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21712 82ND AVE W
APPLICATION
for
The City of Edmonds, SEDE SEWER PERMT
EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS 0
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OWNER \N r-'A
E> ......... CONTRACTOR .......... "....5 ... D ------- " ....... a -------- (Z. --- �-) ...................................................... PERMIT
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ADDRESS at _712- LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
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NAME OF ADDITION ...... .......... r.��.IPCN ....................................................................
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40
DATE ... .. By ..... -4 ......... .......
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APPLICATION
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The City of Edmonds SWE SEWER PERbuT EASMIENT No.
NEW CONSTRUC71ON 0 REPAMS 0
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OWNER......................................................................................... CONMACTOR .................................................................................................. IMUMaT NO.
ADDRMS .... . ..... W.".r .......... I ........ LEGAL DESCREMON: LOT No . ...... __25� .............................. MOCK N . . ............................................
NAME OF AIDDMON ........ 4A.e&S ........ AcLki�.. ...........................................................................
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Appwved:
DATE ......
NOTICE:
No warra�nty of a-c-curacy.
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.onds does not ' wa rra nt the
accuracy of anything set forth on these
map(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
�___t_Fe -map(s), including, but not limited to,
th-e location of any sewer stub shown. Such
sewer stubs may or may'not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
ernp[o-yee-s or offiCerS S'ha-11.1 be l--',1a-b`Fe for 11-he
information given on this map(s), nor for
ion pr 'ded based
any one representat' ovi
upon said map(s).
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 77 -2525 for side sewer inspections BEFORE covering amy portion of the construction.N
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.)
ADDRESS LOCATION OF CONSTRUCTION ....... 21712 82nd Avenue West
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PROPERTY LEGAL DESCRIPTION ....... L.o.t ... 3. __.0_de_n_s.. -Ad-di.t.j. -on ... ... re-cor.ded .... i.n .... Vo.1 ....... 1_4 ... of ... Platls ...... p.ap ... 90 ...............
.... ....... ....... .. .... ..
Records of Snohomish County
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I
....... . ........................................................ OWNER .1%.ND/OR BUILDER ......... Leon A. Gareiss
........................................................................................................................
CONTRACTOR'S NAME & ADDRESS ....... �e.qn...A ...... 8A_re_j.s.s_.,'.111_2 ... 8.2nd .... Ave -pp.@ ... 1--fe.s.t ------------
..........
Permission is granted ......... Ap.ri.1 ---- 18 ............................. 19-N., for repmdr and/or connection of a side sewer to the city sanitary sewer
s"+—n In accordance with City of Edmonds ordinances.
Ar._,-I�ION IS CALLED TO THE FOLLOWING:
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 failure 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.
DISAPPROVEDE] Date_,�..,,, ................... By ................ Date. _0e ------_---------_------- By ................ Date ............... . ................... . By ................
APPROVED
Date.A.. . ............ 22—
. ................... ............. B . .. . ........................................................................................
Remarks: ............ ..................... . .. . .....
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BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction.'PRIOR To Request For Inspection
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............ .................... ... I hereby certify that the side sewer installation constructed under this permit
(Owner of Contracting FIrm Performing Construction)
wa. istalled * accordance with all governing ordinances of the City of Edmonds.
Dated this ...... e /4.
-- ------ ....... P
........... day of ... ...................................................
V V Check BEFORE you dig for: Water E], Gas E], Telephone [], Power F], Sewer V--r, Other F] -V V