515 9TH AVE S.PDFIIIIIIIIIIII
9942
515 9TH AVE S
0. . . 0
Af-DRESS: C�w
TAX ACCOUNTIPARCEL NUMBER: 00 3-71 qW 106 i-On
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:ge�-10� DETERMINATION: E] Conditional Waiver 0 Study Required 0, Waiver
DISCRETIONARY PER -MIT #'S--
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
1'2111WITHWPIM�W m,
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DA'
SEWER LID FEE $: - LID #:
SHORTPLATFILE: (2)V�)Ue�P LOT: (0 BLOCK:
SIDE SEWER AS BUILT DATED: t a .
SIDE SEWER PERMIT(S,).#: (Oqc) 3
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
OTHER: t WkA
LATEMP\DSTs\Fonns\Street File Checklist.doc
'9 CA File Notpko(j
Tritical Areas Checklist
Site Information:(soils/ topography/ hydrology/ vegetation)
1. Site Address/ Locaiion:
2. Property Tax Account Number:
3. Approximate Site Size (acres or square feet):
4.
5.
T fk;_ : -1 -1 V
a 0 M currendy develope
If yes; how is site developed?
Uescribe the general site topography. Check all that apply..
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a horizontal
distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of 10-feet
over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a horizontal
distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: ; Approx. Depth:
7. Site contains areas of seasonal standing water: AD Approx. Depth:
What season(s) of the year?
8. Site is in the floodway - M floodplain _ of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-round?
— M . Flows are seasonal? (VVhat ti mie of year?
10. Site is primarily: forested meadow ;shrubs mixed
urban landscaped (lawn,shrubs etc) X
11. Obvious wetland is present on site: - N
DETERMINAnON
SrUDY REQUIRED. WAIVER
Reviewed by: ___LW
�_ Date:
Critical Areas Checklist.doc/3.19.2001
VE
City of Edmonds
Development Services Department
Planning Division
Phone: 425.771.0220
i9Z Fax: 425.771.0221
The Critical Areas Checklist contained on this form is to
be filled out by any person preparing a Development
Permit Application for the City of Edmonds prior to
his/her submittal of the application to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, or
may be, present on the subject property. The information
needed to complete the Checklist should be easily
available from observations of the site or data available at
City Hall (Critical areas inventoflsWa �—V I&J. ff�A5)
Sim sw
surveys).
DEC 2 -2006
PERMIT COUNTER
0
DateReceived:
City Receipt#: F-C- C- 19
Critical Areas File M&P-A W190 - 0 1 (o
Critical Areas Checklist Fee:— 44&.40—
Date Mailed to Applicant:
A property owner, or his/her authorized representative,
must fill out the checklist, sip and date it, and submit it
to the City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent+ steps necessary to complete a development
permit application.
Please submit a vicinity map, along with the signed copy
of this form to assist City staff in finding and locating the
specific piece of property described on this form. In
addition,. the applicant shall include other pertinent
infon-nation (e.g. site plan, topography map, etc.) or
studies in conjunction with this Checklist to assistant staff
in completing their preliminary assessment of the site.
The undersigned applicant, and his/her/its heirs, and assigns, in consideration on the processing of the application agrees
to release, indemnify, defend and hold the City of Edmonds harmless from any and all damages, including reasonable
attorney's fees, arising from any action or infraction based in whole or part' upon fals . e, misleading, inaccurate or
incomplete information furnished by the applicant, his/her/its agents or employees.
By my signature, I certify that the information and* exhibits herewith submitted are tnie and correct to the best of my
knowledge and that I am authorized 71e cation on the behalf of the owner as listed below.
SIGNATURE OF APPLICANVAGENT DATE 11MA,
Property Owner's Authorization,/
By my signature, I certify that I have authorized the above Applicant/Agent to apply for the subject land use application,
and grant my permission for the public officials and the staff of the City of Edmonds to enter the subject property for the
purposes of inspection and pAs Ling 4t
V�ant to this application.
SIGNATURE OF OWNER
Owner/Applicant:
Namb
lun
Street AddrAs
Umr��-- - VVA
City State Zip
Telephone: NS) ")�r Kn
Email address (optional):
DATE M)AI
— 1 1 k9
Applicant Representative:
UR- N I
\u WwAr-
Name )
Street Address
City , State zip
Telephone:
Email Address (optional):
1-1-59P
Critical Areas Checklist.doc/3.19.2001
CITY OF EDMONDS-
��NT FOR INSPECTION C Permit 66 008'
OEK
SIDE SEWER PERMIT 775-2525 Ext. 4ftAS-'V1 Issue Date
PERMIT MUST BE POSTED ON JOB SITE
1. Address �TCo'nstruction
2. Property Legal Description (include all, easements)
ildri
-4'� 1 no- k I . T) In A I he 4 —, -S5. Ln �-cl S ('A vid I e U
3. Lngle Family Residence Multi -Family No. of Units
Commercial ECEIVED
4. Owner and/or Builder K C/-" 60-v-
5. Contractor & License No.
6. Invasion into City Right -of -Way No Yes (if ?9V1UWAAof-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
E-1 7. Cross other private property: Yes No Easement required -
U attach legal description and county easement number.
H
�4 READ THE FOLLOWING AND SIGN:
P4
a. Property owners must obtain a permit to install side sewers on
>-I their property. A licensed side sewer contractor must be employed to
construct side sewers in the public' right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year.
c. Commercial establishment requires a minimum of a six inch (6")
P4
Z� side sewer line.
0 d. Side sewers may not be installed closer than thirty inches (30")
U
to any structure. 0
e. Side sewer lines must be laid at a minimum grade of 2% (1.15
0 and maximum grade of 100% (450). 0
f. No turn in side s8wer greater than 45 (1/81bend) is 0 allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is require d for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer 'line run.
j. Trenches within City right-of-way must be'restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required.
DATE:
I certify that I have read
and shall comply With the above
F4 PERMIT FEE: DISAPPROVED BY:— Date:
U W By: Date:
CONNECTION FEE: D a t e
APPROVED By!���
0 1e__1 -
44 PERMIT MUST BE POSTED ON JOB SITE
The City of Edmonds
Side Sewer Drawing
C)
EASEMENT NO . ................................. ..........
NEW CONSTRUCTION Ej REPAIRSZ LID NO . .................. . ASMT. NO . ..................
OWNER .......................................... .................. CONTRACTOR ...... ...................................................... PERMIT NO.,(
JOB ADDRESS .......
............................................ LEGAL DESCRIPTION:, LOT NO . ........
....................... BLOCK NO . ...................
...................................................... (2-11-4-1-Lciv; e-L,.j
.................... ..................... S
t
.jj .. .... ......... r
NAME OF ADDITION .......................................................... ' TIREAMEHT
.................... 12 .........................
E
0
PWW.600 1111175 (R EV. 1117 . 8
Approved:
....... . . .. ......
DATE .... -------------
The Citv nf ;:rlmnn,4c
Water Service Drawing
EASEMENT NO . ............................................
NEW CONSTRUCTION Ej REPAIRS R11 LID NO . .................. ASMT. NO
OWNER................................................................................................. CONTRACTOR ....... ......................................... PERMIT NO . ....................
JOB ADDRESS .—I.AVE S.
.. ........................................... I .............. LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO . ....................................
PWW-0001-11175 (REV.11/78)
................................................................ I ..................................... I ...........................................................
NAMEOF ADDITION ..: ...................................................................................
S15 9-rm So.
1,11CO.A
6 A
7'0
P ty
ly
.. P0 *_j
0
Approved:
DATE. 7- ?6 ...................
.............. I ......... B, MARV.�l ...................
APPLICATION
The City of Edmonds for
SEDE SEWER PERMIT
NEW CONSTRUCTION C] REPAIRS EASEMENT No . ..........................................
108-05400
OWNER............ ... C...J.'adin -------------------------------------------------------- CONTRACTOR -------------------------------------------------------------------------------------------------- PERMIT No . ......................
ADDRESS ........ SIS ... ie ... 9.th.-Ave....S . ..................................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAME OF ADDITION
Dye Tested On Sewer 1972
Approved:
DATE................................................ By ......................................................................
L &
CITY OF EDMONDS
U E
USE
S
Z 0
ZONE
PERMIT
NUMBER
9W4Z6
,ICA T'
CONSTRUCTION PERMIT APPLICATION
'0 a
, Fif
AD
... SS
'52V�CIAPT a
OWNER NAME, NAME OF BUSINESS
LEGAL DESCWJAQft.Q&CKrUSDIVISION
NO,
LID,NO�
JON
PUBLIC RIGHT OF
EXISTING —
WAY PER OFFICIAL STFtEET'MAP.
REQUIRED DEDICATION
—
TESCP Approved 0
Rw Primit Reqw d 0
S a'
treet Use Pe —it Rsq'd 0
ZIP
e
�UmSEFI
ILLEPHONE NUMBER
PROPOSED
Inspection Required D
Siderivalk Required 0
�NAME
METER SIZE
LINE SIZE
NO. OF FIXTURES
PFIV REQUIRED
I
I
YES 0 NO 0
ADDRESS
1-)1242..
4
4.s
E Not
ENGINEERING MEMO DATED
REVIEWED
�x . LIP f
Gl 4010e A4 qa402
I TELEPHONE NUM13ER
'77 8, 0 7
M ;R
FIRE MEMO DATED
REVIEWED
I . r
STATE LICENSE NUMBER EXPIR I A
OP12' -J (2,ql 0 6 rs
SIGN AREA
ALLOWED i PROPOSED
SEPA REVIEW
COMPLETE JEXEMPT
EXP
ADS NO.
ts!
Legal Description of Property - include all easemenq
SHORELINE
VARIZINCE OR CU
PLANNING REVIEW BY
DATE
ETBACKS — FEET
S S T.
HEIGHT I
L40T COVERAGE
�ri-x'i�count
Parcel No. -3 71 ?— 00/— 0 0/ —o 0 07
REMARKS
0.EW 01--.ESIDENTIAL LO-PLUMBING14AECH
COMPLIANCE OR
EIADOITION COMMERCIAL CHANGE OF USE
REMODEL APT. SLOG. SIGN
GRADING FENCE
0 REPAIR CYOS. It —FT)
DEMOLISH OODSTOVE SWIM POOL
INSERT HO
GARAGE 13 T TUB/SPA
RETAINING WALL/
CARPORT ROCKERY RENEWAL
CHECKED BY
TYPE OF CONSTRUCTION
/_/Zo
CODE
OC
0
�GR C
RPECIAL INSPECTOR AREA
SQUIRED E3 YES
oc
LOA
MARKS
PROGRESS INSPECTIONS PER.UBC 108
(TYPE OF USE. BUSINESS OR ACTIVITY) EXPLAIN:
ISF/t--
NUMBER
OF
STORIES
NUMBER OF T"CRITICAL
DWELLING
UNITS
AREAS
R
07RIBE WORK TO BE DONE (ATTACH PLOT P I
, eoeZd C1 e Ln
?
FINAL INSPECTION
REQUIRED
r
512 1— V f C --
VALUATION
FEE am
PLAN CHECK FEE
I
FM
HEAT SOURCE:
GLAZING
I %
PLUMBING
Plan Check No.
MECHANICAL
This Permit covers work to be done on private property ONLY.
GRADINGIFILL
Any construction on the public domain (curbs, 31dowpiks,
driveways, marquees, etc.).will require separate permission.
STATESURCHARGE
Permit Application: 180 Days
Permit Limit: I Yea . r - Provided Work Is Started Within 160 Days
STORM DRAINAGE FEE
"Applicant, on behalf of his or her spouse, heirs, assigns and
ENO. INSPECTION FEE
SuCcerS In interest, agrees to Indemnity, defend and hold
lessIct the City of Edmonds, Washington, its officials,
5
employees, and agents from any and all claims for damages of
5
whatever nature, ari'Sing directly or Indirectly from the Issuance
x
of this permit. Issuance of this permit shall not be deemed to
PLAN CHECK DEPOSIT
Ox
modify, waive or reduce any requirement of any city ordln:nc
In City's to
nor limit any way the ability enforce any ordin nc:
TOTAL AMOUNT DUE
provision."
6
I hereby acknowledge that I have read this application; that the
ATTENTION
APPLICATI N APPROVAL
0
Information given is correct: and that I am the owner, or the duly
authorized agent of the owner. I agree to comply with city and
state laws regulating construction; and In doing the work authoriz.
THIS PERMIT
AUTHORIZES
I
This application is not a permit until
ad thereby, no person will be employed In violation of the Labor
ONLY THE
signed by the Building Official or his/her
Code of the State of Washington relating to Workmen's Compensa-
WORK NOTED
Deputy; and fees are paid, and receipt Is
tion Insurance and RCW 18,27.
INSPECTION
acknowledged in space provided.
SIGNATURE (OWNER OR AGENT) DATE SIGNED
DEPARTMENT
W"4eA
CITY OF
SIGNATURE
-71S 61-
A
EDMONDS
ATTENTION
CALL FOR I"AFLEAW
SY: DATE
INSPECTION
IT S UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE
UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR
771-0220 ORIGINAL — File YELLOW — inspector
A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. USC
SECTION 109
PINK — Owner GOLD — Assessor
t02,87
7 HLE
January 18, 1982
MEMO FORRECORD
SUBJECT: STOPPAGE OF SEWER MAIN AT�2515 9TH AVENUE SOUTH.
John Koyles and Terry Hanson were -advised of a possible sewer
stoppage at 515 9th Avenue South, on November 2, 1981, at 6:00 p.m.
The proceeded to check the manhole at 9th Avenue South and C&dar
Street. They found the flow normal at this point. They checked
the manhole at Cedar Street and 98th Avenue and also found the flow
normal at this point. They advised the resident, Mr. Medin, of
515 9th Avenue South to have his side sewer ','Roto"Robteredl' and
ha*ve it marked where the blo*ckage is found. They advised Mr. Medin
that the City of Edmonds would have a crew sent out to check on
the situation, on November 3, 1981.
J6hn Koyles and Ron Holland returned at-8:15 a.m. on November 3,
1981. Mr. Medin explained that Roto-Rooter'had run his rodding'
line out 1101 to 115' where he broke open a clog of some sort.
John and Ron inspected the main from the manhole at 9th Avenue
South and Cedar Street, and could see a blockage about 20! east of
the manhole. They then hand rodded the sewer main and removed roots
that had the inpression of being a whole length.of sewer tile (about
42" in length)', After they removed the roots,'they showed them-
to.Larry Ogle and explained that there were still some roots hang-
ing from the top of the -sewer main.
John, -..Ron and Larry inspected the basement of 515 9th Avenue South
to visu,�tlize damages, take photographs, and advise Mr. Medin of -
our findings. Mr. Medin showed us shoes, boots and rifle cases
with water marks and stains on them.- These items, Mr. Medin had
already removed to his garage to dry out. He also was very concern-
ed about his oil burner and said he was afraid to.use it. He was
advised if he had trouble, he should call a reputable oil burner
service and have it checked out. After leaving.515 9th Avenue
.South, Ron, John and Larry returned to the Public Works Department
and filed their reports.
r-
IAARY OIxIIE
tt
LO: j ky
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENT .
TO:
DIRECTOR
ADMINISTRATIVE SECRETARY
BUILDING & GROUNDS SUPT.
CITY ENGINEER
EQUIPMENT RENTAL SUPT.
STREET DIVISION SUPT.
WATERISEWER SUPT.
TREATMENT PLANT SUPT.
COMMENTS:
SUSPEr DATE:
0
#
Investigate
and Report
Take Appropriate
Action
Prepare
letterimemo
for my signature
for Information
A Previously Ref'd
)v Status of Action?
Return to: 91,44-.11,
p, Wk
- f ROM: DATE:
PWA4ftj-j 1-78
RECEIVCO
E IVEJ
CIAV POR DAMM
D A -
NOTICE
Claim KUST be presented to the City Council and filed with the City Clark-liithiz IM day s
ft9a the date of Accident or Accrual of Damages.
20 TIM CM COUNCIL or TIM CM or =WNW.
PLUSE TAU NOTICE, IMT William C�. Vedin
(it married, give husband's same)
VM MW 1Mn)ES AT 515-9th Ave. Soutn Edmonds, 11,a-
JState present actual address by street, number and city)
AND WHO pop SIX NOMM MM To DATE Oy ACCIDDIT R#S RESIDIM AT 515-9th Ax-, 501th
Edmonds, Wa.
(Give residence by street, number and city)
CLAIm DWG= or AND ncP TEm CITY OF gvo= n THE SUY OF S 4%.0-1-
&rising out of the fol,lowi4g circumstances:
Describe Claim, giving 12:oo P.M. 10-�40-81 to 4:30 ?. 1J.
DA-.E and TIME injury or
dazAge occurred, PLACE 11-2-Bl no ane was at home. Durin'g
and full particular&.
Accurately locate and this time our basement was floaded
describe defects caus-
Jzg injury or damage with-sewaize-back up from Cedar St.
and &3.1 act& of jwgli-
gence claimed.
(.cant. on attached sheet item -,yl)
Accurately descr;�be
:injuries or damage Stinkina. dirty 5 to 6 inch hjZJL—
sewage in my basement. See Ph3t08
and damap-ed articles listed itfm -4-3
State Items Of damage
claimed. Itemize &31 See attached itemizPA list JI-FM :41
ozpanses a" 2,08405.
(Maio ant be smorn to bv clLimant)
SMS&OWD AND So= to
before W thi�---- of
A—btLrj(/Pu'b1ic in wW for
Nsabiagton, rosidi&S at t=CCA,
CLATV FOR DAMAGE
William C . Ped Lit
515-9th Ave. South
Edmonds, U. 98020
Item A continued
11-2-81 at approximately 9:00 ?.V. johnsen Sewer Service roto-reatea,
thru wy side sewer clemi-o'ut. IV line was clean. The rote-reoter
found tke plug -up 110 ft,)to 115 ft. from my clean-outg locating tke
plug -up in the Cedar Street main sewer line.
Not93 11-3-81 the EdmoR6s 11ain-.en&nce people dug up their sewer main.
0
On 11-4-81 they removed & weeping willow tree plus laurel bushed from
Cedar Street read cight-of-way adjacent to @aid sewer line.
Itez #3 continued
Expenses and Losses
1. Rate -Rooter
2. oil Burner Repair
3. Shoes cleaned and shines (4 pair)
4. F.eginish shotgun butt stock
5. Chilton track repair manual (to dump --destroyed)
6. 30 paper back books @ f.60� each
7. Charts, maps, draw'RFs
S. U. S Mint coin covers -and display folders
9. Bathroom scals
10. 3 boxes shotgun shells C MOO each est. cost
11. Clean-up and sanitizing material
12. Laborl, cleaning & sanitizing 32 hours minimum
C $6.00 per heur
Copies to:
Hubbard P.e&l Estate and Insurance Co. Edmonds, Wa.
W. C. Mod in Edmonds, Wa.
$47.43
50.07
10.45
21.06
approx. 17.00
to 18.00
It 24.00
to 40,00
to 1 15.00
it 24.00
12.00
192.00
$473.01
ELDER. HEATING SERVICES, INC.
Furnace Repair & Burner Installations-
19215 ASHWORTH NORTH
.5710 SEATTLE. WASHINGTON 98133 Phone 542-4600
Name al�, XI) Date
Address Phone
ChargeTo S.C. 0
Add ^ . 1-1
C"KCK LIST
QTv-1
PARTO I"STALLED A V- , JA oy
ANOU"T__
CHECK NOZIL9
CRICK OIL $TRAIN
0
CLEAN EL9C.
OIL DEARING&
A111,0114haw 2
0
CUCCA THENIA.
C09CR CONTROL,
ADJUST VLANE
0
vk�
.07
0-
4f X-tv
.22.
TOTAL PARTS
U6
O&IIIAMENT
WQRMATION
Burner TVp"
Air F Ifter—'':
on
TIME
ollp
HRS. LABOR (12
11 -5-Z
Finish
o' 1.00
SALES TOTAL
1
4d
SALES TAX
.2 r
INVOICIE AMT.
CUSIONCA 5 �514NATUAK
0
GUARANTEE: The charges above cover this specific repair job only. We guarantee all parts inst fled
by us for ninety days alter date of repair. But do not guarantee or prate to guarantee other:arts
In your equipment. It now repairs become necessary In the future the'ynd.re subject to our regular
rates. Any discrepancy In repairs Must be reported within 7 days.
IS INTEREST CHARGED ON ACCOUNTS 30 DAYS PAST DUE.
The company &.sum*@ so r.ap.asibility for any damast. 1. 0 ... V ovo—f, --a b. —.I..
JOHNSON SEWER SERVICE
2233 NE 197th PI. 11 C
SEATTLE, WASHINGTON 98155
Phone 364-4868
FA
PREVIOUS
SALA
wig
WNA
'RECEIVED By
77+-je
"Exom awl j�uc� oak em. 91411.
6
BAYSIDE REFINISHING
410 Walnut Street e Edmonds, WA 98020
Phone (206) 771-8066
For:
e"' /A I&J-L
0
Furniture Description
I/ j 1) —
Home Phone
Other
Work Description :::C- JC- CDC
C, t/1,
4
r-j
CONDITIONS — All material is guaranteed to be as specified. All work is to be completed in
a workmanlike manner according to standard practices. Any alteration Or deviation from
specifications involving extra costs will be executed only upon written orders. and will become
an extra charge over and above the quote. Owner to carry fire, theft and other necessary
insurance. OUT workers are fully covered by Workmen's Compensation Insurance. Owner
grees not to hold Bayside Refinishing or its employees responsible for damages to merchan-
a dise in excess of $500.00.
D Authorizing Signature (Owner Signs Here)
Subtotal
Tax
0C
Total
75
C I T Y. 0 F E D M 0 N D S
SEWER DEPARTMENT
STOPPAGE OF SANITARY SEWER MAIN REPORT
DATE: e!zzz1f1 TIME CALL RECEIVED: -'5-"0zp
LOCATION OF STOPPAGE: 2-0 --2 G 14 IAI &�U
A4,Q4A—J
TIM�E OF ARRIVAL ON THE'JOB SITE,---'- 6
TIME NORMAL FLOW OF SANITARY -SEWER REESTABLISHED: q.---30 4,A4, A,10V, 3,IWI
CAUSE OF STOPPAGE: 'Jo"
ACTION REQUIRED. TO CLEAR MAIN AND/OR LATERAL:
,,C�-A4 ml"4 okj q�� 6,<--
=ez�oeq� '224 i-o 2 s ' 6-, olu <fc�,q
CITY CREW ON STOPPAGE CALL OUT (Personnel Involved):
Y, A40 L-L,4&jz�
LOCATION OF RESIDENCE AFFECTED: 57/57
��,o V, Z, / .9,f /-
v 3, lqdl .J-ol4A-j klcyl,&-s
NA2,1E, ADDRE-SS,--AND PHONE NUMBER OF PROPERTY OWNER:
-50
4��QA4 C)A-.,JD '�cJq -7 -7,f - 72,57 q
DESCRIBE DAMAGE TO PRIVATE PROPERTY:
Y
RDIARKS:
- Aq r e9'"44E "Or-- lttgD 01-
--OXZ�
WFgc 4,0 ado 'd I.O.S5.410
.5'0$? e4,41 S 41,0/ 2- 1X91 47-
A r S1
04,V,41e
-Ce -0,0,e st, 7 � �el
c
4e-eC4 t'�4- 47- 60670,44 Xwli
TII,El /Cl (op Jv .0 -74 C t4lo ctJ V.0 oe mo / 4 7- 1414 1 S /00 / Al . -rA C�, # -0 V/-Sc o -z%,c c a s
sis-4�'.4il --e'o Ame 5."Or SCWX4 leaeo ooepo-Ixeco #Aio W,*Az
1-r '"AeACO al44reLr _�IOC40�06,f 1.5. t4&,UO. 4.0,VIJCo ca-�
A*e
0' Z'0.00JV4DJ Ul-0040 SEWO 9 C"Av XeoellOO -e'o' molircoe o4/- 7'5ssjD,0j 1$:;rCeVIIAJ C
IeO74 4t�r Z.04/ /4//�VO IeCt'��W4CIO ,97- 3 8 /, A e A no
-7'
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CITY OF EDMONDS
LAURA M. HALL
250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 77i-0220 FAX (206) 771-0221 MAYOR
COMMUNITY SERVICES DEPARTMENT
-1� go c� Q$ Public Works Planning Parks and Recreation Engineering
April 21, 1993
William C. Medin
515 - 9th Ave. S.
Edmonds, WA 98020
Dear Mr. Medin:
I have reviewed'your account and will allow a credit to your account
according to our City policy: the average consumption for the same
period during the previous year charged at normal customer rates, plus
the excess usage charged at the City's cost, plus a surcharge of 15%
apolid to the excess only. Only one leak credit will be granted in
any1hree year period.
Should you have any additional questionsafter you receive your new
billing, please contact Ilene Larson, Utility Billing Clerk.
Sincerely,
R o n H Ko-T' d
Water/Sewer Supervisor
RH/l k
cc: Ilene Larson
Utility Billing Clerk
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CITY OF EDMONDS BARBARA FAHEY
MAYOR
7110-210TH ST.S.W. - EDMONDS, WA 98026 - (206) 771-0235 FAX (206) 744-6057
COMMUNITY SERVICES DEPARTMENT - PUBLIC WORKS DIVISION
'A'S —9cj
t . 19
July 30, 1996
Mr. William Medin
515 - 9th Ave. S.
Edmonds, WA 98020
Dear Mr. Medin:
I have reviewed your account and will allow a credit from February through June 1996 in
accordance with our City policy. The policy states that the customer will be billed at the
retail rate based upon the average water consumption for the same period during the
previous year. In addition, the excess water lost from the leak will be billed to customer at
the City's wholesale rate with a 15% surcharge added for administrative cost. Only one
leak credit will be granted in any three year period.
Should you have any additional questions after. you receive your new billing, please
contact Ilene Larson, Utility Billing Clerk, at 771-0241.
Sincerely,
Ron Holland
Water/Sewer Supervisor
RH/lk
cc: Ilene Larson
Utility Billing Clerk
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8112 206th SW
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