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21720 82ND AVE W
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APPLICATION
STREET FILE for
The City of Edmonds SIODE SEWER PERMIT EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS 0
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OWNER------------------------------- * ------- ......... * ....... ............................... ....... CONTRACTOR --------------------------------------------------------- * ------------ * ------------ * -------------- PERMIT No . ... .......
ADDRESS LEGAL DESCRIPTION: LOT No - ---------------------------------------------- 13LOCK No . ............................................
......................................................................................... I ..............
r-A (L-1 C.) C---3 k -T \ CD t--�
NAMEOF ADDITION .......................................................................................................................... ..............
Approved
F=-1 Mb.L- DATE ....... 71v.- By .......
12
The City of Edmonds
APPLICATION
for
SIDE SEWER PE]OW
NEW CONSTRUCTION [] REPAIRS 0
OWNER........ ------ e -------- 4--6L ........................................................
�&d ...........
ADDRESS.............. -------------------------------------------------
EASEMENT No . .......................... - ..............
CONTRACTOR.................................................................................................. PERMIT No.
LEGAL DESCRIPTION: LOT No . ........ -;K/ ................................ BLOCK No . ............................................
NAME OF ADDITION.. ....... .........................................................................................................
....................
(� L-) /
RECEIVED
APR 2 2 19A
DATE........... .................................... 13Y ------------------------------------------ ---------------------------
NOTICE:
N:o-warranty of ac-c-uracy.
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 ' warrant the
accuracy of anything set for.th on these
map(�_). Any person or entity -requesting a
copy.should conduct an independent
inquiry'regarding the information shown on
�'rnap(s), including., but not I'mited to,
the 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
emplo-yee-s o-r officer--) -shdalfl be liable for the
i n
information g've 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
- 7"
PERMIT . � �
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.
20
ADDRESS LOCATION OF CONSTRUCTION ....... -7 �_, ............. : ......... .......................................... . .............................................
.. .. .... .......... .
PROPERTY LEGAL DESCRIPTION ................... Lp�� il'p. 4, CCan A�,Jdcn
. ........ 2 .................................... ��! .......................................................................................................
.................................................. . ...................... . ........................................................................... ............ . .................................. . ..................................................
....... . ....................................................... OWNER AND/OR BUILDER .......
.................... . .................................. . .......................................................
CONTRACTOR'S NAME & ADDRESS ........ Dorald IE. Davis, 21.720 82n6
................................................. ............................ . ........ -------------------------------
-------------- * -------
Apri � 2,
7 4
Permission is granted ........... . ..................... ......... . ............ 19 .. ...... for repair amdlor connection of a side sewer to the city sanitary sewer
sy, -i in accordance with City of Edmonds ordinances.
ATTENTION IS CALIXID TO THE FOLLOWING:
NOTE No. I —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 Permlt obtain -able from the City Engineer's office.
NOTE No. 3--ObtaJn 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-
sen the pipe into the wye.
DISAPPROVED Date --- - ---- —7c/- B ... Date .......... By ................ Date ................ . ................... By .................
..... .... Vy . . ..... ............
. ............. 7
APPROVED Date ... . ....
X . .. ...... .. ...................... By .... ... 4 t., ................................................................................
Remarks: ....... .
...... ne ..... jrl�� .....
- - - - - - - - . . . . . . . . . . . . . . . . . .
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
I ....... i6w,__ne,r.T'C_ on',t_r_ac,_ti`n_g ---- F'I*r'zn'* --- P_e'r',f,or'm', i,n- g- --- C'"o-n"s, -t,r- u--c' t- I o--n*') ... I hereby certify that the side sewer installation constructed under this permit
was -installed in accordance with all governing ordinances of the City of Edmonds.
Datedthis ............................ day of ................................................................. 19 .........
Check BEFORE you dig for: Water E], Gas F], Telephone 0, Power E], Sewer E], Other E] V V
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