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21615 81 ST AVE W
PRO
APPLICATION
for
The City of Edmonds SIDE SEWER PERMT
EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS
.................. ........ .................... --- PERMIT No . ......................
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OWNER................................. ............................................................................ CONTRACTOR ----- ..................................
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ADDRESS.......................................................................................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
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APPLICATION
for
The City of Edmonds SIDE SEWER PERMT EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS
OWN. ....... --------- . ....................................... PERMIT No—zkll/
......................................................... CONTRACTOR ... 0AV ...... A"A ....... C_Q %—'
A BI.�OCK No. —10-w. .............................
ADDRESS ...... 21LA� ......... —%_1 ........... OP!� ..... W ............................ LEGAL DESCRIPTION: LOT No . ....... 7 -----------------------------------
NAME OF ADDITION ..... �j ...... �W ....... NRIK .................................................. ...........................
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RECEIVED
APR 2 5 1974
Approved:
DATE................................................ By ......................................................................
�NOTICE:
The information'shown on the attached
map(s) was compiled for use by the City of
Edmonds., its Employees and Consultants.
The City of Edmonds does not warrant the
accuracy of anything set for.th on these
rnap(�_)- Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
.-.--t-Fe -m-ap(s), including, but not limited to,
th . e location of any sewer stub shown. Such
sewer stubs may or may, no t exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
ernp'ro-yee-s o-r office-rs -sh-a-11 be Ha-b-lfe for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT "Tr"
U. �672
Call 775-2525 for side sewer Inspections BEFORE Covering any Portion of the construction.
Inspection will be provided within 24 hours after requat. NO Sat., Sun., or holiday InSpectloZ.)
ADDRESS LOCATION OF CONSTRUCTION ...... p.R�
�M!QtMW�7 ... Rest
PROPERTY LEIGAL DESCRIPTION .....
......................................................................................................... I ...................
.................................................. . .......... . .......... . ........................................................................................ . .................................. . ........ I ..........................................
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� j --- I ---------------------------------------------------- OWNER AND/OR BUILDER ------- WAME ... H.11L ........ ................................... .......................................................
CONTRACTOR'S NAME & ADDRESS --- yn
Permission is granted ............ .. ... ......................
...... Anr' 1 _' I .... 2S ..... 19.14, for repair and/or connection of a side wer to e city e
systeOln in accordance with City of hdmo*nds o`rd_in'_a*_n`ce's. - se th sanitary s wer
ATTENTION IS CALLED TO THE FOLLOWING:
No. I —The owners of the Property may obtain a permit to construct sewer inside Property line. A licensed Side sewer contractor na
side sewer In street area. Do not cover any Portion of sewer before it has been inspected. ust be employed to construct
14—'E No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obt&in full Information regaxding ordinance 11.16.030 and Regulations governing side sewers when You get permit.
NOTE No. 4—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 % will be Permitted.
NOTE No. &--Trenches in street must be water settled ajid surface of street restored to original condition. Contractors shall be respo
work which may develop within one year Of completion. ns . ible fbr failure due to improper
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 appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED
"PROVED
RemiLrks:
E] Date ... . ................................... By ----------------- Date ............... - ------------------- BY -----------_-- Date ............... . .................
Date..A.�:l 'By ................
... ..... ��-7q ...... BY...
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.................................. . ... ......................................... .........
BOTH P - ermit Copies MUST Be Signed By owner of Firm Performing Construction PRIOR To Request For Inspection
.... .... hereby certify that the side sewer instal
(Own c
q
w& -in
r jjon) lation constructed under this permit
Ustalled in accordance with all governing ordinances of the City of Edmonds.
Datedthis ---------------------------- day of ................................................................. 19 .........
V %/ Check BEFORE You dig for: Water E3, Gas [:], Telephone E], power E], Sewer [3, Other E] V Ni