21816 82ND PL W.PDF11 lill 111111
7676
21816 82ND PL W
APPLICATION
for
.1rhe City of Edmonds SEDE SEWER PERNaT
EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS 0
,OWNER ............................ CONTRACTOR .... E-ff�n ............................................................................... PERMIT No . ......................
LEGAL DESCRIPTION: LOT No . ......... 2-
ADDRESS (�C> \rqE -!IT BLOCK No . ............................................
................................................................................................... .....................................
NAME OF ADDITION ...... ..................... . . ......................................
..................................
0
0
Approved:
DATE .... 64 14� Zz� ......
APPLICATION
The City 46f Edmonds.
for
Sim SEW", PERMT
EASEMENT No . ............... ............
NEW CONS�rh"OTIOX cl
OWNER .Q.Re . ...................
...... ......................... . ............ .
db*RACT ................... ......... J ............. - - ---------
PERIM No.
ADDRESS ............... 9 .............
............................. ..........
L19GAIL DESCRIPTION: LOT No. .............. _� . ..........
...........................
NAM'JC OF ADDITION ... . ............. A .......... ...................
......................... ...........
E
a
Approve&
..........................
...................
N.OTICE:
N'o. W'a rra nty. of -a-ccu racy.
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
map(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the information shown on
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-to-yee-s or'off iCe*rs -sha'rl be 1-11a.b.-IFe for the
information given on this rnap(s), nor for
any one representation provided based
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.
Inspecti5on will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections)
ADDRESS LOCATION OF CONSTRUCTION ....... ZIBM ... .... Und ... Plime !,Jest
..................................................................................................................
PROPERTY LEGAL DESCRIPTION ...... DI'l., Adj�i
tinn
........................ ........................... . ........................ I ................. ........................................................................ . ......................................................................................
....... . ......................................................... OWNER AND/OR BUILDER .......
CONTRACTOWS NAME & ADDRESS --------- j3!?tC!A(!1TL ---- f P-11-.-Ray ... KeLklmrn_111 jpf B.Sh i n ry I- n n
. . .................................
Pernilssion Is granted ---------- DI-1 .......................
. ...................... -, 19 ... 7A, for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City of Edmi6nds ordinances.
A'�, _.TION IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners of the property may obtain a permit to construct sewer inside Property ii . ne. 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 obt
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations . ainable from the City Engineer's office.
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
sharperthan % 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 faJIure 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 maln sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED E] Date ... . .... / ----------------------------- By ---------------- ate ...... .. By ......... ...... Date ............... . ................... By .................
----- y
APPROVED Date. 1A_
Remarks�
....... ....................................................................... ............
...........................................................................................
--------------------------------------------------------------------- - ---------------------------------------------------------------------------------------- - ---------------------------------- - -------------------------------------------------------
BOTH Pe it Co,p�qs MUST 137e Sign d
�e y Owneref Firm Performing Construction PRIOR To Request For Inspection
I .. ..... .. . .... ........... ....... .......... hereby certify that the side sewer installation constructed under this permit
g r or
r 1�g
O;;,�ner of Contme I e
rx:�� Construction)
wk_.italled in accordance with all governing ordinances of the City of Edmonds.
Dated this ---- /� ---------------- day of i t7KI
......... ------ ....... 1 19 --- C ...
V Check BEFORE you dig for: Water Ga-s D, Telephone Power E]
.Sewer Other 0 V V