21719 84TH AVE W.PDF111111111111
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21719 84TH AVE W
APPLICATION
The City of Edmonds for EASEMENT NO.
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS E LID NO. -� ...... ?- -------- ASMT. NO.
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- ------------------------------------- --------------- -------------- CONTRACTOR F--.-F-- <=)
OWNER ---- - ---------------------------- --------- ....... - ------------ PERMIT NO. -------------
T
Z ------ LEGAL DESCRIPTION: LOT NO.'f—::> ... ............ ......
JOB ADDRESS BLOCK NO. - ------------------------
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APPUCATION
for
T��,� of admando SME MWER PERMIT EASEAWWT No.
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NEW CONSTRUCTION b REPAIRS 0
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OWNER .. 4t.-IZA ...... frJ ............ CONTRACTOR ... C
.................................... ................ PEMM NO. -47Y .. e....
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ADDRESS ..jR!,L .. ............ ... .......... ............... LEGAL DESCIRIEPTION: L o . .............
..... ...... MN ..... ...................... BLOCK No . ............ ................... ...........
7
NAMEOF ADDITION .......................................................................................
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RecrOVE0
MAY 2 3 1974
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APProved:
DATE................................................ w -- .......................... ......................................
NOTICE:
No w-a r.r a n - y 6_t77a_-c_CJj--r-a-cy
The information'shown on the attached
map(s) was compiled for use by the City Of
Edmonds, its Employees and Consultants.
Th,,e City of �Edm.qnds does not. warrant the
accuracy of anything set for.th on these
map(s-). Any person or entity -requesting a
copy should conduct an Independent
inquiry regarding the Inform'ation shown on
I I
-t-Fe -map(s), Including, but not limited to
th-e lociation 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 c'ity of Edmo'nds nor its
1-1
ernpto*yee's o'r office-rs -shalrl be 11a.b.-IF-e for iffie
information given' on this map(s), nor for
tation provided based
any one represen
upon . said map(s).
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
7,7c)
PERMIT . j 0 � 7 19311 urll,
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 .......
..................................................... ....................................... . .......................................................
PROPERTY LEGAL DESCRIPTION ...... ...... U�ss
.......................................................................... ........................................................................
------- - ------------------------------------------------------- OWNER AND/OR BUILDER ---------
....................... D .................... - -------------------------------------------------------
.... ......
R-M.
�ITRACTOR'S NAME & ADDRESS ...... . .
................................................ ................................. .............................. ... . .......................................................
Permission Is granted ........... . ------------- 119 ... for repair and/or connection of a side sewer to the city sanitary sewer
City
system in accordance with 0 Edmonds ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
1E No. 1—The o ners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
(_'11 side sew,er in street area. Do not cover any portion of sewer before it has been inspected.
No. 2—All work performed in city right-of-way requires an Invasion of RJght-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.
.. ............
DISAPPROVED E] Date ----------- By_ Date* ----- A- ---- - — ------- By -----------_-- Date .............. . ................... . By ----------------
APPROVED -- ------ By/
Date"A ------------
_7 --- - -- - -- - ---------------------------------------------------------------------------------------
Remarks: ................ 7 .............. / ........ . ...................................................................................
....................................... . ................. . ........................ .......... .................................................................................................................................................
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
-- -- -- ---- ----- ..... ---------------- ---- --- I hereby certify that the side sewer installation constructed under this permit
(Owner of Cont tin irmn P�erfoming Construction)
, i r
d in accordance wit all governing ordinances of the City of Edmonds.
Dated this..2�k_� .. . ........... day 0-In 4-
...... 4
............................................... 19.9
. .... 10
V Check BEFORE you dig for: Water [], Gas 0, Telephone E], Power E], Sewer C], Other C] V I