23823 79TH AVE W.PDFIIIIIIIIIIII
6844
23823 79TH AVE W
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
EASEMENT NO. -- ................................... -
NEW CONSTRUCTION E] REPAIRS 2L LID NO. .- .............. ASMT. NO... �
OWNER -7)4 --------- 6-0 04. *.14) ------------------------------------------------- CONTRACTOR --------------- 0 "
.................. ------------------------- ------------------------ PERMIT NO. / . ........ :�7>
JOB ADDRESS ------ ----- ----- �aW .......
-::? -�� ------- 7-`� ..... -------- LEGAL DESCRIPTION: LOT NO - --------------------- - ............... BLOCK NO - ------------------------------------
�j NAME OF ADDITION ---------------------------------------------------------
D
V,
Approved:
DATE.............................. ...... B, ---. � ..... ... ..... - .. .. i.i
We own the house and property at
We give the City.of Edmonds permission to go ont-o our property to - fix the city owned
water run-off system. To begin with the city will use a metal�detector to find out if
the system is plugged on our property. If it is plugged they will call and inform us
of when they will fix the problem * It is our understanding the city pays these expenses.
This action is necessary to prevent any more run-off water entering our house and property.
Signed.
7 7
rock-, C,'-- 6 /Y
L
ST REET FILE
4
FILE NO. 01.1.12
MEMO FOR RECORD
November 26, 1986
On October .26, 1986 the residence at,23823�
79th�:was'flooded.
On October 28, 1986 the City of Edmonds received
a letter authorizing.the City to go onto private property,
to locate the existing storm drain. Upon locating the tile
we, found that the system had a section where the tile had
collapsed which caused the system not to function. The
Street Section has.repaired this and the system is open
and operational. The City also added a catch basin in the
street for better s,erviceability.
.. The City� of. -Edmonds Engineering Division is working
on an easement for this property.
Bill StYou&,_S�reet Supervisor
/cr ,
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 for - th 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
ernp-loyees or officers shall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
I E E T F E: for
The City of EdmoQsR SIDE SEWER PERMIT EASEMENT NO - --------------------------------------------
NEW CONSTRUCTION E) REPAIRS 0 LID NO . .................. ASMT. NO . ...............
4A5 r"
OWNER ......... -------- -------------------------------- CONTRACTOR ........ t-
... Av� -- ------------------------------------------- PERMIT NO.
JOB ADDRESS ---- LEGAL DESCRIPTION: LOT NO. - ------------------------------------ BLOCK NO - -------------- I ......................
0
..................................................................................................................................................................
NAMEOF ADDITION ------------------------------------------------------------- ................................... ..............
- I
00
Approved:
. . .................... By ---------------
DATE .... .. :!Z:xe Aw, ...........
J".
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SIIDE,�
-AED? MM GNID&..`�
!SEW MRI�-.:V,E!�,
TY "OF
'WATEWSEWERL,�DEPA�RT-M-ENTo',,
0
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T
7
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7
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-';portlonj`of'- the' 'constr�ct on
25,, for 'at a,., sew!,r
C. lit 77'5-25' d' .insp6ctionsi .1w
N� .
il�te 6o�eri�figqanx.
ho
liday ih8pections:
-Inspection.',.w t 24,,-ho rs a
fter Fecilust
_4
Y7, L
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4:q�MDRIPSSMOC, AMON: OF,iCONSTRUCTION.t ... .......... ................
C itiP M ...... ........ ....... .................................. .......
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WNEWMqD1, -I LDER"; .........
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'ir..,aitdVbr�,'�oiineciii)n,*,6f-,:v� �se%vek,* to.4 e s.anliary, ff;eW�r',.
49,7p;` h
.Pbrnilsslonds%ranteed� ......... .......... . ...... ........
o'r -finiances
ION �,C �-j�f-'!Edn;jiids, d
�iTHE'-FOLLOWIN fconsf
(57�Ei�N'O-..�.i�—The',':Ow�ner*s'�6f:t�e,�p;operty,,maj-,obtain�.;aI . permit to' ccnstruc(.,S�w�r' lfislagY,'13�0�ertxmlne. .-A licensed Side,�gewe_r-.Cchfrice�r n*",i.
before 'it. has,,beewjnspec�ted'..
:,sidePsewerliwaitreet- -area., Do, not cover.ank., portion M,sewer
'Ml 'Woik. r :4,11J� -of-Way,�Permiv,.okitain�ablel,from) th*e(;Cityl EngineWv6M.�'i
eq6tres, an Inv"lon q - � � I—' . . . * , �:'
t p'er*m*it
Anfo. lnanc6- J+. 16:030. and,,Regti�at�ons, :governingf side,sewers
�matiob- r�gaixdlng�'Ord .w ern you 4e
0 ;,-mInIfi1UML,gra&-.of 2%n,
Im.1's e�t;C30j�Rb`bes,� coyerage;,at'Propierty line 4uidr 12, -line
t; have4at ,I
sharper, ithsLh 14'.,willi,bel permitted
-.be'- k�altei reafore& U - origin ab,*conditibn i
--Tre-nch;e-skln",�treit' in�s- C.fii:ractors. shall!,,,be respol t,
)NOTEI.No. &:� t
whlch,rK&y,develo�� wlthln� one; year !oCcompletiori..
a, p�6 . Vidled fov4n, the-'-pe I r .,to A� h I wer,,.or."it��ELppui,�e�diic�s,..d,.�cep.t -totjt1_-',-
'NOTBj:No.,, n�lt or� ot any.. work orr t emsL n.,se
isSr�.,the:ipilpe:,int �-th
a, wy,,.'
"k
Date.................. .. ......
.............. ... ..... .... ......
�DiSAPPROXM
D' Date'..--: ............... By .... 14
............. ............. . . . .....
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IPPROV
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FIN"
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C fllpi .,Perforimingi oxis.. etion��p-,RIOIV,',To,��equest,�. ..or, In.spe;c n;
OTWP6=IC� g�"MUIST-B6-�Sighbd"-By,-;Ownerl.o... rml
�B
-ise*,er"Ini; doncconstructe *un er: p
b.- 'ihat, ihe,�s' ide., tallaf �!, . �r�
Y'ce�.iii��, isi
�j." j'.
th
Rowner. ��Of_.,C(
nT r. c_�I`n r Pex';fGrming*,Constructicin,)�'-
V dmon s,.,,
Itigove'rh'ing. in�A46�,iof the;City,'�o E d
apbordance, With, a
'7.
do� of: .... ........................ ..........
............. 7 . .....
G , a� i""erAE],
-�Chec 0 &,� ,. . Telephonei,E],. OW
WBEF RE: you
PUBLIC WORKS DEPARINW CHEa<LisT
Plmzmn ME W
BU ILDING
TET FILE (address) *rt- e)
Street Right -of -Way Existing 0
5 REQD
Access Easements Existing.
I;EQD
p4
Utility Easement Exist'
Lot Per Subdivision Plat
Assessor Map
Site Plan -"Checked for Accuracy Kin
Z,
�Uhderground
14iring Reqd.
F4
0
Check Accuracy of Legal Description__0n_Lr6hW,,t--
Z
Review by__��
Date.
Existing Water Main.SiZ6
Wa Main Required
Service quired
Hydrant Size Exist
c4
Hydrant Reqd Per.Fire Code
ize
Detector Check meter Reqd.
Cross Connection Inspection
Fire Department ConTnents
Water �tt ge Reqd.
R �!b�y
Date
Septic Tank Design Approved
Date
Septic.Tank Pernit Reqd.
Permit No.
Sanitary Sewer Availability r.::) Pr0j.
Drm,Ting No.
File No.
Side Sewer Availability
Sanitary Sewer Connection Fee Reqd.
:3:
Review by
te
Open Ditch Exist
Culvert Reqd.
Size
C4
Catch Basin Reqd.
Indicate on Site Plan
0
Shoulder drainage maintain collection on
swale open runoff
En
Manhole reqd.
Indicate on Sit e Plan
Soil.Conditions and Ground Water Field'Checked
Review by,
Date
11
Revised: 1v10-1977
Page 2
Reqd.
Street. Reqd.*
r
Curb and: Gutter
S Si. 1
idewalk Re(qjd.
Curb Cut for Driveway Reqdl%�'
Right -of -,Way Cons Permi t Reqd.
Bond Re or Public Improvement.s
et Nanie Sign Reqd
Other Signing Reqd.
Pre Site Inspection made on
z
0 3Y. S
BY: SEWER
14 WATER
STREET
ENGINEERING
Special*Requirements listed in memo to Comn-mity Developmnt Department,
Building'Division
> BY
jn/7) Date:
c) All items filled.in on Building Permi-t Application
P4 BY Date -
Drawings Stamped and Not . at . ions Made 10,
BY Date
Approved by Public 'Works Department
Revised: lv 10-1977