21911 86TH PL W.PDFIIIIIIIIIIII
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21911 86TH PL W
APPLICATION
The City of Edmonds for EASEMENT NO . ......... --------------------_---
SWE SEWER PERMff
zi NEW CONSTRUCTION REPAIRS F-1 LID NO . .... ASMT. NO.
OWNER ----------------------------- CONTRACTOR ..... SS\Nal;?�
- - -------- ------ --- ---- -- ------- -------------------- ------------------------ PERMIT NO. SCDC)4
21<Z% � - e>� \M_=S-T
JOB ADDRESS ------------------------------------------------------ ------------ ------------- .... LEGAL DESCRIPTION: LOT NO - -------
-------------------- BLOCK -NO. _ ----------------------------------
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0
........................... ------------------------ ------ - ------------ __ ........ ------------ --------------------------------------------- -------------
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N- - ----- . .............................
Approved:
DATE ..... By ......... -----------
APPLICATION
for
The City of Edmonds SIODE SEWER PERMT
EASEMENT No . .................
NEW CONSTRUCTION 0 REPAIRS E:]
/--
. . . ..................................... CONTRACTOR
OWNER ...... aj��.IV.3 ..... PERMIT N,.,��.l
................................. BIA)�CK No . ............................................
ADDRESS ��/..Td ......... h ......... ....................... LEGA-L DESCRIPTION: LOT No . .......... .
I 'lei
NAME OF ADDITION ........
......................... v ...... ;",*"* ------
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Approved:
DATE................................................ By ..........................................
t/',/ ,
NOTICE:
-Nb"Wa r-ra
The information *shown on the attached
map(s) was compiled for use by the City Of
Edrnonds� its Employees and Consultants.
Th.e City of 'Edm.onds does not - warrant the
accuracy of anything set for.th on t . hese
Map(�_). Any person or entity -requesting a
copy should conduct an independent
e inform'ation shown on
inquiry regarding th
-map(s), including, but not Hmit(-2d to,
th'e location of any sew-er stub shown. Such
sewer stubs may or may- not exist and may
or may not exist at the location shown.
Neither the City of Edmo'nds nor its
empJo-yee*s o'r offi-ce-rs shal] be 11a-b-11--e for the
information given on this map(s), nor for
tation provided based
any one represen
upon said map(s).
CITY OF EDMONDS SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
F-- -"P
PERMIT
call 775-2525 for side sewer inspections BEFORE covering any portion of the construction.
Inspection will b . e provided within 24 hours after requst. NO Sat., Sun., or holiday inspections)
ADDRESS LOCATION OF CONSTRUCTION_.2191� - bu,,�, Place ljesl�
............................................................ .................... . ...................... . .................................................
PROPERTY LEGAL DESCRIPTION .... j&;;1V UMG C-:,nn..A t on
.. . ............ .... I .......... ... cidi I
............................................................................................ * ------------------
...................... . .......................... . ...................... . ......................................................................... . .............. . ........... ..........................................................................
................................................................ OWNER AND/OR BUILDER..tj�';J..`.�'�,,. SAMIDERS
... ............................................................... . .......................................................
n,,Oe Road, cis, 'g,
CONTRACTOR'S NAME& ADDRESS. Ly nawoo �, s7,1t:��r 427r,,"�,2:tt
--------------------------------------------------------- .. ..................... . .................................. . .......................................................
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Permission is granted ............ ............ 8 . ............ 19.2"L., for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City of Edmonds ordinances.
AT/-_-TION IS CALLED TO THE FOLLOWINC�:
I —The owners of the property May obtain a permit to constru t 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 sewerebefore it has.been inspected.
NOTE No. .2—All work performed in city right-of-wav requires an Invasion -'of Rlghtzof-V�ay Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030.and Regulations goveirning side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in gr e .
sharper than % will be permitted. ad
NOTE No. 5—Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure 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 E] Date ... . ...... By ................ D �t�e
------------------------ ....... .. . ..... .. By -----_-------- Date ................ ................... By ................
B
'go:
APPROVED 7�el
..........
.... ......... 0�� ... ... .......................................................................................
Remarks: ....... . ...... . ........................... .. . ............................................................ ...................................... . ............... ...................................................
--------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- . .......................................................
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
hereby certify that the side sewer installation constructed under this permit
(Owner of
wp stalled in accordance with all governing ordinances of the City of Edmonds.
Datedthis .... 7_)C�) ........ day o ................................................................. 19 .........
V -� Check BEFORE you dig for: Water Gas 0, Telephone E], Power E], Sewer C], Other 0 V V