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21907 83RD AVE W
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WAT1ffiV9kW!�R.DEPA -MENT,-
RT
PERMIT,
-10 4638�
E n of -the construc i,on.N
v da,11. 775-2525..for' side -sewer inspection s iIKFOR covering 5xi y poiftio- t,
G
nspe� ibn kiil* b� - pro, ded within 24 hours Ifter. requst. No Sat.* Sun.; or jiqliday� jnspe�ponsj
2190 83--d Minve West
7 t U,
.A.DDRIESS LOCATION OF CONSTRUCTION; ...... ....................... ---------- 7 ----------- 7 ............. .......
---------------- -----
tTROPERTY -LEGAL 1DESeRj1-1Pt16N
7 ------------------- -------- ---------------- ...... ... . .......... .......
.................. ..........
------------- ---I-' -------------- .... .......... . .......... . ..................................... ............. . ........ ........ . ... ........... ..........................
.....................
m BUCHANAk.l.
............. . ........... .. ..... ............ O-VVNE1F(A'ND/OR- BUILDER. ............................. .. .............. ..... ......... ......
& ADDRESS .. F-E- �'BeChtold Co . 'P.-O B6x 586
CONTAACTOR'S NAMF ............ . ................................ .............. ------------ Kenmore- V hf-' dton.....
- ---------- ------ -----
& ib* re orcminectio-ni of: Side i; er to the' city sa�it
j.' granted .......... I -------------------------------- - ------
on r �air and/ a
6f,EJ m- o-hds ordinances.
Sys a666rdanci6,with 6
e
AT'.- ..TION IS CALI;ED TO THE FOLLOWING:
0-;.*I�,�T'he oi"irs of th� pm�ehy rhay o�tain �L per7nit to construct sewer imsidi 'property line., A�liceftsed S . id I e.Sewer Contraft6r rhuft b
�mp oy� t�o
tilde �ewii in stiitet aie Do not cover any portion OfL sewer� before it has b;een inspected.
N�Itt N6. 2--A:11,woijk' ��ri& ed in 6ty'right�bf-way requires apIfi
vs�zion of Right -6f-WAY.Petinit obtainable fro n the City Engineer'.,6fhce.'L� ti
L.
in:ibil iniormation regar gL
&I . - � `6 iu
din idinamci 11.16.030 and R�! lations -' joverning side sew�r� when-.
NOTE j�of iide�s-e�,ei-':inust hav:� :. t lea�i �6 "L ch yow
e a in es coVerage,it prbpertk' line ifid 12 inches i�side-�prop'eri� 'Jin -grade 6i 2%.-'No ben[�-
e rrunimurn
w
sharper - an 1/s ill be pe*tte&.L
N
no ade
�-Trenches irir itrek niust be water�isiAtied,and surfaie of street restored iii, ori ij, condition; �`Conttiacto'A -hall iie ieiPohsibl�. for -failure d&e t- ' �"L
- " I I L. . . . - .... I i. � I � . -f!'- - - o 7
whiafi inii:j di�i��lop Within on�. geii '6f cornpi6tiofi.
�40T
Z
6z�jt is :qnlawful, to 'iilt�r'oi d'o'any.-other work than is.bJrovided for in -the'perniit or to do akiy work'.ori th6 ffiiu. s- , I per
'ifert th6 'i3ilie !nt6 the Wke: ewek 6r'its �Lpp��enapces.
IK1§0iRo g ----------- bate-,
v A) Date ------- ....... By ........... .......
................ ------- - ------ ---------------
Dat ------------------- By.m - - ------ - -----
APPROVE D ........ .............................
'oe .........
....... ........ ........................... ................. ................... . ..........
7 --------- - - -------- ----------------------------
........... ........
7 --- 7 ------------------ * .............. :-7� --------------- ------------------------------------ --------------- ------------------- - - -------------------------------- - ................. ...............
:40TH P6ftriit 4ies mvgir 'y Ow Fi ri
4p Sigmed B i, g Construction, PRIOR Toiequiest i,
F' or Ihsp.ectioll
21by c.,
ereb - certify that.the side Sewer. installaticiii don§t cted utider th"
f; (jo �,.
Firin. P f; 4-1�.Fm r�cti6n) IS -nit
i Owner ofitracting
ed ih �L&6r�ah�c6 With'all g6i76rn1`n-'k ordinances of the Cif y�
of Edmohds.
Dated this_.:. -------- (lay, of.—;..
---- ------ --------------- -------
'eh'& BEFORE d1k for: Water
V V y6li Telejpl�one PoiWer, in, Sewer �1], Other E]
NOTICE:
-N'o ... Warran y
The -inform atio n'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 forth on t hese
rnap(�_). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform-ation shown on
tFe -map(s), 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
%_.1
ernp-1-o-yee-s o-r office-rs sh-al-I be 11a.b.]e for the
information given . on this map(s), nor for
ion provided based
any one representat'
upon said map(s).
V
.� The City of Edmonds ,
APPLICATION
for
SEDE SEWER PERMT
EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS 0
Ll 1�'A C��,N F— 7- PERMIT No.
OWWER ....... M.n ........ V:�D ......... . ......................................................... CONTRACTOR ...... -H ......................................... ...............
SS a I �->-) c) -? - � � - *11� E-->
ADDRE .................................................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
------ ---- **'** .. .... * ..... ..
NAMEOF ADDITION.. .......................................................................................................................................
0
Approved:
� V'IL� By
DATE-,,e . .... . ....... -------- .....................................
5
APPLICATION
for
The City of Edmonds SIDE SICWM pERRM
NEW CONSTRUCMON 0 REPAIRS 0
EASEMENT No.
2- /j-) i
OWNER 15 Uc 1-1,4 N4 ,V
.........................
..................................
........................ CONTRACTOR .. . ..... ......
ADDRESS... .................................................... PEpwrri NO.
............... .............. ..................... LEGAL DESCRIPTION: LOT No . ...... -5� ............................. BLOCK No . ............................................
NAME OF ADDMON...,f,4..;.r-XAUA .. t4 Op & .&-.
.... ........ / .......
I,_ ...... .... I .......................
3 #v-e w
APProved:
DATE ......
7
LIST
5= OWS . ......
4,
j, r-� A
Street Pdrht-oF-Way Existing Tzm")
Access Easommits Rx is, t i n g PEOD
Utilib, Fasmont ENistinn RY.OD
VENOM,
Lot Per Sul)div4sion Mat Y% Assessor I'al)
Site Pl-.m n1ccl:ed for Accurac�. rz
c)
PnOcr,arcund 111cod.
L*14, ,
Da� te 11
e--r
!'Cm!iT-C-d
AC >
llvdnv�t si:",
Pv(lrant r. r i re ze
Rcclli,n'd /—)go
AAD
_V7
-77 'Z/7
�CP-Li.c Tani: Date
!"on"lit !!0.
si.dc Sewer
Sa- 'I'lly
(n 1 1) i t d I �:x t I,,,-
.111. vc r t PCIC I I i re d
0
CItC11 11;1,Sill L '(111.1 Yr'(.
-1 t C�
CO) 1D 0- 1
Ca n
Nnni 101c requil-CO
Soil CollditiolIF, 17 .1d Field (106�cd
C
roi
C —0.
J1101c"I've on
U-1 n
Ilai Cal �001—i, , —I
lan
Street Paving, Rcquirc(I
Ojrb wic , tter Rcolliml
Sidewalk Peouired
In reol -.Ccl—
D.irb (), i t for J'jrijrO.j.,,,j%, j'c(jjli
ction Pcniit Re :iuircc
j',ond iircd for Rihlic Improvements,
(r. strcct �,'xic Sign
Other Signiril, R
Cqui red
-)cction madc on
Pre Ilcr,,.,,it Site Insi,
c
Sewer-
1%'atcr
Street-
Ynginccrinp,
spod'!]. Pom"ircrMnts listed in mc-..,.o to Buildin,(� Dc-prirtmicnt
)u J.-Iding, Pcii,.dt Application
fill-ed ill on 11
-Itc
—64j-
C,
Stanpod an(l "...'Otaticils, '-!,[('C
r- Ay.provc(l by Puhlic Tk�partmcnt