21614 84TH PL W.PDFIIIIIIIIIIII
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21614 84TH PL W
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NOTICE:
-N'o ... wa rra nt Y- 0 T -d-L-C, U d - Y.
The information'shown on the attached
map(s) was compiled for use by the City Of
Edmonds, its Employees and Consultants.
kn
The City of �Edm.onds does not. wa rra nt ti ie
accuracy of anything set for.th on these
Map(�_). Any person or entity -requesting a
copy should conduct an independent
0 'ation shown on
inquiry regarding the inf* rm t limited to
_tFe -map(s), Including, but no
th*e lociation of any sew-er stub shown, Such
sewer stubs may or may not exist and may
or may not exist at the location sh * own
o nor its
Neither the City of Edrn nds,
emp-to-yee's o*r office-rs -shall] be Viab-'Fe for the
information given on this map(s), nor for
tation provided based
any one represen
upon said map(s).
APPLICATION
The City of Edmonds for EASEMENT NO. ... . ...............
SIDE SEWER PERMIT
vi,
NEW CONSTRUCTION REPAIRS F LID NO. ------ ASMT. NO.
OWNER ........ CONTRACTOR ------ -- PERMIT NO.
------------------------------------------ ...... ............... . ....... - --------------
JOB ADDRESS F>\— LEGAL DESCRIPTION: LOT NO - ------ —?
................................. -------------------------------- BLOCK NO. PPP.--CD--lD5D.
... ................. -- -- ------------------------------- .............. ---------------------------------------------------------- .....................
—I—
NAME OF ADDITION . ..........
...... I .............. . ..........................................................
Approved:
DATE By - ---------
-7-7-
CITY OF 110M ONDS,
�Ek PERMIT
WATEPVwSEWER DEPARTMENT
ql�_
PERMIT
Call 7.75-2525 for side sewer Inspections BEFORE cbveiy'ing� any portion of Ahe constr tion,
Inspection. will be provided within 24',hours,after.�requst.�; No Sat;. Sun'.'. or* holiday inspeute ions.),
SS','LOC' I
�7ON �OF CONSTRUCTIONJ-1.6;J.4 ............................................. t .......................................
. .......................... * ......................
�PftQrERTY,,I,;EGAL,'DESCRIPTI[014 .........
..... .. .... ............ .......................... ...... V�oc .................................. ........................ . ................ .. .
......................................................................................................................... ....... ............................ .............................................
............................
..................................................... ........... ONAWERANDVOR BUILDER; ....... .........
7 . . ........ : ..................... ........... : .........
;CONTRACT-OWS NAMV,& -ADDRESS ..................... ........... 7 ......................... .......
...................... V ........................................... ! ........
Pennission Is, granted ............ .............. I .............................. 1� for repair and/or .'Connection, of a side sewer to- the, city., sanitaryz sewer
syr-telinirf accordance, with City of Edmonds ordinances.
i�ENTION I&�b�k.LLtD!�tO'THF,',�FOLLOW�ING:
NOTE No. 1---�The, owners. of the -property may obtain a permit to. construct sewer inside- property line. A licensed Sidi Sewer Contractor must be,employed! to construct
slde� 'sewer. -in stre ' et area. Do not cover any portion of sewer before -it �has been Inspected.
NOTE No.. 2—All work,performed in city right, of -way requires an Invasion of Right -of -Way Permit obtaJnable from the City. Englneei!s office.
NOTE No. 3—Obtai n'full information regardin q Ordinance 11.16.030 and, Regulations governing. side sewers when you get permit.
NOTE'Nc. 4—To&p��f. side sewer must have at least 30 Inches coverage at property Aine and 42 inches, inside property line; minimum,,grade of 2%'.., �No�,bends In! grade
h 'per than 1/s will:obe permitted.
NOTE No. 5>—Tre`nches, in street must be water settled ajid surface of street restored to oilginal conditlom Contractors shall be responsible for faJIurs12,:due t ., ,I I mproper
wo'rk which' may � develop within one year of completion. o
NOTE) No. 6—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 appurtenan'ces,�excep.t to; in-
sert the, pipe Into �the wye.
DISAPPROVED Date;.. By ................ Date�....
. ................................... BY ................ Date ............ 7 .. . ....... ........ By ..................
APPROV,ED� Date.*. 'Y ....................
B xi� ............................
.. .................... . ...................... 7 ............
Remarks:.
............................... 7 7 ......... ............ ............... ......... .. ......................... ................ ........ .......... ..................... ................. ............
........................... . ........................ ........... ........ : ................................................................................ . ........................ ..............................
BOTH Permit Copiesi MUST Be Signed- By Owner,of Firm, Performing Construction PRIOR'To Request For InSpectibn_.
-he side,sewer installation constructed' under this permit
........ . .... ................ .... hereby certify that t
(Owner of contracting Firm Performing Construction),
w_,,'Installed in accordance with.all governing ordinances of the City- of Edmonds.,
Dated'thls ........... ....... : .... day of ........ ........... .......................... MIA
Check BEFORE you dig for: Water E],,- Gas, E], Tele hone.,E] Power :Sewer, 0,, Other [j, I
JAMCATIONE
The City of Edmonds fat EASEMENT NO - ---------------------------------------------
SIDE SEWElt PERMff
NEW CONSTRUCTION Pj REPAIRS LID NO - ------------------ ASMT. NO - --------------
OWNER ----
........................ CONTRACTOR. ------- ------------------------ PERMIT NO.
Y_j 7.c 45
JOB ADDRESS - - ----- F-K- --------------------- LEGAL DESCRIPTION: LOT NO - -------------------------------------
- BLOCK NO. .0
.................................... .......... .................. ------------------- ..................................................................
NAME OF ADDITION 1pja)� k
-------------------- ---------------------------------
M
R�
5,!
Approved:
DATE............................................ By