428 12TH AVE N.PDFiiiiiiiiii
629
428 12TH AVE N
Vkw_ APPLICATION
The City of Edmonds 'r- for
EASEMENT NO . ............................................
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS LID NQ_. -------------_ ASMT. NO.. ................
OWNER ------ PC>t'�4 ...... . ........................................ CONTRACTOR ... ........ . ......... PERMIT NO.
JOB ADDRESS - 12-n4 bhNjE___. a..%
-------------------------------- ................................................... LEGAL DESCRIPTION: LOT NO . ........................ ............. BLOCK NO - ------------------------------------
0
...............................................................................................
..............................................................................................
Approved:
DATE ......... B
"��y - ----- -K� _____ : .................
J,
lji
A
t
T-1
W
'i SE:,'�4
The pt .7
""d
!ON
41
SIDE"SEWER.-PERMU,
NE 0 u -fION
w C, i�Stii c REPAIR
s
................................................
lbll'
ADDfRESS',
---------------------- I -----------------------------------------------------------------
CONTRACTOR ---
- ------ . ..... --------------------------------------------- PERMIT NO.\,
LEGAL DESCRIPTION: LOT NO.
---------- ....................... BLOCK NO - -------------------------
--------------------------------------------------------------------------------------
........ ..
-7
)OyLx,
Approved:
.:0—. "b -E ...1 ....... By
AT
3 A
7"
CITY OF EDMONDS SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
7
775-2525 1 or side sewer inspections BEFORE covering any portion of the construction.)
(Call
Inspection will be provided within 24 hours after requst. No Sat., Sun., or holiday inspections.
rth ...... ............................
i�ve.n�26 No . ....................
0.
ADDRESS LOCATION OF CONSTRUCTION -----.. . ... ...... ......... ...... ....................................
pROpERTy LEGAL DESCRIPTION --------------------------------- --- - mer--------------------------------------------------------------------------------------------------------------
......................................................................... ............... ............ .............................................................. . ................................... ................. ............... : .................
ON. FINNYGAINT
. . .
.................... ......... OVVNERI�/OR BU ILDER --- .......................... . ......... ......................... . .......................................................
...................................
P service 24�006 92nd Ave - BdTIORCIS
4
Aka.in Baclkho ....... ....................................................... ..
CONTRACTOWS NAME ADDRESS_2.�� .............................................................. - ---------------------
11 for repair and/or connection of a side sewer to the city sanitary sewer
is . ........ 19.7.5
Permission granted --------------- "'** ----------............
sy 4em in accordance with City of Edmonds ordinances.
7.
A.1�;-2NTION IS CALT D TO THE FOLLOWING:
to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
NOTE No. 1—The owners of the property may obtain a permit
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 obtain -able from the City Engineer's office.
when you get permit.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers minimum grade of 2%. No bends in grade
at property line and 12 inches inside property line;
NOTE No. 4—Top of side sewer must have at least 30 inches covera ge
sharper than 'A will be permitted.
surface o I street restored to original condition. Contractors s hall be responsible for failure due to improper
t,.
NOTE No. 5 —Trenches in street must be water settled and
work which may develop within one year of completion. the permit, or to do any work on the main sewe r or its appurtenances except to in -
than is provided for in
—It is unlawful to alter or do any other work
NOTE No. 6 sert the pipe into the wye.
By Date -------------- By ................ Date --------------- - ------------------- 'BY ----------------
DISAPPROVED Date --- - -------- - -------------------_---- ........ ........ ......
By ... ..........................................................................
APPROVED Dd Date ....... ..... . ..... ............................. . ............
.... ......... ............ ......
..... -- -------
Remarks: ....... . ...................................... . ............................ ...... ..................... ................. ............ ..... ..............
.................... .........
...... ..................... . .............. ..........
---- ---------------------------------. ........................................................................................ . ...... .
............................ ....
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
hereby certify that the side sewer installation constructed under this permit
L(
�6 . ....................................................... .................... ...
wner of Contracting Firm Performing Construction)
4
led in a ccordance with all governing ordinances of the City of Edmonds.
W_,Instal
19 ?i
Datedthis -------------- ........ day of -----------------------------........ ...
Check BEFORE you dig for: Water Gas Ej, Telephone Power Sewer Other 0
-777,
..".w:
�7 -T,.77, kv. -Tprj t-
30
4