21709 82ND AVE W.PDF111111111111
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21709 82ND AVE W
Date
IC 14ORKS DEPARIMU. CHECKL �4ZZ25
BUILDING PERMIT REVIEW
STREET FILE Z4700cj —82-"u, Address
Exi t' REQD
Street Right -of -Way s ing
Access Easements Existing REQD
Utility Easement Existing REQD
Lot per Subdivision -7 Plat Assessor Map't4"
0 YEA.
Z :Site Plan Checked for Accuracy
Underground Wiring Reqd.
Check Accuracy of Legal Description
Environmentally Sensitive Area
Environmental Checklist Reqd.
F-4 -Flood Hazard Zone
0 Shoreline Management Area
Z Slope, Soil, Vegetation
Stream, Creek, Drainage Basin
Existing Zoning Per Code
Amenities Design Board Approval Reqd. ADB # Approval
Board of Adjustment Approval Reqd.
Review By: t r! - Date:.
Ice
Existing Water Main Size
Water Main Reqd.
Service Line Reqd.
Hydrant Size Existing
Hydrant Reqd. Per Fire Code Size
Detector Check Meter Reqd.
Cross Connection Inspection. —
Fire Department Connents
Water Meter Charge Reqd.
Review by:
Septic Tank Design Approved
Septic Tank Permit Reqd.
Sanitary Sewer.Availability
Drm,Ti% No.
Side Sewer Availability
Sanitary Sewer Connection Fee Reqd.
Review. By:
Date:
Permit No.
Proi -
File No.
Date:
Lis M 72r Wlr
j I L
q)en Ditch Existing Reqd.
Culvert Reqd. Size
C4 Catch Baiin Reqd.
Indicate on Site Plan
.0 Shoulder dram'aj:,,e maintain collection on -swale open runoff
%
En '.�u�hole reqd. Indicate on Site Plan
Soil Conditions and Groupd Water'Field Checked
Rc,,.ri ew by
I UUM
Street Paving Reqd.
Curb and Cutter Reqd.
�Sidewalk Reqd.
Curb Cut for Drivew-a
,y Reqd.
v4 Right -of -Way Construction Permit R(2�d-
Bond Reqd. for Public Improven-lents
Street Naiire Sign Reqd.
Other Signing Reqd.
Pre Permit Site Inspection made on
0
BY: SE1,JER
WATER
STREET-
IMTNTE PING
0
P4
P4
Pq
<4
Special Requirenie-nts listed in memo to Com=ity Development DepartTmnt,
Building Division
BY Dat , e
1 items filled in on Building Permit Application
I 9yo
Date
DraiAng,s Stamed and Notations Made
BY Date
Approved by 'Public 1%lorks DepartTnent
Revised: lv 10-1977
NOTICE:
Nb-warranty of accuracy. -
The -information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Edm.qnds does not warrant the
accuracy of anything set forth on these
nt*ty-requesting a
map(§ Any person or e. I
copy should conduct an independent
inquiry regarding the information shown on
I ited to
-t-Fe -m a p (s) , Including, but not I'm'
tub shown. Such
the loc'ation ofanysewers
sewer stubs may or may"not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
a. I b e I.-i a- b.-IF e f o r tL h e
ernp]-o-yee-s o-r office-rs -sh
information given on this map(s), nor for
ion prov'ded based
any one representat'
..upon said map(s).
CITY OF EDMONDS - SIDE'SEWER PERMIT
WATER SEWER DEPARTMENT
PERMIT
"j, 0 45@9
Call 775-2525 for side sewer inspections BEFORE covering any portion of the construction.
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.)
ADDRESS LOCATION OF CONSTRUCTION ..... 21709 - 82nd Avpnijp Wpst
................................................................................................................................................................
PROPERTY LEGAL DESCRIPT91ON -------- LAt --- 7_.L__.01e.n --- Addition -------------------------------------------------------------------------------------------------------------------------
-- - -1 ---- -- ----- -- - A I -----
-------------------------------------------------- - ----------------------------------------------- * ------------------------- * ------------------------------------------------- * --------------- * --------------------- ------------------------------
................................................................ OWNER AND/OR BUILDER ......... RQNAL-D ... SMAN.SON .............................. . .......................................................
CONTRACTOWS NAME & ADDRESS ..... Russ Johnson Sewer & Plumbinq, 16009 N. Meadowdale Rd.. Edmonds
............................. I ................................................... . ...........................................................................................
Permission Is granted ........... M-a ... r --- c ... h ---- 21j,
.. ............. ............ 1934., for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City of Edmonds ordinances.
r �Ir
AT--_.,rION IS CALLED TO THE FOLLOWINd:
NOTE No. 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—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--Obtain full information regarding 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. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for fallure due to improper
work which may develop within one year of completion.
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.
DISAPPROVEDDate ---- ------ ............ By ---------------- Date -- ----- ------------------------- ...... ......... Date ............... . .................... By ................
APPROVED Date ....... � By
......... By ... .......................................................................................
................. L ...........................................
Remarks: -------------------------------------------------------------------------------- ----------------------- - -----------------------------------------------
................................ ------ ; ........ . ........................................................................................ . .................................. . ...................................................
BOTHXerraZiCcbiej WSyle Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection —
------ ------ * ---------- .... .... hereby certify that the side sewer installation constructed under this permit
i. ing Construction)
r c�in'�i�;;�&r rn�i'
Yer 5,
in ac-7rd),e with all governing ordinances of the City of Edmonds.
VDated this__,__,,_6 ------------- day of ------- .. . ... .............................. ....... ig-7
6— / 0
V V Check BEFORE you dig for: Water C], Gas 0, Telephone [], Power E]t "Sewer 0, Other E] V V
APPLICATION
The City of Edmonds for
SIDE SEWER PERMIT
V* �E CONSTRUCTION REPAIRS E] EASEMENT No . ............................ .............
C:) 112)2�
OWNER ..............................................................................................................
CONTRACTOR .... . ......................... PERMIT No . ......................
e>a t-f' t�:N t- MWEL \N ��SV LEGAL DESCRIPTION: LOT No . ............ 7 ..................... ....... BLOCK No . ............................................
ADDRESS Z� .............................................................. .................................
NAME OF ADDITION
.......................................................................................................................................
0
40
I
DATE ..... (..!�
.................
. . ............
4 APPLICATION
The City of ]Edmonds for
SME SEWXR PERAM
NEW CONSTAUCTION-4g.-� MpAMS 0 rASZ3CMNT No.
.......... PMUUT NO. .+Yl .......
OWMM .... -------- sa-4--eltI)s ------- CONTRACTOR
,lFa--s -j ..........
Jfv r-
ADDREM ........... Z,72
.. e-4�24�.- . .......... LEGAL DESCRIlMON: LOT No - -------- 7 ------------------------------------ BLOCK No . ............................................
NA3dE OF ADDITION . ........ ......... 100.61 00 ... T .. c>
d.no ...............................
0
i �,j
MAR 26 1974
ApprovW:
DATE................................................ ft ................................................ ... . ..... . .........