a comroc prim Of.. $ Skjnature
WATER PRESSURE PSI:
CUSTOMER INFORMED El
an remse skW
ACCIP104a OF COMMa - I &W to = andrn
1P P I amil - I In vAh ft heW
N, opt to hove been 'A- In a uft
ML VAn MANAM
my of nV credD 6ords for ft = or
and I opm lo polo., 21i'mors set
==omkobb card holde the am
60#m;;jziafln#dsmn0u
IMW lo be do Wal arW rm Oak c
I to q IBM am
in emt of legal ;;G� I admo
I how read and J a hole ow of ft 0
SEINICE CG.
FLAT RME I
" TOTAL
AMOUNT DUE
PLEME IN YM ASME ANAKM
oammid, due uno - comoletion of w
Citv of Edmonds
C.
RIGHT-OF-WAY CONSTRUCTION
PERMIT Permit Number,
Issue Date: // 5161
A. Address or Vicinity of Construction: 21415 92nd AV W
GTE to place, operate, ana maint!in a DOME service
nr e 4 IF 4 +.4 1 Aark2a I +- .4 4- lihil Q') A A� W
9 C� JD. I M 0 %.Lre spec %,j. - - - - — ex - nij 1— e
t en east to a residence-a—t7fM 9Znd AV W. Ult to plow 55 feet,- Push one
driveway, and push one road 72 feAt. R.Q.W_ Al fapt,
Mary A. Bower, Permit Coordinator
Contractor: GTE Northwest Incorporated Contact: Dennis Alexander 771-9036 mobile 388-1358
2312-C W. Casifio Rd Phone:
Mailing Address: l7verett, Wa 28204-1440 Mar-y 20GA88-16-28 lar 740-0,420
State License #: Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. (-] Commercial Subdivision El City ProjectX)n Utility (PUD,�5 WNG, CABLE, WATER)
0 Multi -Family Single Family [:1 Other 2100-9POOlDB 242310
INSPECTOR: INSPECTOR: W�',4cA I
F. Pavement or Concrete Cut El Yes ONo G. Size of Cut: 1 f t/x 2 f t H. Charg,�_$
Possible. Please see attached sketch.
APPLICANT TO READ AND N
of Edmonds 8kle;o
INDEMNITY. Applicant understands and by his signature to this application, agrees to hold har e88 from injuiies, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made agtainst City of Edmonds, or any of its departments or
employees, including or not limited to the defense of any legalproceedings including defense costs, and attorney fees by reason of granting 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 COMPLETEO BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT.
Construction drawing ofproposed work required with permit application.
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 tMe City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the above statementsp-djwderstand thepermit requirements and thepink copy of thepermit will be
available on site at ur oses.
Signature: John H. Sfewart Date: November 6, 1996
(Contractor or Agent) Sec. Mgr. -Access Design
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE'ONLY
"PROVED BY: RIGHT OF WAY DEPOSIT
TIME AUTHORIZED: VOID AFTER JAN 2-2 DAYS DISRUPTION FEE/FUND Ill:
SPECIAL CONDITIONS: NA. i'RESTORATION FEE:
PERMIT FEE.
TOTAL FEE:
COMMENTS: RECEIPT FEE:
DATE: ISSUED BY,
NO WORK SHALL BEGIN PRIOR TO PERMIT
UANCE
Eng. Div. 1994
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.)
El YES
Date:
Date:
El NO
PIE�MIT SUBMITTED BY
GTE
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