22311 100TH AVE W (2).PDF22311 1 OOTH AVE W
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT
SIDE SEWER PERMIT
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FOR INSPECTION CALL Permit �J�o
775-2525 Ext. 220 Issue Date
LPERMIT MUST BE POSTED ON JOB SITE * I
*,"�77777' VAC
Address of Construction
Property Legal Description (include all, easements) VIA EDMONDS I
6 4 LINE
Single Family Residence Multi -Family No. of Units
Commercial
Owner and/or Builder
C, 0 �//C/
Contractor & License No. �,;2
, - & / 1'1�' �-- - 4/ 0 - N, 44
Invasion into City Right -of -Way:
way Construction Permit Required
No ">/\ Yes (If Yes Right -of-
- Call Dial Dig (342-5344) before
excavation)
E-4 7. Cross other private property: Yes No""/ Easement required -
. attach 1 egal description and county easement number.
U
READ THE FOLLOWT,.NG AND SIGN:
P4
P4
4 a. Property owners must obtain a permit to install side sewers on
>4 their property. A licensed side sewer contractor must be employed to
construct side sewers in the public right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year.
C. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
0 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
0 and maximum grade of 100% (450). 0
E-4 f. No turn in -side s8wer greater than 45 (1/ owed
between cleanout. All 90 turns must be constructumU W431/s
bend) and Wye with removable cap. 'EFORE ay0l) Qkq
g. No down spouts, footing drains or floor d a3jl..s c -M nected
to side sewer system. i - 300 - 562-6478
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 100.1 along sewer 'line run.
j. Trenches within City ri4ht-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 �Uncov'ered until inspected and approved
by the City. 1� 1�
1. Inspection during normal hours only. Two (2) working
days notice required. 1,
_jW4
DATE: k
I certify��t at/I havi�'read
and shall comply With the above
---,-,PERMIT FEE: DISAPPROVED BY: Date:
By: Date:
'::n�),��,CONNECTION FEE: 0() APPROVED Date: ol?724 7
PERMIT MUST BE POSTED ON JOB SITE
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT FOR INSPECTION CALL Permit N *0 __6662 .
775-2525 Ext. 220 Issue Date
SIDE SEWER PERMIT
PEP -MIT MUST BE POSTED ON JOB SITE
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Address of Construction
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Property Legal Description (include all easements)
lo � �- a-/' �'6 ,v� 7 �'otql 6o 4 / /
Single Family Residence Multi -Family No. of Units
Commercial
Owner and/or Builder
Contractor & License No.
� k' '4' L'; f -� /YC/;11 0 � ]"�' C "
1"MIRSWIMM
Invasion into.City Right -of -Way: No X 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�4 Easement required -
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
a. Property owners must obtain a permit to install side sewers on
>4 their property. A licensed side sewer contractor must be employed to
construct side sewers in the public right-of-way.
b. The side sewer contractor assumes full reponsibility for each
E-4 installation for one year.
N
4 c. Commercial establishment requires a minimum of a six inch (6")
P4
z side sewer line.
0 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
0 and maximum grade of 100% (450). 0
f. No turn in side sgwer greater than 45 (1/8,-hand) s a�jqwed
between cleanout. All 90 turns must be constructegW44W R58
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drAWHAPAAected
to side sewer system. 1- 800 - 562-6478.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cle'anouts 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.
1. Inspection during normal working hours only. Two (2) king
days notice required.
DATE:
ify- that//I hav'6 read
and shall conoly With the above
E i; ERMIT FEE: 7ato - <9 2 - DISAPPROVED BY: Date:
U 2 ce- By: -Date:
P4 ONNECTION FEE: 2L--�,, oo APPROVED By: Date:
PEP141T MUST BE POSTED ON JOB SITE
DATE: Septelmer 26, 1980
MEMO TO: John B. Mitchell, Supt.
Water/Sewer Division
FROM: James E. Adams, P.E.
City Engineer
SUBJECT: SEWER CONNECTION CHARGES
22311 7-100th Avenue West
----(-Street Address)
(Legal Owner)
Single Family Residence 'X Subdivision Plat
PRD Multiple Commercial
LEGAL DESCRIPTION: County.Short Plat 206.(6-76)
The North 140 feet of the West 1/2 of the West 1/2 of Block 4,,c;Fourtener's
:Homestead Plat, as per plat recorded in volume I of plats on page 97
records of Snohomish County,
EXCEPT any portion thereof lying East of the following described
fence line as described in boundary agreement filed July 3, 1967
under Auditor's File No. 1970738, refiled January 29, 1971 under
Auditor's File No. 2182452:
Beginning at the Southwest corner of the Northwest 1/4 of the
Northeast 1/4 of Section 25, Township 27 North, Range 3 East, W.M;
Thence South 890 17' East along the South line of said subdivision
170.65 feet to the true point of beginning of said line, said��
Point being the intersection of an existing,fence line with the South
line of said subdivision;
Thence North 00 47' 52" East along said fence line for 333.34
feet, more or less, to the North line of Block 4;
KNO14N AS Lots 1 and 2 of Short Plat recorded under Auditor's
File No. 7608160311;
Located in the County of*Snohomish, State of Washington.
U.A.B. Street Improvement - April 1971 @ 10.00/Z.F.F.
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Z. F. F t ion:
6 8 9;- iCO 0—
F. F. _O
2 $ .'726.89 Connection Fee
Lateral Charge
L
Lateral X( $
jak
cc: Owner
Units(s)x( $25.00)
q74 I e,> 1 .5 rt::)4
Equivalent Count
$ (when applicable)
$ 25.00. Trunk Charge
$ 10.00 Permit
$ 761.89 TOTAL
-70 V--F Z-9�4,
0
o9 <2- 7 67
The City of E
T .................................
EASEMEN
dmondra'TREET FILESide Sewer Drawing
- --------------
NEW CONSTRUCTION le' REPAIRS E] LID NO . .................. ASMT. No. z
...........
R
OWNE Jet—, CONTRACTOR .... ........
4.-":y ............... ................... PERMIT NO . ..... ..............
gig- .........
_tA
JOB ADDRESS .... ....... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
� T A � ff� ��_
.................................................................................................... ..........................................
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..............
117'
6)6 41�- L'u)
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Approved:
PWW-0001 -11175 (REVA 1/78) DATE ........... By",... . ....... ..........
CITY OF EDMONDS No.
PUBLIC WORKS DEPARTMENT a
Issue D e
RIGHT - OF - WAY CONSTRUCTION
Eff FILE
P07M,
A. *Address or vicinity of Construction
Permit Iss wd To:
—22231 300
Owner: Washinct nn Nitn1ral ca S
�Tyoe of Work to be Done: --New, Seryi.c�*-
Name
385 156 kyepue N. E,
Mailing Address
Work, in -Connection With:
'D
Bellevue, washingtion 9800,
SU6 or Plat Cr, Single Family
Comml. / Ind. El Apt. Condo.
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City, State, Zip Code
�C]
t Pavement Cut: 0 Yes 0 No
Contractor: Same As
Name
Z'
Mailing Address State License Number
Q
city, State, Zip Code 'Telephone Number
NO WORK TO BEGIN PRIOR TIOPERMIT ISSUANCE
B. AEPLICANNT TO READAND SIGN
INDEMITY: A pplican t 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'deictiption 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 defrnse� costs, court costs, and attorney fee' by, 0
s rem n of granting this permit.
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Upon issuance of this permit, the contractor is responsi d
ble for work, ns ip an materials for a period of o ne year
following the final inspection and acceptance of the restoration by� the Engineering Division,
to il
Funds held from the Security Deposit (estimated restorati n fee)'w' I be held until the final str e patch is completed, at
C
whkh,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 re uired for inspection by Engineering. Call
775-2525, extension 220.
understand that this must b vailaVat)tob site for inspection purposes at all times.
Signature: te� March 17�, I-ql
/A
r
Own gent
THIS PERMIT MUST BE POSTED AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL DIG PRIOR TO BEGINNING WORK
C, Issued By: Fee:
Permit
Time Authorized: Void after �30 —days Security Deposit:
ZSpecial
'Conditions: Receipt No,:
Fund, i
Ammendments: Street Cut Dimensions
X
NO WORK TO BEGIN PRIOR To, PERMIT ISSUANCE
KIWI' Enk, Div, December 1978,
ItTES (Fund. 111 -Oo-ute cony to Street Dent.
FIELD INSPECTIO, I
Commr-nt- c;:
Diagram:
Contractor called for inspection Yes No
T
Nork Disa.T.3proved By: Date: Bv: Date:
Wo rk AL)proved By.: Date:
Inspector:
EnG. Div. December 1978
-CITY- 0V EDMONDS t No,
PUBLIC WORKS DEPARTMENT Issue Date
RIGHT - OF - WAY CONSTRUCTION PERMIPTREEt FILE
A. *Address or vicinity of Construction
-4 ")mj
Owner: ��,`!A i-� Qk'07-
Name
—1�4 � I �, -3
Mailing Address
City, State, Zip Code
0 Permit Issued To: C J � i
9 Type of Work to be Done: ye I
* Work in Connection With:
0 Sub or Plat -5f Single Family
0 Comml. / Ind. 11 Apt. Condo.
0 Pavement Cut: El Yes -92, No
Contractorf Ltl u e
Name
Mailing Address State License Number
City, State, Zip Code 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.
0
17-
Z
con
Z)
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 that this permit ust be a
A
Signature:
le at �The job site for inspection purposes at all times.
Owner or Agent
THIS PERMIT MUST BE POSTE& AT THE JOB SIT FOR INSPECTION PURPOSES
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Void after days
Special Conditions:
Ammendments:
Permit Fee:
Security Deposit:
Receipt No.:
Fund Ill Fee:
Street Cut Dimensions L-
X
DEC 2 8
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE Dir. Ot P!Jh�ir
Eng. Div, December 1978
FIELD INSPECTIOdWES (Fund. 111 -01te conv to Street' Oent.
Comments:
Diagram:
Contractor called for inspection.. Yes No
Work Disapproved By: Date: By: Date:
Work Approved By:, —Date:
Inspector:
Encr. Div. December 1978