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CITY OF EDMOND�r Permit No.
PUBLIC WORKS DEPARTMENT issue Date
RIGHT - OF - WAY CONSTRUCTION PERMSTRIEET FILE
A. *Address or vicinity of Construction
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Permit Issued To: -1-,
94023 79th Pi.West, gdmn s,
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• Owner: Carol Ann Mp-yAr-q
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Type of Work to be Done: f L dc-�, LA ) 0 �,,i
Name
24023 7qth PI -West
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Work in Connection With:
Mailing Address
0 Sub or Plat 4?gingie Family
Edinoiids, Wash 98020
El Comml. / Ind. D Apt. Condo.
City, State, Zip Code
0
Pavement Cut: El Yes P'-No
• Contractor:— Olds Olymvic Inc.
Name operating Echs Paving
P.O. Box 180
223 01 OL PS 0 317 �il)
Mailing Address
State License Number
Lynnwood. Wash 980 6
778 3124
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
nQ e onds
armless
from any injuries, damages, or claims of any kind or clescriptio
,)yl
Ga may
whatsoe e fores n aArgfD10a
e made
against the City of Edmonds, or any of it's departmentBs or empi
ees, i or ot I iteq �"Jefe
,8toW"ftMJefe e of
y legal
proceedings including defense, costs, court costs, and attorney fee
by re n g is MORE
Upon issuance of this permit, the contractor is responsible fo
work s M of
year
following the final inspection and acceptance of the restoration b he E ee g . i
Te
Funds held from the Security Deposit (estimated restoration fee) ' PF A% A $Ra "p ted, at
ul!=W�Irq My romf ON MCC
which time a debit or credit will be processed for issuance to the a 20..
tUM,)W 11111111TV COOMARMC
Work is to be inspected. Restoration to be to 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 must be available -aft the job site for inspection purposes at all times.
16 Oct 79
Signature: ------Date
Owner or Agent F J I ;' 8ail6jv President
THIS PERMIT MUST BE POSTED AT THVOB SIT FOR INSPECTION PURPOSES
J
CALL DIAL - DIG PRIOR: TO BEGINNING WORK
C. Issued By: LIZI�7
Time Authorized: VoicUfter —days
Special Conditions:
A I
Ammendments: 1% C)d 0
Permit Fee: /
Security Deposit:
Receipt No.: 00 �?:S S
Fund 111 Fee:
Street Cut Dimensi (rs
X
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
FIELD INSPECTION NOMS (Fund 111 - RoU* cony to -Street Dept]
Comments: I' �
lc'11717f C
1� i �s /e
AV, --� Cl kA-' _S +'---/ ILLy
qh4:f C-*,� a,- -�_,
0 OtkP- 1,.,./ 40
Ar-A
Diagram: Ct
OVA -
Contractor called for inspection C�Yes No
T
Work DisaPproved By: Date: Bv: Date:
Work Approved By: -Date:
Inspector:
Enq. Div. December 1978
b P- CA OF W, R - 0 C ,
CITY OF EDMONDS' W ST11m 'qw Permit No.
PUBLIC WORKA DEPARTMENT cET FILE Issue Date
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. eAddress or vicinity of Construction 0 Permit Issued To: F_-T- �So_i lr,�a
94091 79+-b PI-WeRt Edmonds, Wn. U
• Owner: Carol Ann �4�vers' 0 Type of Work to be Done: 0 rz vetuaw
Name V
24023 79th P1.West 0 Work in Connection With -
Mailing Address 0 Sub or Plat !��gle Family
Edmonds, Wash 98020 El Comml. / Ind. 0 Apt. Condo
City, S ta te, Zip Code 0 Pavement Cut: El Yes �Ko
• Contractor:— Olds Olympic Inc.
Name operating Echs Paving
P.O. Box 180 223 01 OL DS 0 317 BD
Mailing Address State License Number
Lynnwood, Wash 98036 778 3124
City, S ta te, Zip Code Telephone Number
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE
B. APPLICANT TO READ AND SIGN
co
INDEMITY: Applicant understands and by his signature to this a lication, agrees t hol h rmless
from any injuries, damages, or claims of any kind or description hatso orese 0 MDWn -b made
against the City of Edmonds, or any of it's departments or employ es, in n li ited% 6e Mis legal
proceedings including defense, costs, court costs, and attorney fees y reaso ti th pBEE
0 YOU DIG
Upon issuance of this permit, the contractor is responsible for orkm at period of o year
following the final inspection and acceptance of the restoration by t vis' n.
0
Funds held from the Security Deposit (estimated restoration fee) he c e d, at
which time a debit or credit will be processed for issuance to the a R
N IIN
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. ----- -
z
0
�D
0
I understand that this permit must be
I
Signature:
Owner or Agent
* * THIS PERMIT MUST BE
CALL D
MU-11101M
inspection purposes at all times.
Date 16 Oct 79
AT THYTOB SIT FOR INSPECTION PURPOSES * *
- DIG PRIOR' TO BEGINNING WORK
C. Issued By: I
Time Authori*zed: 11ifter I —days
Special
Ammendments:
Permit Fee: - 0 C7
Security Deposit: Ad - Fl_.
RecelptNo.: 00617:ss
Fund 111 Fee: Q� P_
Street Cut Dimensio
X(ELaA_Q)_=
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
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
emp-l-o-yee-s o-r officers -sh.all be I.ia-b-.I-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
STREET FILE for
The City of Edmonds SIDE SEWER PERYaT
OUTSIDE N' INSIDE r-1 REPAIRS E]
CARDNo . ......................................
EASEMENT No . ......................................
/-/P /09
OWNER ............ ��z 0. CONTRACTOR ...... .....................................
..................................................... PERMIT No.
-4-0 2- 3 - -7 r-) - STREET
HOUSENo . .................................................. ......................... .................................. AVENUE LOT No - ------- ...................................................... BLOCK No. r ------------------
t)o/ /y df12
NAMEADD. /�;/ &�!3 ----- . ........................................ ---------------------------------------------------
f )�-
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-APPROVED
IWAR 1 '1963
Date Approved:
By
BACKFILL WORK ORDER ISSUED .................. ................ DEPOSIT, $ ................................. ...........
SEWER WORK ORDER ISSUED .......................................... DATE ..' - - ------------