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24319 76TH AVE W
C11 Y (1! i! ut"'OND",
ENGINEERIN(; DEPARTMENT
APF.I)SCION FOR R1GHT-0F`,,/AY CONSTRUCTION PERMIT
_ _ _, znt to Cc=Zete A .5 P and S',&rmt in Durlicate)
STREET, Z,10
Pe:nit to be issued to': -
For work at: (address or vicinity),
Type of work to be done:
(Attach Dra,,,,ing !,Iien Aoplicable)
j _J ,
�_A
0
Time Required �tart: Finish: E. C,
017 Or EDIVIONDS ENJGINE
Owner:
Name Examined b
C")
—_.4 Date— 24n
Mailing Address
D
City State Telephone Number
6
Contractor: 7, .:
Name State License Number
Mailing Address
4
B. PIPTY.. p nt ArPt fid's raadlbb�"hl assl! Qgna X r e' tRtSpp�'�, 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 applicant or the City of Edmonds, or any of its departments or employees,
including but 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 accep,tance
of the restoration by the Engineering Department.
'Work subject to inspection and restoration in accordance with City Code. A
24-hour notice is rqquired for inspection by the Engineering Department.
Call 775-2525.
V"
Signature: ;k
4er 8�� Agent Date Signed
DO NOT WRITE BELOW THIS LI.NE (To be completed by Issuing Agency)
Permit Iss*,ued (Date)fRND Permit Number —
Fee: Bond:
Time Authorized
Subject to inspection and restoration. All work to b accordance with
Ord. No- ilzw- A '7A_1,_.iF-Retiee ",9
A.
required for inspections. For inspection
call 776-1107. 0J,'JT'S A 111'.V
AL DATE
:-RING UEPT.
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 exi 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).
APPLICATION
The City of Edmonds for
EASEMENT NO. .-,C�-rTLACHE ------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS
k- LID NO . .................. . ASMT. NO - ------- ..........
OWNER ................. CONTRACTOR .�5 ... 4 .. P�----
-------------------------- :X-4 ------------------- PERMIT NO.
JOB ADDRESS ---------------------- LEGAL DESCRIPTION: LOT NO. . ........ BLOCK NO - ------------------------------------
7
4
11
20 1�
F—SC6% �40 sw
—r7zv zew
..................................................................................................................................................................
NAMEOF ADDITION ...................................................... ..........................................
SC" 40
t
4�zz =4ce",
EE'41 c--5
1:21 f—= N ci —=
Approved:
DATE.... 7 ........... B y ------------ �r -----------
RIPE I IT
ITT 0
F MWON1
-WATEWSEWER"DEP RT-P T:�
(C lilS-21525, for side 4e%�er insoections* BFFORE covering ,any ortionj of lhe� construction.),,,,
�p Y 0
lnspec*tiom,wIil6e provided. w ni-24'�3hours.laffer:requst:..-N(ii.8at.,;,Sun�,�4 or-holida ..Anapectl ns..
�,,'-!AWDRESSV,L OCA-'nON,�O]�,"�CONST-RUCT-IONI.- i9 �6-th' enue� W. .......... ,.0....
7. AV
............ ...... .......................... ......
�,`�O P*.R'QP* 'EGAL,MESJCRlrTlON ..............
'ea. attached),
-,ERTY,,L ................
................ ....................................... .......................... ..............................
........... ........................................ ............
.................... ...................... ....................................... _: ,
...................... ........................ ...... ........ .......... ................. .
0%WER,.,AND/OR BUlLDER:_....MOYn.. -R,.'A?jR ... or ............................ . .....................
.......... ........................... ..... ... ..... . .. .................... ............
B & D cons,tructi6n ;:23716�'5.lfid W.� , ilt lk. Td-i�
ORlS,MUlE4;, ADDRESS ....... ..................... w ................................ .................. . . � . race
. . . . . . . . . . . . . . . . . . . . .. ......... ......... .... . . . . . . . . . . . .. I . . . . . . . . . . . .
P gr , Anted�_-.. �;-�N&vember 23 7A e i 6vxo� .of"' -�sl' '��,,Isanitarw,,:se I wer,.,
or, ssibmis! ........ ................................... 9. for, r pa r andV nii6eti6n' a de sewer,to4t4�-,o
isv-4em i , h, ac 46ordaiiee�.Vvith,fel�y,*df��Edriiondi; ordinances.
Ai-rFNTION,�ISICAILILED�f;io� &.F0, -OWING,:
TH LL
NO=,No� 6 i��Ttie,iow'neis,tof",t���-ip�rbp�r�j may obtain a- per m*it to'c,onstruct- sewer driside properlty'llne: Wl�,Iicensed'Sid I e �Sewer'�Contra:cto,r,)ImusV'bd,�employici�.to.�.constr�ce.
skd�,sswer'ln'stredt area 'Do not cover any`por�ion,, of,sewer'before it has beem inspected.
2=-A,11(.work-.,,pe�for�ned�!in,�city,;right-of-vv'ay',,requires -arit Inv"Ionl,_of' RJght-'of-Way:Permit,6bt;�n'a*61�tf r'om,tthe City, EnglneWs�,Offlcer
NOTE�-No, '3'—Obtain, fu;l']'.;inf�orm�t'ibn;-regaxding Ordlnance� 14-.16*0301'and� 'governin�g;laide.'se%iers,'whent yod,get permit..
��'Of! 2.%.1, VoiAbend grade.
,TopVofi,sJde'sewer,,�must �have at,least 30, inches rag at Property� iine 'a:na�12i,�nches iine';' rrhnimum, grade s;, in, i
t C
,NOTF,�No�,,!��,T�renclibs�,i'n,,it feet7 mu st� be, water., Bet tled,,and� surface,,'of,' st reet'-rdstoredV lo, orl gjlnaX,condt Ion,., - ontractors shall �be responilblb .for lafture due��to imprqper�
�may 'devel'opi with _bne�'
work�whlch I& )year,of completion'.
NOT-EhIlo, fub, o;iaIter';or.7do),&ny :6ther, woWthaiv Is providiUjor�, n
I the poermit*,;li!r",to, d6vany"Work. on the �main, sew�r.,%6r'lts.appuit�xia�n66s,lex�-cepti.,toi,in�,
'f,ie the pipe, Into,,the wye.
�01SA-.PiM
.................... . ..... ........ By,�! ........ ........ Date� ................ ........... ..... ........
Ao y ........ OAP., ...... ... ...... . ............... -- - ----- ........ ...................................................... .................
j
R ... ......... ............ ........ .......... .............................
........................................... ................ ........................
.............. ................. . ..
.... .. .................... ........ ......... ....... ......................... ........ ..................... ..
............ ...... ........... ...........
;Bo-T-H�'pi�rmit,,�c.'6�ies�:- USYB&. Sig-ned�.By�,0',wiier'16f.,F-irm,, Performing, -do'n'structibn PRIOR To Reiii�est-'Forjmpedtion.
q
lie
......... reb cerfif 'tiiatAh'e,;s;'id el�'s� Anstallb�tion con'!Aructedl%u d6r:�'Ltliii,,P
..........
... .......... . ewer'! n
7- Y Y ermit'
A
..... .....
"S
nirac g ming Cbristructlow),'
P., 0 Firm Peifor
Wi
)*4.,rin;S6lle6'.i?n�acco �atnce� k1tht,bull governing ordinafi*66s of f
heCity ofidhi'onds.
thi Y/� ............................................... �; ........
............... of ..... ....
Othe
40 hec!c BEFORE; -'You, dig for:,. Waiter' -G�fs -El Telephon .J�o.wer� 'S6wer,&,. r
L� Wvl� f4
xl�
J
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION 9 REPAIRS F�
EASEMENT NO - ------------------------- -----------------
LID NO . .................. AsmT. NO - -----------------
— W&�'7 V� &-,
OWNER 6,�-Oe, - ------------------------
i, CONTRACTOR . ..... -------------- PERMIT NO.
JOB ADDRESS ------------- ................... LEGAL DESCRIPTION: LOT NO. . ..... AZ?��-C---".LOCK NO . ........... ------------------------
k
..................................................................................................................................................................
W,
010
NAMEOF ADDITION ........................................................... ...........................................................
Approved:
DATE............................................ By --------------------------------------------------- j-j7.y6
L 4 1i L_ L, F_ .2 1, 1 N � V i On i : :t.
PARCEL A
The west 120 feet of the north 110 feet of Lot 16, Block 6, Lake Ballinger
Land Company's Plat Subdivision No. !, aCLording tc the plat thereof recorded
in Volume 9 of Plats, on pages 57 and 58, records of Snohomish County, Wash-
ington.
EXCEPT portion conveyed to the State of Washington forhighway purposes.
SUBJECT TO and TOGETHER WITH an easement for ingress, egress and utilities, over,.
underi across, through and upon that portion of Lot 16, Block 6, Lake Ballinger
Land Company's Plat Subdivision No. 1, according to the plat thereof recorded
in Volume 9 of Plats., on pages 57 and 58,�record5 of Snohomish County, Washington,
described as follows: Beginning at the intersection of the west line of said
Lot 16 with the south line of -the north 110.00 feet of said Lot 16; tht�nce
S89'45'30"E, parallel with the north line of said Lot 16, a distance of 345.51
—feet to an intersection with the east line of said Lot 16; thence N22'I4'i6,,w,
along said east line, a distance of 48.70-feet; thence N89'45'30"W, a distance
of 18.00 feet to an intersection with a curve h ' ay.ing a radius of 20.00 feet,
from which intersection the radius point of sai,d carve bears N89045130"W;
thence southwesterly, along the arc of said curve,'.being a curve to the right
and consuming a central angle of . 90'00'00", an arc.& ' is-tance of 31.42 feet;
thence N89'45'30"W, a distance of 288.89 feet to �n iniersect-ion with the
west line of said Lot 16; thence SO'14'30"W, along 5ai,d west line, a distance
of 25.00 feet to the Point of Beginning.. EXCEPT por'.tiuncunveyed to the SLdte
of Washington for highway purposes.
PARCEL B
The east 100 feet of the west 220 feet of the -north 110 fee.t. of Lot 16, Block
6, Lake Ballinger Land Company's Plat Subdivision No. 1, according to the plat
thereof recorded in Volume 9 of Plats, or, pages 57 and 58, records of Snohomish
County, Washington.
SUBJECT TO and TOGETHER WITH an easement for ingress, egress and%utilities,
over, under, across, thtrough and upon that portion of Lot 16, Block 6, Lake
Bal-linger Land Company's Plat Subdivision No. 1', acco'rding to the -plat thereof
recorded in.Volume 9 of Plats, on pages 57 and 58, records of Snohomish Coun ' ty,
Washington, described as follows: Beginning at the*intersection of the west
line of said Lot 16 with the south.line of the north 110.00 feet of said Lot
16; thence S89'45'30"E, parallel with the north line of said Lot 16, a distance
o f-3 4_3 --- T- I thence
5. 1 Re-t,.to an intersection with the east line of said Lot 6;
N22'14'16"W, along said east line, a distance of 48 , 70 feet; thence N89*45'30"W,
a distance of 18.00 feet to an intersection with a curve having a radius of
20.00 feet, from which intersection the radius point of said curve bears
N89045'30"W; thence s-outhwesterly, along the. arc of said curve, being a curve'
to the right and consuming a central angle of 90'00'00" a n arc distance of
31.42 feet; thence N89045'30"W, a distance of 288.89 feet to an intersection
with the west line of said Lot 16; thence SO'14'30"W, along said west line,
a distance of 25-00 feet -to the Point of Beginning. EXCEPT portion conveyed
to the State of W'�shington for highway purposes.
-IN TER -OFFICE COM
'MUN
FROM
-irs on
P :.'-iiarr.v ',0-,itCtYtt
T city npgjheer
ilding official
Parild-Ln o
-puchtions f I
locat%Q: ate, tjjp go m�- -he buimar.
i7fouse ana utilities ,ihility of t
Aier.
2. connsirtio,wof all lots to
vinc
31".jenoot a RAW r r mmi red
MOM-& (Atabhed
A. -.'76j�-W-01�ad te-quir64 Pet 8handard Dig
DrjLvE_
vjay slopes not bs e P?
tom
dradnaqp. to WcontainA on sjj&A directV to CQPY�S.
z,<
An regPired
r4yomd 0;
i 1T -Y
r. mj,r
L'OT -A� /
LaT %:, $5 1 J
Reviewer's
T n+i ;kl c
3/9/76
0- R0, R1
Permit Address.
Lec Descriptio?_&Qa!�L- A.
pal e
� I !q oft 5 5...712
BUILDING PERMIT RFVIE!4 - FNGINFFRTNG DFPART1AFNT
CHECK LIST
I Septic Tank System Oesi-nn Approved
2. Sanitary Sewer Availabili . tyYM5 S 11 t. of DWn. No.
Project: Side Sewer Availabili ty:
%.01
3. Any-Sani'tary Sewer Connection Fees-13DAW
4. Site Drainage Checked
5. Storm Sewer Availab'ilitv: Sht. f Dv1q. t-lo. It
Project:"%!Sr,W 1�� Roadside Ditch
6. Grading & Final Contours
7. Sidewalks (Site Tnspection shows condition of,existinq vialks as follows):
4") 7ert6 1 71,
8. Curbs W01 RVAO 11±6 7n MV7
9. Curb Cuts
10. Underground Wiring A Street Liahtina
11'. Street Right-of-viay A Bldg. Setbacks:
of Dwq. No.
12.. Existing Utility Easements—.
.. 13. Access.Easements
of Official Street Map.
-14. t-later Mains A Fire Hy . drants (Indicate Size Yater Main)
if lk &A & AAL a A L Art" 4---JOL 1 &-4~64 A
15.- Bonds for Site Pork
16. Special Requirements listed in memo to Bldg. Dept.
17. Commercial & Apt. Requirements form comnleted
18. Drawings stamped A notatio T M? de
19. Site Inspection made on.
.Sht.
20. All items filled. in -on nldg. Permit Application
21. This Lot included in Subdivisio (List any special
requi rements) :