The URL can be used to link to this page

21916 86TH PL W.PDFiiiiiiiiiiii 8259 21916 86TH PL W t .The City of Edmonds APPLICATION for SIDE SEWER PERMIT NEW CONSTRUCTION REPAIRS E:) EASEMENT No . .......................................... --CONTRACTOR- — ..... ......................... .................... ................................. ...................... .......... ... ADDRESS'*,-2�-C:�-)*I(��'.--8��"<2DT"- .............................. : ....................... ------------- --------------- ............ LEGAL DESCRIPTION: LOT No . ........ ................. ........ .......... .................. NAME OF ADDITION ........................ - ............................................... I Approved: DATE .... ........ ..... . ......... By ............ .................... SIDE, .:SEWER,, PERMIT, PERM, IT 4583 (Call 7.7 2526. f6r, side sewer Inspections BEFORE ,coVering_any p6rtl n: 't the constructio' 57 '0 .9 � I n�,y, Inspection will be. provided withiw,24 %our& after requst.. NO. Sat., Sum, or holiday Inspections. -,A,DDRESS,--LOCATION,;�OF,.,CONSTRUC,TIoN ..... 2,1916 86th Place west .......................... : ................................................................. ........................ f .................... .................... CRIPTION ..... Igt 2 Dofiny- GI en ........ ......... ................ ........ ................................................................ ....... ..................... 7 .................. ....................... ......................................................... ........................................................................................... ..................................................... .................................................. ............. ................................... : .................. OWNER ANWOR �Uji-,DEp ........... I.A14F.S.*.A., ... M&YB.E.RR.Y ....................... ...................... .. ....... .. . .. ... .... .. .... .. ............................... CONTRXCT-OR!&NAME'& ADDRESS ..... Russ Johnson Sewer & Plumbina. 1-6009 N. MeadoWale Road, Ed onds ............................................................................. .......................................................................... M .............. P 4' *1arch' 21, ermiss on 49�'.grak�� .. ........... . ............................................. 61 f914.*,- for repair and/oi,connection, of a side sewer to� the city sanitary sewer dince,with City of Ednionds,ordihaneek.; A&N,7�ION Iq�,,CAT�L�]D,T-0'.THE FOLLOWING:, NOTE. No. �l�.—'The�iow�;i�,of,�tfie�prpperty may, obtain.'a -permit to constru 't. sewer Inside property line. A licens I ed, Side Sewer Contractor must be employed' to constru c ct sidsi sew`ei0n�jjtreet area., -Do not cover any portion of, sewer before it. has,lbeen Inspected. NOTE No�-.2—'_ �'T�� '_rnedin: city rIght-o'f-wa�,:requIres,,an Invasion " of Right -of -Way Permit obtainablet-frorn -the City, J�nglneer's, office. p6rfp! N6TE.�No."3�Obt�iiil.-iiill,iinf6ri�Eitiont regarding Ordinanc.e I - 1.16.030 andi Regulations -governing sid . e. sewers 'when �you get permit. NOTE. No. 4--�'o� oi,ilas�i sewer must have at least'30 Inches, coverage at property line and 12, Inch6s inside property line; minimum grade of 2%. No -bends in grade '�*a�rper':tba.n �� vlll. be permitted.. NOTE No. 5—Trenches,1n �street -must be water settled and: surface of street restored to, original condition. Coritra�ctors shall be responsible for failure due. to Improper work which, may, develop'within one -year of completion. NOTID No: 6--It 'is mlawful to"'alter or do, any other work, than 'is proy"Ided',fo r in the permit, -or -to do any work on the main I sewer or Its appurtenances except u sert- thelpipe ifito� the wye� DISAPPROVED Date ...... . . ....... ... .......... �By ................ Date ........... ..... . . ............. Date ..................................... By ................ ---- ------ ......... . By, ......... APPROVED . ............................................................................. Remark ............................. ............................... .......................... . ................... ................................. ............ ......... .............. ..................................... . ............................................ ........................................................ ........................... .......................................................................... -pie" On PRIOR To Request For(Iris ' tion OT 0 UST Be igned By Owner i4, Firm Perf orming, Construtti Pee .. .... ................................... ... hereby certify that,the side sewer installation constructed under this permit n r; of.� I g' Fir erforming, Constru6tlofi) ,,wa ..istall in ace with,a governing,ordind.i.ice�',6i:tb.6 City of. Edmonds. his ... ............ Aay� -of ........ . Dated !t . . ................................. vi V bireck.BEFORE you dig for: Water ;E]I, `Gas,[3, Telephone E], Power,E], Sewer,E], Oth er NOTICE: N&W-arran-ty... 0 T -awc-(-_. Y_ The information . shown on the attached map(s) was cOmPiled for use by the City of Edmonds" its Empl,oyees and Consultants. Th..e City of Edmonds 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 inquiry regarding the information shown on including, but not limited to, tF�e -m a p (s) -h er stub shown. Suc the lociation of any sew exist and may sewer stubs may or may not I or may not exist at the location sh ' own. Neither the city of Edmo-nds nor its ernpto-yee-s o*r offi-ce-rs -sha[l be 11a-b-'F-e for the information given on this map(s), nor for tation provided based any one represen upon . said map(s). APPLICATION for The City of Edmonds SIDE SEWM PEB3M NEW CONSTRUCTION jj� REPAIRS 0 EASEMENT No . .......................................... OWNER 0.ftft.E�5 ....... .......... MAY-&Eg!�W ............................ CONTRACTOR ------- ---------- ------ ---- ......................... PERMIT No. ADDRESS ....... ....... Pl!� .... j(�!! ......... ;�� LEGAL DESCRIPTION: LOT No . ...... 02 ----------------------------------- BLOCK No . ............................................ NAME OF ADDITION ------ ....... GA-a..Vo� RECEIVED MA 21 1974 Approved: DATE................................................ By ....... T + IT F ? + t:\ Y-Y\ ev-�,, + uSiL 0 HID' ge v P-,r 4 Al4�dwo�)CIOLA Rd' l t nn C- c C-4-a I 4k,'Yt ef r� co-,,�Ieel q-T po-�e. 11 13� rec C D. 4 t + ----- -- + ;41 Z 0 W U W4 0 -CITY OF EDMONDS PermitN(o.' COMMUNITY SERVICES DEPARTMENT klGH . T-OF-WAY CONSTRUCTI ON PERMIT Issue Date' A. 9 owner: Washington Natural Gas Compa y 90se-rcer Street UAR�Iddress wA 98111 Mailing Address City State Zip City State Zip State License Number Telephone Number C. * Address or Vicinity of Construction: 21916 86 Place West Type of Work to be Done: Install New Service a D. 0 Work in Connection With: 0 Sub or Plat El Single Family 0 City Projects 0 Commercial El Multifamily XX Utility t�� E. 0 Pavement Cu N F. 9 Size of Cut: - X Cut in Driveway inside RIV r-na APPLICANT TO READ AND SIGN C/ 0 Y"tion, agrliT� 4ola thef City of Edmonds INDEMNITY: Applicant understands and by his signature to I ,app IN harmless from Any injuries, damages, or claims of any kind or r-escription whatsoever, forseen or unforseen, that may be made against the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal proceedings including defense costs, court 60st d ttorney k�es by reason of granting this permit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. Estimated restoration fees will be held until the final street patch is completed by City forces, at which time a debit or credit will be processed for issuance to the applicant.. • A 24 hour notice is required for inspection; Please call Engineering: 771-3202 • Work is to be inspected during progress and at completion. • Restoration to b ' e in accordance with City Code. • Street to be kept clean at all times. • Traffic Control to be in accordance with City regulations. • All street -cut ditches must be patched with asphalt or City approved material prior to end of working day; NO EXCEPTIONS. I understand the above and that this permit must be available at the job site for inspection purposes at all times. Signature: aAd.A Date: November 2, 1990 Owner or Contractor This Permit Must be Posted at the Job Site For Insp : ection Purposes Call DIAL -A -DIG Prior to Beginning Work APPROVED BY: RW Time Authorized: Void after ESS 20"n-'4d.... Special Conditions: W A. - RELEASED BY.4, Date PERMIT FEE: Restoration Fee: Receipt No.: Fund I I I Fee: Street Cut Dimensions INSPECTED BY $ Date NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE tng. Uiv. marcn iwsq FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Deple.) Comments: Diagram: CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO Partial Work Inspection by P. W.: Work Disapproved By: — FINAL APPROVAL BY: Date: Date: Eng. Div. July 1985 'i I It, Whishhxjton aummmp� NatwN Gw --� AVA5st�&-WCcffV-W Dq�(p ?b PLvq WNG to window proposed gas main Addendum to: City of Edmonds Permit Application Engineering Aide: Kerry Walsh Washington Natural Gas 622-6767 x2761 kpjA-Ir I DE-, -1\AI A6. HVater main depth unknown �w STIS-W Key: :s: sauitary sewer w water -g- gas water valve hydrant 815 Mercer St. (P.O. Box 1869), Seattle, WA 98111 (206) 622-6767 tsj Sal d-c-1 2 Ito c2% coo. -ow "U1 m RiRllp. /A 50 1 <� -Z .00 CA . . . . . . v4 *lpu-r