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21823 95TH AVE W
NOTIC�:
No"Wa r-r a n
The Jnform ation'shown on the attached
*led for use by the UtY 01
map(s) was com ' p
Edmonds/ its Empl-oyees and Consultants.
Th,.e City of *Edm.onds does. not. warrant the
n these
accuracy of anything set forth 0
Map(s). An . y person or entity -requesting a
conduct an independent
copyshould
I Orm-ation shown-c
Inquiry regarding th*e *nf'
-t-He -m a p (S); i n c I u d i n g, but not limited to,
-er stub shown. Su(
the location ofanysew
rstubs may or may, not exist and ma�,
Sewe
or may not exist at the location shown
incls nor its
Neit-heir the City of Edmo 1-4-/ for t'h
emp-co-yee-5 O-r office-rs -shal-1 be Via-b-1--e
information given on this map(5), nor for
any one representation provided based
upon'said.map(s)-
J&"
APPLICATION
The City of Edmonds
for
SIDE SEWER PERMIT
EASEMENT NO . ............................................
NEW CONSTRUCTION 0 REPAIRS E]
LID NO . .................. ASMT. NO. ------------
OWNER------ L—VEEV24=W -------
...............
CONTRACTOR ------------------------------------------
----------------------------------------- PERMIT
JOB ADDRESS ----------------------
: ----------- ------------------------------ --------------------
LEGAL DESCRIPTION: LOT NO - ----------------
<- ------------------- BLOCK NO - ------------------------------------
...................................................................................................
00,
............. B, ------------ *'
, Ef ��
9,2
Aklll ic.
"PERIMT
MY N
AT .,.ER
T� DE Ak_"
-MEN
T
P R TO
E MIT �jr
1".1 7
(C-11��75-�525 )for side se,"r �'J�sPectlon
.8 BEFORE covering Portion of the construct] omy
any
.III' be provided':-Ithin '24 fi
ours: after requst. NO Sat.,
Sun.. or hoild
ay. inspections,
h Aven
ON 0
2
... ..... ye
West
. -1 ............................
I �T E .............. ........... ....................
!tT-�,-�,MGWL`y CRIP17ON L .......
........ ...
...........................
....................
7 .. .... ..............................
............................ ............................... ........................... .................................. . . .
...................................................
* .......... ..........
.................... 01"ER f �-D/ LERO -HASMAGER
OR BUILDER y
.................... ........... .......... .......... ........
�CdbfiIeA&�'ORIS _kANIE .....................
..........................
ES 0WINER ....... .......
...................................
P.............................................................. ........... ..............
........ 41�ly '76 ..... ......................
r .... ....... ........... " 19— ..... for repair' and/
or connection of a side s
C tybf Edmonds ordinances.j� el-Ver tof th6:�ci
ti-sanita4'sewer
T T14
-4 0
T1 E FOLLOWINr,:
OTE No, I� ;,,owners. o i , the .,projerty MELY obtain a permit.
si t construct sewer inside Property line. A licensed St
de Sewer, in 'street area. �Do not co 0 de Sewer Contractor n1ust'be e
ver any -portion of sewer..before
it has been inspected. mPloYed -to construe
-of-Way,�p6rn, t
In. City right, of -way requires an Invasion Of Rlght
n regar'ding Ordinance 1 1.16.0210-and Regulations go It obtainable from the Cit
9 1 L Y Engineer's office;
-as"
P_'of�sic]6, wer verrjing aids � sewers when you get� Permit.
. I � -must have at least 30 Inches coverage at property
arPer,thah`%
-will be �ermltted. line and '12, Inches Inside property line; minimum �g
NOTE -No �5_LLT, _`
renche�i,jj str"t, ynqst be water rade'iOf 27.. - No bends. in:� rade
work � which�misy develop within settled and surface of street restored to original con tio,
NOTE] -No. .6-:L One Year Of Completion. di , n. I Contraetors shall. be res I Ponsible for failure'(iue Ao' Improper
It' I to, alter or do any other work than is provided' for in
P �int I o;the wye. the Permit, or to do any work on the maJn as I wer or its appurtenances except to in -
"DE
SAPPROVED� By .............. D le/,
APPROVED, I j a ti a.. BY ................ Date ................................... 'By .................
ay.................. ......
Retnarks: .. . .................... : ........................... ......................................
01, .. .....
.......................................
............................................................................................
. .................. ........ ..................... .......................
7 ......................................
-P .......................................................... ........
.................................. ........................ .
6rririt C6pies MUST Be Signed'By -owner -of Pi p - !.z ................. 1% ........ .........
rm. erformi ng Constructio p
n . RIOR Td Request For,Inspection
................ ...... ..............
(Owner Of Con .......................................... hereby, certify- that the, side sewer in
d` tracting Firm Performing Construction) stallation - constructed -under
this'permit,
7ln'a9CQr sence With-all,governing Ordinances of the City, Of Edmonds.
Dated this .....
. .............
......................
N('-V' Pic WBEFORE you .................................
19 .......
dig �6r: Water Gas, Tcleph'o =.cr ,
wer
E); Sewer Otbeir
JIV
The City of Edmonds
APPUCATION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION E] REPAIRS F1
OWNER,
-/ --------------------------------
JOB ADDRESS .-A-f �K--Ia- --- ---- -.
f
EASEMENT NO. -- -------------------------
LID NO - ------- ---------- 'ASAtff. NO - ------------------
-------- CONTRACTOR -------- ---------------------
-: ....... ---------------------------- --------------- PERMIT NO.
-------- LEGAL DESCRIPTION: LOT NO - -------- -------------------------- BLOCK NO - ------------------------------------
------------------------------------------------ ---------------------------------------------------------------------------------------------------------------
NAME OF ADDITION ........
RECEIVED
JUL 16 1976
Public Works Dept.
Approved:
DATE
BY
Permit Address
STREET FILE
Legal OescriptionL401—(
40
BUILDING PERMIT UVIE14 - FNGINFFRTNG DEPARTr,4FNT
I CPECK LIST
Reviewer's
Intials
Septic Tank System Design Approved
00,2�Sanitary Sewe,r AvailahilitYY45_Sht'. of Dvin.
Project-T(=.Ox Side Sewer AvailabilityTIEE PL
Any Sanitary Sewer Connection Fees UoNf,
,,,�Site Drainage Checked (o
.100�5-Storm Sevier Aviallability- k Sht. Z of Dwq. No.
Roadside Ditch
C Qln
Project.
.. �.Gradinq & Final Contours S
i
'01WS
Sidewalks (Site Tnspection shows condition of existinn walks a's follows):
8'r �Curbs
400000
Curb Cuts 010
00'
4000,
Underground loliring A Street Liqhtina_SZE�1040
JA Street Rinht-6f-%qa,v A Bldg. Setbacks: 9JAA) (9n ht.
<Vr 0Z C
of Dwq. No. of Official Street Map.
i s t i n g 1) t i I i ty FasemPntswff0q[ff I -Lff)rf F-56ST&ODAW OIL
Access Easements
e Size !,late
_AM. Water Mains A Fire Hydrants (Indicat' r Main)
,4 q<,r1#
51-1-10-Bonds for Site Work
-MOT- V75n
W
1-6-:' Special Requiremptits listed in memo to Bldg. Dept.
X: 0. /Jol
Commercial & Apt. Requirements fo rm comnleted_
Drawings stamped & notations made
19. Site Inspection made on 4,1*2j6l� CP
Al items filled in on �ldg. Permit Application4�i6 -Z5
oar
2,. T his Lot incTuded in Subdivision FUf (List any special requirement"s):
3/9/76
40