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21908 83RD AVE W
APPLICATION
for
SME SEWER PERMT
The City of Edmoriji*,'� EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS
F N (:�\N N .............. . . . ... ... .... ..
................................................ I ...... -
OVVNER ............................................................ ................................ CONTRACTOR ... PERMIT No.
a I C-�-) C:D EfD - t-,� E . \\tq
ADDRESS.................................................................................. ...................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
P L:y P, I c— i C��,
NAME OF ADDITION ........................................
....................................................... .........................................
Approved:
D A T E fl11, Y ..... BY.. .. .. .....
... .............................
The City of Edmonds
APPLICATION
for
SEDE SEWER PERNaT
NEW CONSTRUCTION C] REPAIRS
OWNER ..............................
...............................................
7
ADDRESS ............. ....... A ...... V �Sl
.............................
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A
EASEMENT No . ..........................................
CONTRACTOR.................................................................................................. PERMIT No. 40�
LEGAL DESCRIPTION: LOT No . ....... 1.3 .................................. BLOCK No . ............................................
NAME OF ADDITION`Pg::�7V-c.;c7 ........ A-".,v ........ YO-0-A ......... 3 ............................................
. ... ..... .... .... ... .... . ..
RECEIVED
APR 17 1974
Approved:
DATE................................................ By ......................................................................
NOTICE:
No warrantyOT d-U(,U1`d�'Y-
The -information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, Its Employees and Consultants.
Th,e City of �Edm.onds does not. warrant the
accuracy of anything set forth on these
map(s). Any person or entity -requesting a
copy should conduct an independent
inquiry regarding the inform ation shown on
.�-___Fe'map(s),
t 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 �jty of Edmonds nor its
emp-1-o-yee-s o-r office,rs -sh-a-1.1 be 1--ia-b.-Ife for the
information given on this map(s), nor for
ation provided based
any one represent
upon . said map(s).
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT J. 3 411,
Call 775-2525 for side sewer inspections BEFORE covering any portion of the construction.1
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday Inspections.)
ADDRESS LOCATION OF CONSTRUCTION ----- Z190a .... ... 33rd Avenue 11o.-st
................................................................................... . ................................ : ..........
PROPERTY LEGAL DESCRIPTION ..... L-o.t --- 3.s,..?.aVJc.j_a ... ADD ... Rad .... No ...... 3 .....................................................................................
................................................... . .......... . .......... . ........................................................................................ ................................... . ..................................................
................................................................ OWNER AND/OR BUILDER ...... ................................ . .......................................................
CONTR - ACTORS NAME & ADDRESS ....... OWNER
............................................................................. . .............................. . ... .......................................................
Per—ssion Is granted --------- A_qdl 17,
. .. .... .................. . ........... I 19.7k, for repair and/or connection of a side sewer to the city sanitary sewer
syu� in accordance with City of Edm . onds ordinances.
ATTENTION IS CAT-T D TO THE FOLLOWING: -
NOTE No. I —The owners of the property may obtain & 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 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 obtaInable from the City Engineer's office.
NOTE No: 3—Obtain full information regarding Ordinance 11J6.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at leazt 30 inches coverage at property line and 12 inches inside property I Ine; minimum grade of 2%. No bends in grade
shaxper than % 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 fallure 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 By ............ Date ............... . ................... 'BY ----------------
APPROVEDDate ... . . .... ------- --- / ------------ ....................................................................................
Remarks: ....... . ....... ................................................................. / -------------------- - ------------------------------------------------------ ....................................................
..................................................................... . ........................................................................................ . .................................. . .. .......................................... .........
- BOTH Permit Copies MUST Be Signed By Owner of Firm Per -forming Construction PRIOR To Request For Inspection
0I ....................................................................................... ... I hereby certify that the side sewer installation constructed under this permit
(Owner of Contracting FIrm, Performing Construction)
was installed in accordance with all governing ordinances of the City of Edmonds.
Datedthis ............................ day of ................................................................. 19 .........
V V Check BEFORE you dig for: Water [-], Gas E], Telephone E], Power E], Sewer E], Other [:] V v