21821 95TH AVE W.PDF,9292
21821 95TH AVE W
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i
NOTICE,
'0 war,rant-y ... oT-
N'
on the attached
The lnformatiOn
piled for use by the City 01
map(s) was cOm '
Edmonds/ its Empl-oyees and Consultants.
Th,.e CjtY of Edm.onds does. not. warrant the
f anything set forth on these
accuracY 0
Map(s). An . y person or e.ntity-re-questing a
copy should conduct an independent
orm'ation shown-c
Inquiry regarding the infi
-M (3 p Including, but not limited to/
the lc�ation of any sewer stub shown, Su(
sewer stubs maY Or may not e.xist and ma�,
t at the location shown.
or may not exis
Neitheir the -ity of Edmonr-41 - z-, nor its
em p'-o-yee-s o*r off i-ce*rs *sh-a-1-1 be 11abi-1--e for th
intrimation given on this map(5)) nor for
e.ntation provided based
any one repres
upon'said. map(S).
'APPLICATION
for,
EASEMENT NO . ................. ..........................
.4hie City of Edmonds STREET FILE 'SIDE SEWER PE�RMIT
NEW CONSTRUCTION REPAIRS 0 LID NO . .......... — ...... ASMT. NO . .................
OWNER...... ...... ----------------- CONTRACTOR ........................................................................................ PERMIT
JOB ADDRESS ---Zl Wl�—r LEGAL DESCRIPTION: LOT NO . ...... i
......... ........ A-1-1 . ............... .. ........... — -------------- ........ — .... ......... ---- BLOCK NO . ............. .........
I L�-v �' icr=— - - *
................ .............................. ....................................................
-- ------------- By --------------
1��
4
!, V I. T_r:
f"IM
In " D,' "PERMAIT
AM N
.4 A]
V, E
i4V
WATEWSEWER DE� RTM
-IT
PERM 552t
of the construction.,%
Zcay 171-,�525 f6r side �sewer inspections BEFORF,:. covering -any -portion,
Alinspsc�,�o�-_will lie provided,, withim ��ourb after.:re'qust. NO� SEU., Sun., ior 'holiday� inspections�
a
'2182t 95th Avenut W08t .......................................... .......................................
......... .................. 7-.0 .... ............... IV
0V',0E--/C6NSTR,UCT10N.--
.................................. I ...... ......................................................
Lot I -
PR6PERTY LEqA%L'.,?DESCR1PT910N ..................................... Xt
.................. ............................... .................................................... ...................................................
.......................... ............ .................................................
FOR .............. ............. ......................................... ............
MVAr.
. .................... OWNER AND/OR'BUILDER ...... . ..........
...............................................
?."�"Dw�ss ........ U ..................................................................... ........................................ ..................................................
CONTRACTOW.&NAME
of a* side SeWer to the city sanitary' Sewer,
19.16, for repair and/or, connection
-Wsslon,,l&grah"-_, ......... . ......... ...............
)r Pty'of Edmonds ordinances.
in acc(ird,ance,,�vitli,
ATTENTION ISI.CALLEDTO)�THE'l FOLLOWING,: 'A, licensed o,�construct
nstruct,sew�r Inside propertyAlne. Side!Sewii Contr actor must be,�emplo�.e& I
:tprop, 'fore it has been Insp
NOT.E� No.'j -Theio"srs�of"A �rty may obtain- a.permit to cc
slde'�sewev i`wsirc ea., D.,n.t,cover any portion.of,sewer'be ected.,,,
e mit,obtaInable from., the City Engineer'.s, office;,,
of� Rjght�of-Way P r
city right-of�way S . , I..
require: , an' inva'sion,
sewers, when you get permit.
rn�ing side
1�formatiowregaxdlng Ordinance 11.16.030. and. Regulations gove ;NoNbends,-jnr,grade
8 coverage at 'Property line and' 12'Inche insfde'.pr6perty line; minimum, grade of 2%.
NOTE11,70'. 4—T;0��of",s ieZ'er'-_,i�u�i: have at least 30,inche
a"iper'tfian,;1A'. ,vill,,be�perrnitted. 'shall be responsible for failure duejo improper
", ; — t � , et -'Must be w�eer settled and surface. of street restored to: original condition. Contractors
.NOtE'Nb., 5--Treinches In 's r
- work whi6h,',miyj develop within one year of completlom do any wor'k on the main sewerL or its appurtenances except to, in-
6_4t is,,unlawfulf to alter or do any rk than is, provided for in the permit, or to
NOT& No. other wo
By .................
Dt .......... By ................. Date ....................................
DjSA.PPR0,YJED.`E]-�`Dat8 ... . .... .... ...................... By ................ . . ........
40e .....
APPROVED. Date.:..*..... , . ....... ........ ............. By ...... . ............ ............ . .........................................................
7
..............
Remarks:- ............... .............................................................. ............................................
............................
.......... ........... ..................... ......
............................. ................................................ : ...........................................
....................... ............. . ....... .................
ingdOnS't!ruction,'PR10R-,To- Request For Inspection
_A�OTH Permit �Copiesl'-MUST Be Signed By Owner of Firm, Perforrfi
wer installatio
-the� side se n 6onst�uct6d�urider"this�,perrhit
.................................................... ... hereby certify. t hat.
(owner�-of- Contracting, Flrm� Performing Construction),
all, -governing, ordinances, of the City of Edmonds.
was installed in accordance, wi
.......................................... .......
Dated this .................... ........ day Of
Telephone. 0' Sewer
you di for: Water. E],. -Ga&:[], ower Ell
heck �BEFORE .9
APPLICATION
-the City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION E] REPAIRS F� LID NO . ................ ...ASMT. NO - ------------------
OWNER
- — -------------------------- CONTRACTOR .......................................... ---------------------------------- ------ PERMIT NO - --------------------
JOB ADDRESS ...........
---------- LEGAL DESCRIPTION: LOT NO - ------- ------------------------------ BLOCK NO - ------------------------------------
................. ....... .
-------------------------------- .................................................................
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
RECEIVED
JUL 16 1-976
P,d
Approved:
DATE............................................ By ......................... ...................................
11/75