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APPLICATION
The City of Edmonds for
SIDE SEWER PERM EASEMENT NO - -------------------------------------------
NEW CONSTRUCTION REPAIRS E] LID NO. -- ------------- - ASMT. NO - ---------------
OWNE ------------ ----- - -- - ----- ONTRACTOR ----------
PERMIT NO.S-^C-1
... GAL DESCRIPTW: LOT NO.
JOB ADDRE ---- --- ;w, ---------- ------- .................... BLOCK - -----------------------------
-----------------------------------------
................ .
NAME OF ADDITION
APProved:
DATE............................................ By --------------------------------------------------- Yi7ye
NOTICE:
No warranty of accuracy.
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of Edmonds does not warrant the
accuracy of anything set forth on these
map(s). Any person or entity requesting a
copy should conduct an independent
inquiry regarding the information shown on
the map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
employees or officers shall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS - SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 775-2525 for s ide sewer inspections BEFORE covering any portion of the construction.)
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday Inspections.
6'�� PL-.
ADDRESSLOCATION OF CONSTRUCTION ......... .............. ............................................................. . ............ I ........... .......................................................
r!t1A,4,.:4M!n ..................................................
PROPERTY LEGAL DESCRIPTION ... ; ....... t=nt� ........ ------------------- . . ................. .......
....................... . .......................... . ........... .......... . ........................................................................................ . .................................. . ..................................................
............... ---- OWNER AND/OR BUILDER --------- ..... . . 0,, S-- .............................
....................................... . I '* ----------- - ----- —
,,INTRACTOR'S NAME & ADDRESS --------------- !!T.5 ------- ........... ... . .......... . .. . .......................................................
LM4 011.... for repair and/or connection of a side sewer to the city sanitary sewer
Permission Is granted ........... . ................................. . ............ 19
system in accordance with City of'Edmonds ordinances.
A
ITION IS CAM D TO THE FOLLOWING:
Ni,—JNo. I —The owners of the property may obtain a permit to construct 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 sewer before it has been inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing 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 grade
sharper than % will be permitted. i
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.
DISAPPROVEDDate ... . ...... .................... By ................ Date ......... .. .. .............. By ................ Date .............. . ................... . By ................
* --- I:: A -
APPROVED Date ---- ----- 4 -------- Z ------ 7-� ---------------------- By------, -------------------- - -- - ---------------------------------------------------------------------------------------
Remarks: ....... . .............. I -------------------- . ................... ------------------- ------------------------------------------------------------------------------ ---------------------------------------------------
n---------------------------------------------------------------- - ---------------------------------------------------------------------------------------- - -------------------------------------------------------------------------------------------
of Firm Performing Construction PRIOR To Request For Inspection —
....................................................................................... ... I hereby certify that the side sewer installation constructed under this permit
(Owner of Contracting Firm. Performing Construction)
wr stalled in accordance with all governing ordinances of the City of Edmonds.
. Dated this ............................ day of ................................................................. 19 .........
V V Check BEFORE you dig for: Water [3, Gas E], Telephone F], Power 0, Sewer [], Other [] -� -V
4, �PPLICATION
The City of Edmonds.— for
FILSIDE SEWER PERMff EASEMENT NO - -------------- ----------------------------
fmNEW CONSTRUCTION REPAIRS LID NO - ------------------ - ASMT. NO - ------------------
OWNER
--------------- CONTRACTOR ----- k-ACZ�.sMEEaC)
........ PERMIT NO. V/
JOB ADDRESS --- . .....
.... -----------------------------
--- LEGAL DESCRIPTION: LOT NO - ---------- ----- --------------------- BLOCK NO - ------------------------------------
NAME OF ADDITION ....... ------