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12462
336 OLYMPIC AVE
A
890 - 199 -
City of Edmon
MGHT-OF-WAY CONSTIRT4ffJ FILE
PERMIT
Permit Number. eRA
Issue Date:
A. Address or Vicinity of Construction: 336 Olympic Av. (9321978)
B. Type of Work (be specific): Install New Service
C. Contractor: Radhington Nat'l. Gas Co. Contact: Frank Swan
Mailing Address: �15 Mercer St.Seattle, Was . Phone: 224-2278
State License #: 98111 Liability Insurance: Bond: $
D. Building Permit # (if applicable):
Side Sewer Permit # (if applicable):
E. El Commercial El Subdivision 0 City Project ffk Utility (PUD, GTE, WNG, CABLE, WATER)
n Multi -Family 0 Single Family F1 Other
INSPECTOR: INSPECTOR: V'J� C'.
F. Pavement or Concrete Cut :B Yes []No G. Size of Cut:(1) 2 x 4 _ H. Chargq_$
Cut @ Gas in Asph. Walk.
APPLICANT TO READ AND,SIGN
h�
INDEMNITY. Applicant understands and by his signature to this application, agrees to h d, i�� ity ofEdmonds harmleyfr W JF3, damages,,6r
7
claims of any kind or description whatsoever, foreseen or unforeseen, that may be m/a-94-t the Cityof Edmonds, r any of z s eprartments or
employees, including or not limited to the defense ofany legalproceedings including de ense costs,iand attorney fees by rqn ofgranting thispermit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS R PERIOD OF ONE YEAR -FOLLOWING ME FINAL
INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THE FINAL STREET PATCH
IS COMPLETED B Y-CiTY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with pep�_Iit applica&n.
7�7i=02
A 24 hour notice is required for inspection; Please call the k&gu�eering Division,
Work and material is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes.
Street -shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
Ihaue read the aboue statements and understand thepermit requirements and thepink copy ofthepermit will be
auailable on site at all times for inspect1*90ppurposes.
Rugust 2, 1993
Signature: Vt- Date:
I (Contractor ofltdeWt_�
CALL. -DIAL -A -DIG PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
APPROVED BY: C'
RIGHT OF WAY DEPOSIT
TIME AUTHORIZ ED: VOID -AFTER 3 DAYS
DISRUPTION FE E/FUNDi,111.
SPECIAL CON , DITIONS:
RESTORATION PEE:
V
PERMIT FEE-
172,
,TQTALFEE:
RECEIPT
COMMENTS:, FEE.
DATE: ISS I
�D�By;
4z'
NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
4
FIELD INSPECTION NOTES (Fund 111 Route copy to Street Dept.)
Comments:
Diagram,:
CONTRACTOR CALLED FOR INSPECTION El YES El NO
Partial Work Inspection by P.W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
AV*av-gon
Addendum to City of Edmonds
Right of Way .
Permit Application
Submitted b Guyla Connors
Engineering Ai de
Washington Natural Gas
521-5248
7
-W
7,
WNG to window
t\ff-AWater main depth
unknown
gas main
(ZX4) C�U--v-o G4�,-S
-w-
water
-9-
gas -
-ss-
sewer
-e-
water hydrant
0
water valve
'�'S McrccrSt- (PO - BOx iPeg). Sciank, --A 92111 '- �) 622-6-167
APPLICATION
for pj.44�-,
The City of Edmonds SWE SEVVER rMbw '4
NEW CONSTRUCTION 0 REPAIRS 0 EASEMJR-rr No . ....................... ...................
OWMM .......... Tz ........ P� ................................. ........... PER3daT
------- . ....... <:PN ------- No -
LEGAL DESCRIPTION: LOT No. .................................... BLOCK No . ............................................
ADDRESS J-1.4 .....
.................................
NAME OF ADDITION ....... �11
Lu
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ftftaft
LL
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"COVED
I#* I ig 1971
IPPA:4 // 7 —h4 A Vl� Al,
Approved:
DATE . . .......... B�.- �$-40e&...
CITY OF EDMONDS
CIVIC, CENTER —WATER-SEWER DEPARTMENT Can PRospect 6-1107 when work
Is ready for Inspection. (No Inspec.
tions Saturday, Sunday or holidays.) N? 3892
SIDE SEWER PERMIT
ADDRESS..................................... 3-36 ..... ... 1.1th .... Ave.n.qe.ApKth ........................................................................ .............................
OWNER ............. Paul ... Fritz ...................................................... CONTRACTOR ..... .. !�Pnatrw�tion
Permission Is granted January. ... 1.8 ............ 19 .... 71, for ........................ days to REPAIR or CONNECT a side Sewer
with City Sewers in accordance with application on file and governing ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—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 seweri,before it has been inspected.
NOTE No. 2—Obtain full Information regarding Ordinance 11.116.030 and Regulations governing side -sewers when you get permit.
NOTE No. 3—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.
NOTE No. 4—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.
F -'w 5—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 appur-
tenances except to Insert the pipe Into the wye.