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PUBLTC
'JC WCPXS — EMINEERING
ACTION REPORT
SUSPENSE DATE:
Date: Time:— _File #
Attachme"t.,
SUBJEC2T:�: , , ff- , --/—
13
REQUESTOR: NAME
ADDRESS:
PHONE:
REQUEST RECEIVED BY:
TELEPHONE
CONTACT IN OFFICE r--7
OTHER:
— — F---1
RECEIVED BY
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N9 2813
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All concerned Notified " —,--/
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Action COmpleted/File
APPLICATION
The City of Edmonciv, for
C EASEMENT NO - -----------
SIDE SEWER PERMIT ...............................
NEW CONSTRUCTION REPAIRS 0 LID NO. Y�Z-.--ASMT. NO . .....
OWNER -------- MR-S.-JPP�� <��
---- ----- - .... D
---------------- CONTRACTOR ------ - -------------------------- ------ ------------------ - ----------- ----- PERMIT NO. 4': ..........
JOB ADDRESS .... 2.1- -l=-!)c:) �� --- ---- <151-4 . ..... LEGAL DESCRIPTION: LOT NO.
--- ------------------ -- - ------------ .... ... ..... ------- - -- ... BLOCK NO - ------------------------------------
NAME OF ADDITION
FEE
Approved:
DATR
........ ---- By
/ ;;;:--q -------------------
1TY- Q0E-,`EDM*QN'D
PERM
sewer, -Inspections --JlEI?ORE:*cov*eHng any�. portloinofl�the.' t it
co�s_ K�c_ on\,',-.
r
oviddd!. ikIth1n.-24'=hours 0" or�-holiday;: Insliebtions:1,
a er. requst. :N _SsA... Sum_
ADDRESS�;L;;6c,&t.losi",�OF"'CO, N-STR U,*CT'l*
..................... ........... .......
.............................................
St N
T'i 27 _R-T�26A'.-:�-S._� �,-, -'- S�' - -
................................ ................. ......... .............................................................. 41 ..... . ....
................
1 i�i aw, I ac�,� n, ".k. - Tac C, 1 7n.-
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................................ .................................. ......... .
........... ...... .................... .......... ...........
.................................................. ...... ......... .......
.........................
%
...................... ONYWER7 AND/OW BUILD . ............... � ................. .........
7' ...........
'6).M�VRACTOR_ IS,�NAMEi &AMDRESS.:.10W1Y1&R
......................... ..................... ...... ................................ ............... ......
........... ...............
.110 V
,it"P 'S 19 0' ............................. 6. ihe',,citV7 �4nitary -sbiAier.:�
-19..?A., -for reprdr- and/or,C'6fini��tlon,� of side,
�ysteM.Jfi --dic'co rdance4itfi, -CitV -of,,-Ed monds -ordinances.
A�-. r-IONwIS-CA-1,�OD-4-�-,-t-ii'l�.iOLLOWING:
ow'.e,�',:o`f' the' property' may, obtain: a'�Pumft" to -'construct seweF - pr6perty -line. A'� I icerfsed. Sid e'Sewer -Contractor -must be—empl6Xed to construct
'gidc siwer-In street -area. Do not - cover- any --portion of sewer.1before'it
NO f wa' �e
�E-N.�2!-L�,*Ii-.�,or perforniiedt in '�Ity right-o - 4 res,�in Inv -Engineer's'offt'
y _ ui asion of Rlght�ofzWay Permit olitainable. from the: City: cb.".
NOTE'No.,3—.-Obtain full-_Anformati6n regax'ding: Ordinance 11'.16:030 and- Regulations g�verning.'slde $�Wers when�-y
- ' . � . - .- , - . I - � - . - - - !, �- ;. . .1 . - ou get'-pehinit.: -7
_NOTE,No.:-4LTop of!:sidesewer must'. have at- 1�"L,30 �ln
ches7 coverage�at property Iine and;,.12'�inches.inside',property line: minimum -grade of. 2%. _-Nd,bi�zidsln grade
sharp-er,Ifian 1/. 4111 be-perinitted.
4 T
NOTE;T o; 5 renches� in-Pstreet, must; be water 'sktledc and� surf ace- of -street restored `t6i orlgi�al.;condltlon. sb&W -be' responsible' for, failu� -due" to�_ Imp oper
..,5�ork-�7vfiicht may evelop,within one, year-. of. �coffipietjbh.'
-,*r*- �Is�,unlawfu, work' than�ls-,provided for in, t
N�OM No. lAo�aliter��on'do. any other the,permit;' or. t6�do3'any, Work oii- he main sewer or. its.-i pUften&nces-�except- -ifi-
tnto�the;wye;
p "to
:DISAPPROMED-,E):
7- .......... BY ............
ate.z� .......................
............. .......
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................ .. .............................. ............................... .......................
�d -i- Al 64 R e u e 9 r . i s; 6 6�"ti`
B 0 T H 6P 6 Rn i e'�;6-0�1 '�)' orm ,SE.rat ion
op!es ,Bb. Siknq�&�B3!.-,.q�vn of mr-rii, -P i
on-
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6reby.,, cei b s'e* enIhstallifflom-comfAile _1�6�
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................. ......... ......... .... riifyrm� -,&�S d
Firm Perf rmin*g-��don'stFu�'tton)--.'
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'of -the*.City-.o Edmdnds..
3 t6tlle6i ii�acqoida:n ce% with 11 6verniriz,or'dinai�&es` f
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11 FORE� y9ti- d'l-g f or.*�Watar,
G.. -7 _�o�vim h'.,- _-,-sewer. ci',
Eli-
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
EASEMENT NO - ------------_---------
NEW CONSTRUCTION REPAIRS E]
LID NO.
,:�p -_
ASMT. NO.,�_4
OWNER j
---------- ---------------------- CONTRACTOR -----------_----
PERMIT NO.
JOB ADDRESS ---- ---------
.. ... -----------------------
4;:tF-6-(:,7LEGAL DESCRIPTION: LOT NO - ---------
---------------------- .....
BLOCK NO - -------- ---------------------------
NAME OF ADDITION . .........
-------------
R —PC E IV E -D
'U 2 j 11 9 -N
lie
A
I 1 11
Approved:
DATE-------------------------------------------- By --------------------------
NOTICE:
-N:o---w-ar-ranty.-OT-aic,(.-,u.i��d�,:Y..
The info rmation'shown on the attached
map(s) was compiled for use by the City Of
Edmondsl its Employees and Consultants.
The City of �Edrn.onds does not * wa rra nt t, ie
accuracy of anything set for.th on t ' hese
Map(�_). Any person or en.tity -requesting a
copy should conduct an independent
inquiry regarding the inform'ation shown on
-t-Fe -map(s), including, but not Jimited to, -h
th-e location of any sewer stub shown. Suc
sewer stubs may or may, not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
emp-1-o-yee-s o-r office.rs sh.al-1 be 11a.b-'Fe for the
information given on thi5 map(5), nor for
tation provided based
any one represen
upon said map(s)
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CITY OF EDMONDS
PUBLIC WORKS DEPA,_MENT'
SIDE SEWER PERMIT
FAM F4 a$
Permit N? 6647
Issue Date I-- 2-P —
k * PERMIT MUST BE POSTED ON JOB SITE
L
1. Address of Co;;`sti=ution��mmw Igigg gjT
2. Property Legal Description (include all, easements) S— 30-79
6oTs. -z - .3 4-
3. Single Family Residence Multi -Family No. of Units
Commercial
4. Owner etnd;�er B der
5. Contractor & License No.
6. Invasion into City Right-oi-Way: No to,,�Yes --*I (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
0-
L
excavation). C7. Cross other priva�e property: Yes V__�No Easement required -
attach legal description and county easement number.
READ THE FOLLOWT-NG AND SIGN* L45k * I -(:r) L,� 2-13
a4i-d �A-ov_ 4o Rw4 A?pvovaA.
a. Property owners must obtain a perm to in tall side sewers on
their property. A licensed side sewer contractor m"MeMAKWASt to
construct side sewers in the public right-of-way.
b. The side sewer contractor assumes full repA1991k. "PoLD4
tw ch
installation for one year. 1- 800 - 56276418
C. Commercial establishment requires a minimum or a six inc (6")
side sewer line.
d. Side sewers may not be installed closer than thirty inches (30")
to any structure. 0
e. Side sewer lines must be laid at a minimum grade of 2% (1.15
and maximum grade of 100% (450). 0
f. No turn in side s8wer greater than 45 (1/8-bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing- sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered until inspected and approved
by the City. o (2) workii-
1. Inspection during normal working hoL#s n .1g
days notice required.
DATE:
PERMIT FEE': 10.0o
CONNECTION FEE:
2, �j - P_
>
* PERMIT MI
I Lpertify that I have read
and shall comply with the above
DISAPPROVED BY: Date:
By: Date:
APPROVED By: Date:
T BE POSTED ON JOB SITE *
Z
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CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT STREET
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. *Address or vicinity of Construction
np)
Permit No. i--V P,/-,
FILE Issue Date
Owner: n
Name
7- n rH f W V\J
Mail' Address
E'ZrVv_)M01S1 Wn 9910zo
city, State, Zip Code
ContractorSWW-mil.,---m -PUDA
Name
2-1aO H\AN 39
Mailing -Address I I
LVNXJA)(�00 \A)A T&W-0
Cilty, S ta te, Zip Code
• Permit Issued To:_Ipt
• Type of Work to be Done:ZcgooTc cvr-��_
OEAD goc-IL'I
• Work in Connection With:
El Sub or Plat _'=*aE�,—Singie Family
11 Comml. / Ind. E Apt. Condo.
• Pavement Cut: El Yes No
State License Number
1-7:7 �A -- 7_1
Telephone Number
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
B. APPLICANT TO READ AND SIGN
INDEMITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
from any 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 it's departments or employees, including or not limited to the defense of any legal
proceedings including defense, costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
following the final inspection and acceptance of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until the final street patch is completed, at
which time a debit or credit will be processed for issuance to the applicant.
Work is to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering. Call
775-2525, extension 220.
I understand th at this permit must be available at the job site.,for inspection purposes at all times.
Si nature*
b
Owner or Akent
r
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By: Permit Fee: —
Time Authorized: Void after —days Security Deposit:
Special Conditions:
Ammendments:
Receipt No.: .
Fund 111 Fee:
Street Cut Dimensions
X
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
FIELD INSPECTTON NOTES (Fund 111 - Route conv to Street Dept.
r r%mm ea n 4- a -
Diagram:
Contractor called for inspection Yes (S�
r Date: Bv: Date:
Nork Disapproved By:
Work Approved B�r: —Date:
Inspector:,
Ena. Div. December 1978
1_'_tITY OF EDMONDS
.,,-PUBLIC WORKS DEPARTMENT- LL Permit 6647
Tsemt
U20
i - zv "ll."If
IDE SEWER PERMIT Issue Date
77"77 PERMIT MUST BE POSTED ON JOB SI
TE
Address of Construc7l4mw,
on
2. Property Legal Description (include all ea�ements) T?
�,G)T� --a - 3 91 4-
3. Single Family Residence �--' Multi -Family No. of Units
Commercial
4. Owner der 4<
5. Contractor & License No.
6. Invasion into City Right -of -Way: No �� Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
E-4 7. Cross other private property: Yes No Easement required
attach legal description and county easement number.
READ THE FOLLOKING AND SIGN:A"..' kv(le;*'t,
P4
"to;
t
a. Property owners must obtain a perm , to in;tall side sewers on
>4 their property. A licensed side sewer contractor mu(AL648MOM to
construct side sewers in the public right-of-way.
b. The side sewer contractor assumes full repoffF%%ktM1DW&ch
installation for one year.
c. Commercial establishment requires a minimum (6
side sewer line.
0 d. Side sewers may not be installed closer than thirty inches (30")
U to any structure.
W 0
M e. Side sewer lines must 0 be laid at a minimum grade of 2% (1.15
0 and maximum grade of 100% (45 ).
E-4 f. No turn in side s8wer greater than 450 (1/8�bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-6011 from each plumbing exit line
and at minimum intervals of 1001 along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions-. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. TWO (2) working
days notice required.
DATE: 20
eertify that I have r__ea_U_
and shall comply With the above
PERMIT FEE: /0 0o DISAPPROVED BY: Date:
1 B Date:
1 '*
Pd CONNECTION FEE: �j APPROVED By OM Date: al IjF7
.0e
PRRMTT Mtl_qT RR PnIQTth MT Tnn 9TTV
The City of Edmonds
Side Sewer Drawing
EASEMENT NO . ............................................
NEW CONSTRUCTION [:1 REPAIRS LID NO. J2ig ...... ASMT. NO . ..................
OWNER ...... ................... .............. CONTRACTOR ......
.............................................. PERMIT NO.
JOB ADDRESS LEGAL DESCRIPTION: LOT NO. -4�ol ... & ................ BLOCK NO . ....................................
--------------------------------------------------------------------------------
�s --3o —78
.............................................................................................................. ...................................................
PWW-0001-1 li75 (REV.1 1178)
4
't-JAMP CIP AnnT"nW
"14ve-, W I rl �0 P,,- 6 1',,- R/NA/,
Approved:
DATE T1 ............
0/
,177'