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TAX ACCOUNT/PARCEL NUMBER: a 1 �(5 b to -7 (500 0 (0, oco
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: Ej Conditional Waiver Ej Study Required E] Waiver
DISCRETIONAR'� PERMIT #'
DRAINAGE PLAN DA:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER)
9 1 -aq-5
PLANNING DATA CHECKLIST DA
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED: d I LA g
SIDE SEWER PERMIT(S) #: a4 asall 901
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DST's\Fomis\Street File Checklist.doc
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'ONTRACTOR . ......
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ermissil'o'n'.is-'g'ra'n'tied.,.
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n 67ZilT afidn�.onjfle� and.,go.vernihg_-OrAin�i
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N LLED TO�:THi JF.OLtOw.ii�q.:.
CoDtraGt6r
own t�e��pr�ii_�'rly ay�b tain-'�d'permit to construct sewer insi& propert�., iin,.�A & �Side.. Sew�i
uit-b. &�ipl6yed:�_o_:�ons, ,r _ uc,-Mile- sewer in street area. Do not'.cover: anilpoiiioii-,'6f:se�Wei'�before it, has* be�n% nepecled.
l� sewei� when -you get permit.'.
11;rOrmation regarding Ordinance 11-.16.030 and Regulations., i6yerning; Bid
ine; -adc'- of:-
8 sew�er M�ist,have at'least 30 inches�'coverage at. proper�t� nc arid 1' rnlnimuffi� gi
0 12' inches; insidejxoperty
0
an vill be ro�rrnittcd. -
N b�n& in 'grade sharper th
0 0. es,__jIn str�et must 66 water settled 'and surface of street, 'ristored-to original coi�ditlon -Contractors, shaW be, resp6ns1bI6 for'-
e d to impi.ol) . er :work whieh may develop within, one Jear"of--com lotion...
'f 1, t& alter or do' any,' other. work -than, is provid �ap�
1:11E n ed- fonin the permit,- or to do. any:.lworl�. onAhe- main. P�Vbr, or,!!�,
y u to insert'the pipe into the wye.;
ea.'except
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Ve, j- - -
FW 1, 1 W EYMON
Cadl. PJFlospeict,. -6-1107, wlie�, _vvor
ICW TER.'�' W,AT.ERW'SEWER!_:,hDEPARTMENT
ls4eadj*�MrAn il ___ (No-Ingiiec-
spec. om
tions satUT, qay',-,. Su . nday� 9y, PoIJO& N-0. 241-4
yst),
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0, O'ER
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MONT
S-Mobile, P r �T- --`�-7Abtli�.ExcAvat*n-
....................... AAb OR ....... g ..............
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r I ss n s granted- .... Aiigust..2 ........... ...... jq...,f�7 t6SEPAIR or. CONNECT a side sewer
s
goverhing:ordinances.
T= E s cc TH'ri,J�O'LLOWING-
NO - No. e---6' nbrs 'of thg�'�Opertk�,may-.obfiiln -a: permit to construct se�ver inside property line. A licensed 'Side sewer Contractor must
a e oyed -W.c6ihstiuct. side'6evver in 'streef�area. Do not 6ov r an -porflon- of.sewer before It has been inspected.
e -Y
NOTE No. 2—(:)btain-�,,fullinforifi-ation regarding. Ordinance'- ft;M066 �aad. Regulations" governin 91 de. sewers
9 when you get permit.
WO E NO-, T_ fl'side' sewer -must have at -16"t Winches. coverage at property it I
Z 0 dsjiri�grade-
ne. and 12 Inches inside property line; min murn grade of 2%.
shaxpertthan, will bi4ermitted.
- 2M,
-.I,- No, es th'ifidet-,must-be.wat6r settled -'aFnd. aurface of - street restored to 'original condition. Contractors shall be responsible for
_du6l
H A to Ifiiprobei work which -may develop within one.year of,completion.
0., Q�8_ awful to. al6r or.do any other work --than Is.provided for In the permit, or to do any work�on the main sewer or its appur-
enances except to Insert the pipe into the wye.