22053 99TH PL W.PDF9780
22053 99TH PL W
OV ED_4
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS,WA 9802ST,,
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
STATUS: ISSUED ENG20070604
SIDE SEWER PERMIT (1-Single Family)
Permit Number: ENG20070604 Expiration Date: 2/6/2007
Job Address: 22053 99TH PL W, EDMONDS
'APPLICANT CONTI;LkCTOR
WILLIAMS NANCY P A ROTO ROOTER
22053 98TH PL W 8015 BROADWAY AVE
EDMONDS, WA 98020
SUITE E
EVERETT, WA 98203
360-914-7383
LICENSE #: 402ORSCI 22BR EXP:
JOB DLSCRIPTION
•
L_LJj PROPOSE TO RaJSE LATERAL LID NUMBER--
•
IREPAIR P
CRfNDER PUM N I PROPOSE TO REUSE SIDE SEWER
SIDE SEWER REPAIR
N
EAS BIENTINFOR'NIATION
PROJECT CROSSES OTHER PRIVATE PROPERTY
N
I VERIFICATION OF RECORDED EASEMENTS COMPLErE
IADEMATTY- The Applicant has signed an application which states helshe holds the City ofEdmonds harmlessfrom injuries,
damages or claims ofany kind or description whatsoever, foreseen or unforeseen, that may be made against the City ofEdmonds or
any ofiis departments or employees, including but not limited to the defense ofany legal proceedings including defense costs and
attorneyfees by reason ofgranting this permit.
CALL DIAIA-DIG (1 -800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220 EXT. 1326
24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS
APPLICATION APPROVAL
THIS APPLICATION IS NOT A PERNIITUNTIL SIGNED BYTFIE CITY ENGINEER OR HISMER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN
SPACEPROVIDED.
Printed: Thursday, December 06, 2007
BY
F-1 FILE COPY
r�,�S PEcTOR COPY
12— /(P /0 ----?
DATE
E] APPLICANTCOPY
STATUS: ISSUED
ENG20070604
• Refer to City of Edmonds Side Sewer Information handout for approved pipe materials, inspections and other requirements.
• Maintain 10'separation between the sanitary side sewer and the water service line.
• E-Sanitary Side Sewer Inspection
• E-Engineering Final
PARTIAL INSPECTION DATE: INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL: