21817 82ND PL W.PDF11 lill iiiiii
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21817 82ND PL W
NOTICE:
No warranty of accuracy.
The information 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
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 City of Edmonds nor its
ernp-1-o-yee-s o-r offilCe,rs -shal-1 be l.-',1a-b--1`e for the
information given on this map(s), nor for
ion provided based
any one representat
upon . said map(s).
APPLICATION
for
The City of Edmonds
SIDE SEWER PERMIT
LEASEMENT No . .........................................
NEW CONSTRUCTION REPAIRS 0
OWNER -- - ----
................................. ................... ...... .......... ......... CONTRACTOR- El—
...................................... .............. .............. 2 ...... PERAUT No . ......................
E_SS G-A�L -DESCRl-PTION-:- LOT -No .. ......................... . :.:.* .......... BLOCK No . ......... ................... ..............
ADDR ......................... ..................... _'t
. ............................ ....... T _E
............
NAME OF ADDITION
Y
................ i .. .......... . .
APPLICATION
The City of Edmonds
for
SIDE SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS Cj
EASEMENT No . ..........................................
Z— A
OWNER ..... �A.A� .............................................
..........................................
CONTRACTOR .... E.1 . ........ ..............
61
................................ ..... PERMIT No..451�
ADDRESS --- jq� ........... ...... I .......................
.................................................
LEGAL DESCRIPTION: LOT No . ............ . . ......................
--- BDOCK No. ........ ..........
NAME OF ADDITION ............ & ......... ......
..............
I .... ... ................................................. ..................
Approved:
DATE................................................ By ......................................................................
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT 4
tCall 775-2525 for side sewer Inspections BEFORE covering any portion of the construction.
kinspection. will be provided within 24 hours after requ.4t. NO Sat., Sun., or holiday inspections.)
- '7 - ., 1� �
ADDRESS LOCATION OF CONSTRUCTION ........ ............... : ... ::,.; I - - - N .j-
.................................................................................................
1. z
PROPERTY LEGAL DESCRIPTION .......... .......
................... ...........................................................................................................................
........... I . ........ ...... I ................................ : ................................................................................... .................................................... ..................................................
... ...........
. ................. ...... ............................. OIVNERANDXOR BUILDER.......-.,.. ..................................................................................................
XONTRACTOR'S NAME & ADDRESS ...........
... ..................... ................................................ a ...................................................................
!'ermisslon Is granted " "e * - ' - ' ......... ** ............... * ........ 19 ...... I., for repair and/or connection of a side sewer to the city sanitary sewer
syq411 in accordance with'.. City of, Edmonds-,tordinances.
ATT—MON IS CALLED TO THE FOLLOWING:
NOTE No. I —The owners, of the property may obtaln,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`,atiy� portion of sewer before It has been Inspected.
NOTE No. 2—All work performed in city rlglt.of-way requires an Invasion of Right -of -Way Permit obtain -able from the City Engineer's office.
NOTE No. 3—Obtaln 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 'A 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 Date.- ............. By ................ Date .......... / .... Date ............... . ................... By ................
.................... ""BY ............
All AV./
......................................................................................
APPROVED Date ... . ..... 7/4 ........ By .....
Remarks: .............. ...................................................................
..................................................................................................................................................................................................................................................... .........
BOTH Perq�iit Copies M:IUIST Be Si;ne B Ow er Firm Performing Construction PRIOR To Request For Inspection
. . .... io
I .. ......
h
.............. ereby certify that the side sewer installation constructed under this permit
rm P,
-in 'r rmt.g 0
m Performing Construction)
/&n �t .................... ....
wa-Zstalled In accordance with all governing ordinances of the City of Edmonds.
Dated this ........... j .............. day of .... _
g7),t-0 -71/
.......................................... 19.,X .... 1.
V V Check BEFORE you dig for: Water E], Gas L], Telephone [:], Power E], Sewer 0, Other E] I V
i
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CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT JOB ORDER
REQUESTOR: CENTER: IDATE PREPAREL.-f--3-L
REQUESTING
DEPARTMENT HEAD'S JOB ORDER
SIGNATURE: FAC I L ITY: NLJ,\ . IBER:
DESCRIPTION AND/OR SKETCH OF 14ORK TO BE PERFORMED
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estimated: lactUal:
I'MATERIAL REQUIRED:
AUTHORIZING SIGNATURE
DATE ASSIGNED: PUBLIC WORKS DIRECTOR:
DATE COMPLETLD: CRAFTSMAN'S MITIALS: MANIS INITIALS:
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'STREET FILE
Director of Public Works Dept.
City of Edmonds
200 Dayton Street
Edmonds., Washington 98020
Karl L. Hansen
21817 82nd west
Edmonds., Washington 98020
7 7 -7
May 31, 1979
Dear Mr. Larson;
As per my conversation with Bob Franklin earlier today,, I am writing
in regard to the storm sewer at 21817 82nd west Edmonds. On 8-30-73.,
I granted the City of Edmonds a tan foot easement on the back of the
above property in exchange for free connection to the sewers on that
easement. I was informed that three drainage pipes from my home at
the above address were connected to the sewer when it was installed.
It has become apparent that this was never done. At that time,, the
pipes were about four feet under ground. Since then,, a new street has been
put in and it appears that about two more feet of fill have -been
put above the initial four feet,
The ditch on my property is open; I am requesting that the City
run connecting pipes from the sewer to my property. In the event htat
this is not accomplished in the near future., I will consider our
easement contract void.
; Si7nely
arl L?Hansen
(STREETIBLE0
PUBLIC Ivi'ORKS DEPARTHEifF JOB ORDER
REQUESTOR: KORK Cl"":'lFR: 6 7-e 4!e- '1!r/ I)AII: PRLPARED:
REQUES'l
b E PA 11: N F liF.Al S JOB OR.Dl-'R
S I GX . X1 I NF:
FACILITY: ---
DESCRIPTION' AND/OR SKETCH OF I-,'0RK\ TO BE PERFOPMED
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MATERIAL REQUIRED:
DATE ASSIGNED:
DATE COMPLITH):
Alv/ AUTHORIZING ',,IGNATURE
PUBLIC 1'�'ORKS DIRL-CTOR:
CRAFTSMAN'S liNITIALS: FORPIWS INITIALS:
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City of Edmonds
RIGHT-0F8fftE(MK*CTI0N
PERMIT
Permit Number.
Issue Date:
A. Address or Vicinity of Construction: 21817 82 P1 W (9408073)
9 0 C� B. Type of Work (be specific): Iustall 2" Plastic IP Main in 82 P1 W
from 14'S to 1341S nantarline of 218 St SW. Per-dwi: 9408073
C. Contractor: Washingalm Natural Gas Compapy Contact: Frank Swan
Mailing Address: 815 Mercer St. Seattle, WA Phone: 224-2278
State License #: 981il Liability Insurance: Bond:$
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. F1 Commercial E] Subdivision El City Project gg Utility (PUD, GTE, WNG, CABLE, WATER)
n Multi -Family E] Single Family n Other
INSPECTOR: INSPECTOR: 1,4,"
I
F. Pavement or Concrete Cut: 91 Yes []No G. Size of Cut: 1 (2 x'4) -H. Chargq�_$
APPLICANT TO READ AND SIGN
INDEMNITY. Applicant understands and by his signature to this application, agrees t6 hold the City ofEdmonds har'm—less from injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds, or any of its departments or
employees, including or not limited to the defense ofany legal proceedings including defense costs, and attorney fees by reason ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required,with permit application.
A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220.
Work and material is to be inspected during progress and at completion.
__....Restoration is to be in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihave read the abovestatements and understand thepermit requirements and thepink copyof thepermit will be
available on site at lx��� ses.
Signature: Date: April 1. 1994
(Contractor or Agent)
CALL DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: I_AAi6_-tf RIGHT OF WAY DEPOSIT
TIME AUTHORIZED': VOID AFTER. JUIle, 10— DAYS
DISRUPTION FEE/FUND Ill:
SPECIAL CONDITIONS: I—WArE 64 S Q0Vf- RESTORATION FEE:
PERMIT FEE':
or
CtJI-10%/ -rQ PA37- S124 j&4PWA
_.1AjS-re4o oic weSr 100nc ,vezr To H2..g2
COMMENTS:
DATE:
TOTAL FEE:
RECEIPT FEE:
ISSUED BY:
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Enfrg. Nv. 1991
FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Deptj I -,
Comments:
Diagram.:
CONTRACTOR CALLED FOR INSPECTION El YES
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
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END WINI AT 1254'St OF
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V,\/A'l TO 2-181ro.
DESCRIPTION I DATE i BY
REVISIONS
NOTES: EDMONDS
1.) FIELD LOCATE ALL UTILITIES
CALL 1-800-424-5555
48 HOURS BEFORE DIGGING
2.) I14STALL LOCATING WIRE OVER
ALL PE DIRECT BURIAL PIPE
3.) INSTALL A ONE POUND ANODE FOR
EVERY 1000' OF LOCATINC WIRE
4.) SURVEY IS NOT REQUIRED
5.) MAINTAIN A MINIMUM OF 5'
HORIZONTAL AND A 3' VERTICAL
CLEARANCE FROM ALL CITY
UTILTTIES AND APPURTENRNCES
6.) CUTS IN PAVING ARE SHOWN AS
7.) 1 CUTS ANTICIPATED
8.) COMPLETE EXPOSED PIPE CONDITION
REPORT WNG FORM 1563.13 (D-1)
SADDI
120, 4- eALX2.E CJE�-
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izo' ?--, SDR-- 11 PIPE
ITEV I ;:UA",! % CCK �,O
BILL OF MATERIAL
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AREA
TAX CODE
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PROP 2- 8DPL- I I ? E VP MAI N EXT.
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