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21615 96TH AVE W.PDF111111111111 9415 21615 96TH AVE W NOTICE:* -N"0­'w.'a'r.ranty ... OT. The 1 nformation . 'shown on the attached Hed for use by the City 01 map(s) was com ' pi Edmonds/ its Empl.oyees and Consultants. Th,e City of Edrn.ond-s does. not . warrant the these accuracy of anything set for.th on M a P (s). A n . y person or entity -requesting a copy should conduct an independent -e infbrmation shown,c inquiry regarding th _ffi� -rn a P (S) 11 including, but not J*rn'ted to er stub shown. Su( the location ofanysew sewer stubs may or may- not exist and ma�, or may not exist at the location shown r-ity of Edmoinris nor 'ts Neitheir the �1� I�A --/ t I e m p` o,y e e's o,r o ff ic e *r s *s h. e balf.e f o r it- h information given on this map(5), nor for ion pr *ded based any one represe.ntat' ovi upon said map(S). APPLICATION The City of Edmonds- for -7-7P-7=lQ2-'H->7 EASEMENT NO. ........................................... SIDE SEWER PERMIT NEW CONSTRUCTION REPAIRS F� LID NO. ---- ASMT. NO . .................. OWNER ...... ------------------------------------------ C ONTRACTOR J7�1���t':4EEFS ------------------------------------- PERMIT NO. 55-4�.cz.,� JOB ADDRESS — — ----- - --------- . ....................... LEGAL DESCRIPTION: LOT NO - -------------------------- ............... BLOCK No - ------------------------------------ .................................................................................................................... -------------- ------------------------------ NAMEOF ADDITION .............................................. ........................................................................ E 0 4 E S WN/tR.- RMMT� ITY-01F ED! MY 0, N IDS, -E PE WATER -.SEWER, DEPARTMENT., P'E,-R. MIT' 5864. ng: 'anv Portion; jdf� tfie constru tion,., (;,Call side lsewer� inspectionw BEr�oRE, coveri tio %e provided within 24� hours, after requ c St. NO��Sat.i..Su.n,.*,�'or,,holiday' inspee ns). nue W ADDRESS L,06�� j�.q"-PF C014ST-RUCTION ......... ................ ...... 1PY, ........................ PROPERTYLEGAM; DESCRIMON ................... . ........................................................ ............. ...... ......... ........................... ............................................. ...... ............... ................... ............ ......... ..................... .......... ...................... .......... ............ ........................... WNER, AND/OR, BU .......... 0. ................. ..... ........... ................ ...... ....... . I �% .. ........... 0 ONTRACTOW&NAMIE, AMAES S ....... 1j0MWN.E.R ...... _. . , 1. - I I . I'. � . � , -1 , I ...... .. .. ................................................. ...... . I .w ..... '. " I . . . . 11 1 :� I I - . ............ 0 .......... .............. .......... il-AIK ........................... 19 7.7. Sion ls,,grant�4'. ............ 7 2 ....... for Pair an�d/or, connection, of a side. sewer to, ce, wit the city sanitary., sewer in accordan' h �Cdy- of'Edinonds .�rdihances.,' ATTENTION IS,Cj�LLED-TO,�THE,�FOLLO'W.ING': NOTE No. I —The owners, of the:',�roperty- may obtain a permit to construct sewer inside Property line. A licensed Side Sewer side:sewer in,street are I a., Dc, not cover any portion of sewer before it - has Coritr . actor must be',eMPloyedl.,to,tconstruct -of-way,requires,-an Invasion of' RJght'-of-Why�j?ermjt obta3n-able from the City 'Engineer's office*i NOTE' No. 2—A,11�xork. Performed, In city right -,been inspected. NOTE No. 3—Obtain' full'i'riformatiomregarding Ordinance, 11.16.030 and, Regulations governing, side, sewers, -hen,you get permit. u NOTE, NO. 4—Top of Side. sewer.' r .9t have at least 30 inches coverage at property line and, 12 Inches inside, propeky ilne;, mjnjmum� grade of� 2%., "'No ln;:grade aharp6r.4ham, 'A­wilh be,�permltted' be ds NOTE No. &--Trench6s; in; street rimet be",water settled, and surface of street restored; to,.,orlgInEUi condition' responsible fo I r. fail : ure work whi6l,mayj develop within one year of completion� Contractors shall; US)' OL,improper NOTE No.. 6—It As unla;�full,io, alter: or do,,any'other work �than is �providedf for�.In 1�e'per sert"the;�.'ipp��into,the�,wy,�. mit, or, to,do;�any work on the madn 'sewer,or, Its appurtenancesi,�xcepit,16� in- DIS"PROVER, , t .. ...................................... By ............... Date ................................ ........ .. lay ...... ...... ..... BY, ................ Date ................ APPROVED ate ....... .. 7 ..................... By .... ........................... .......................... -Reinarks,:: .......................................... ................................................................................................... ........ ........ M ................................ 7 .......... .................................. ................ ..................... ................. ...................................... .......................... .................. ................................................... ......... les BOTH, Permif,C6p,' M!UST Be Signed�.By :ONV-ner of'Firm Performing, Construction �PRIOR'T I o Request For Insp ec.tion,, ................ ........... (Owner.,of Contrac i�, * , -, ­ * .... *,"* * ....... * .............. ..... ..... hereby qerfify thaf thersidb; sewerInstaffaLtibn cons fruct edlunder thi�,`permft .9 Firm Perfrrming -Construction) -was installedin accordance; with,all governing. ordinances of therCify. Datedt. this .............................. day of . . ................................. V '-Cheiak BEFORE you dig,� for:, Water, r?we Telephone,:E],,� Sewer :0;. -'.4�Other. APPLICATION The City of Edmonds for EASEMENT NO. SIDE SEWER PERMrr NEW CONSTRUCTION jV REPAIRS E] LID NO - ---- -- j� -------- - ASMT. NO - ------------------ OWNER -Ift JC A� -C,, , -r--1 ------------ -- ------------------------------ CONTRACTOR ------- �ZZ-J7.? .... 3� -1 JOB ADDRESS ------------------------------------- .. PERMIT --------------- LEGAL DESCRIPTION: LOT NO - --------- ---------------------------- BLOCK NO - ------------------------------------ 45�� rn C) A cy S 7W�.*-.--z - ............. ..T ..... j� ...... 6 ------- I --------- ------------------ 4� --------------------------------- .................. 11 Ilk) 'j� NAMEOF ADDITION ........................................................................................ ,76 Ac. &'-') - IN DATE-------------------------------------------- BY --------------------------------------------------- a7ye C. CITY OF EDMONDS PUBLIC WORKS EMINEERING ACTION REPORT N9 4260 SUSPENSE DATE: N& uj� Date: Time: 06 QM File # !�� LTf-)L' QS -j 0 �-Z," DO u z Attachments: =Yes Ld 0 0 Do SUBJECT: L LL 1- 0 w (,n < CY 0� W Z c�21(o 1:5 M 0 �- :E V) LL 0 La 1 0 �- z :3:. REQUESTOR: NAME: XIA-10 < U-) M z -j t-- ADDRESS: 0 cL LL 7) 1.41 00 I.- LLJ U-) PHONE: 0 REQUEST RECEIVED BY: Q� Lu 0 0 Lij TELEPHONE L) cl� CONTACT IN 11110E,,X < Lij �— OTHER: 0 0� V) z 14 -, M RECEIVED BY:C,/� u- 0 _0 0 ly r�, 0 LIJ ROUTE TO: 0 4 OPR N INIT. DATE # OPR NAME INIT. DATE Lu Lij CL LL . C:) cn (n 03 :T 9 10 v) z CL. z 5 ; 4-j' 5-T t� LC- �'(K- Cy- 0 C ACI ION: (D 0 Z uj z �,W .4 F 7- < C:) C -i L u 16F.IV. All Concerned Notified fmz��, Action Completed/File gs Alt., 04KA-." L`7 A4 At4 CA, Par 7- FM 9 1 MMLA mlw 7-1 tA/ i5p/UO"P,5f V4 gs-0.2-0 9. 0 6-4-5-0 MUC !.*0!1';',S )):�!'T. %.- '4a --- -- '., cAl.. r VD --I Strcet Pdr vi -f Access Fascments Existini, pj-,nn Ef;7 W Utility Fascmcnt ExistinI, Izj:n!) Lot Per Plat Assessor Iap Sitc Plm Olicc�.ed for Accurac-v cu:ic n; ,c(: r J Yxistin- I'ater �-Iqi n Sj -c, 1"nt-cr "'dn TVA.- Hydnv�t Si-zc V�I'ist�:l!" Hv('Mmt n-d ze tector —V- !-!12 Ritc ')C")'1C 11 Soptic Tnnl. Ilvnr.it Pec:uired !�vnqit ji Sunitary "Icwcr Availaidlity ro i'. C vaj I nbi li t' ;L: Side 5 on rc-' -'-er C:k'-'7'.:lcc!L- i(!;l 171-1c. I'C'muircd L....)o f6' Pate Vcn.".j I-VO N td) 1A-, c;t; j"" Clilvoyt 1'emdred 0 A� Catch ]"'isin Pc"illirod 111(licate oil '�;te I I < oil Sito "Im" Soil Conditions F., Growid 1.�'atcr Ficlu Oiccl'cd Revic..: I)v 6-77 Street Paving, Required ftirb mid (:,�ittcr Rcquircd — &ILI Curb Put for Privowav R'NUircd Pight-of-I"ay Construction Pcniit Rccluircd Bond 11,cquirc(l for RiblIc Improvcmcnts ";trcct 'Nanic Si I oil Other Si ning Pcowii cl J,rc I)c,,r,,.iit Site Inspcction made on s), -7 -7 c 11 Sci.:cr Street ?D s'no-CiA, Pom". rcricnts listcd in 11c,17)'O to Bui)(1in, jAcp)-Un'runt 1)'Itc, ffln( ; PCI-mit Apnlica-�,-.ion 1)"Itc and, ".'Otations !!"'(1c P4 Dato C_. tk', b)' PLII)1iC R'IMI use PERMIT 00 DEPARTMENT Applicant Fill ZO-E)�� -U;7 s' —A PERMIT APPLICATION Inside Heavy Lines JOB ADDRESS NAME JOR NAME OF BUSINESS) .in U Z SF ON es — JOB E ADDRE L L.G L 7� EGAL LOT T AREA m YES ONO s`BS!§"7-0:'7 W M Al LI NG 1ADD R ESS ST z STREET R/W 0 -71 ZV C EXISTING STREET R/W e-,r_77 FT. DEFICIENCY THIS PROPERTY CITY ELEPHONE NUMBER COMP. PLAN ST. R/W FT. FT. 0 9 L �t2� NAME I REMARKS U ADDRESS CHECKED By U M CITY TELEPHONE NUMBER STREET AND/OR UTILITY WORK R/W PERMIT REQUIRED < REQ'D. 10 YES 1:1 NO 19 YES ONO NAME UNDERGROUND WIRING REQ'D. iff'-f ES Im ea L 0 ADDRESS TYPE CONNECTION IMYES VERIFIEJ BY SANITARY SEWER ONO u. 37,�-71 kE IX CITY TELEPHONE NUMBER SEPTIC SYSTEM 0 YES PERMIT NUMBER I- z APPV'D BY CITY ENG. 19NO 0 S I/ U sTATEIUICENSE NUMBER CITY LICENSE NUMBER REMARKS S f-)? Legal Description of Property (Show Below or Attach Four Copies) A —r7— METER SIZE _;5� 1 BUILDING SUPPLY SIZE W z 0 I- W W j SIGN AREA ENV. REVIEW ADS NO. A' I WED I PROPOSED I COMPLETE I EXEMPT I REMARKS VARIANCE OR CU PLANNING REVI , By KOEWS — 9 F DATE YARDS & I I 02S_ FRONT 7 X--)- SIDE REAR ILOT COVERAbE' NEW r AD D D ALTER r r EJ REPAIR 1:1 RESIDENTIAL NON-RESIDENTIAL DEMOLISH EXCAVATE OR FILL PRE -MOVE INSP. GAS L NE S:GN RETAINING WALL FENCE X_FT) swim E] POOL FIRE ZONE ar J_ I TYPE OF CONSTRUCT _r 77' 1 CODE /7--/3 SPECIAL INSPECTOR REQUIRED 0 YES NO ?D AREA o 03 OCCUPANCY 1GROU17_ OC CUPA LOAD PLAN CHECK 'BY LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. REMARKS NUMBER OF STORIES NUMBER OF DWELLING UNITS NATURE OF WORK TO BE DONE, '81ki td/A VALUATION I FEE PROPOSED USE PLAN CHECK z NO. PLOT PLAN (INDICATE BUILDING SETBACKS. ABUTTING STREETS) BUILDING Ir PLUMBING U V) 0 HEAT & GAS LINE FENCE SIGN RETAINING WALL SWIMMING POOL 0 r— Z 0: W W z r1( 0 (- Z W 31 1'. z W z W 0 j W W z 3 0 U T E FR rff�\ RA FR K A D J WENDELL BLACK L J4 ROBERT B A LDR D:;E E. SEARS ALLAN S. RA"MM ;P I -IN E ST. t, L 's� �"o 0 80.00 7 5.0 0' 70.00' 30 30 1 5. 75' I Story UJ 0 Fro-e c� 0 H.Ups ro W.W. EDDY 0 0 0 13' r-. K.A. TELFORD A - - f, 'c 8000—sq.ft. �5 192 q-ft. 8392 sq.ft. J\lj u 1\1 G) E R 80.00 761 ����3 8 8 0 0 W) ' T 1 3-3' 3 �8.8 0 2.17 TH. ST. S. W PAUL E POULIN Pj _0 (JUNIPER--- ST) uj Z Lj .20 -f I C) 1\1 > WILLA PAULI Lli > LARRY D. WILLIAM 0. KAALD LARSON LO 0) QD 3 0' 30' _0ES ENGINEERS 9 SURVEYORS . PLANNERS D11- 324 Ma;n Street - Edmonds, W-isn;nwon 98020 CH.