522 ALDER ST.PDFiiiiiiiiiiii ii.
10045
522 ALDER ST
CITY OF ED�WDS
Call PRospect 6-1107 when work
CIVIC CENTER WATER -SEWER DEPARTMENT Is ready for Inspection. (No inspec-
tions Saturday, Sunday or holidays.) N2 1248
SIDE SEWER PERMIT STR EET FILE
ADDRESS........................... 5.2.0-Alde.r ... Stre-et- ........................................................................................................................
Alex Kuzmoff Owner
OWNER........... ..... ............................................................................ CONTRACTOR ...............................................................................
Permission Is granted ... June 28 ................ 19-fiA, 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 obtaln 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 sewer before it has been inspected.
NOTE No. 2--Obtain full Information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
TE 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.
QTE 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.
No. 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 ap-
purten&nces except to Insert the pipe into the wye.
PUMC WCRKS — EMINEERM
REET FILE
ACTION REPORT
- - 1
SUSPENSE DATE:
Date: Time: File #
'Attachments:
SUBJECT:
N? 2698 -
=Yes
=No
REQUESTOR: NAME:
ADDRESS:
PHONE:
-, T-5 Cy"
ef d
REQUEST RECEIVED BY:
TELEPHONE
CONTACT IN OFFICE r---j
OTHER:
RECEIVED
DMITP Tn-
=mom
MM
ACTION: -k;;,1R0KF-N MIAM-
All Concerned Notified
Action Completed/File
ADDRESS: f52-D 5�yee+
TAX ACCOUNT/PARCEL NUMBER: Db�OV
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS DETERMINATION: 0 Conditional Waiver 0 Study Required Waiver
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DA
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):'Lcol O�- -�y
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID
SHORTPLAT
SIDE SEWER AS BUILT DATED: Dbj�k,5—
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER: Mte-k
will Yx-, 5zz
LOT: BLOCK:
LATEMP\DSTs\Foffns\Street File Checklist.doc
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMT
OUTSIDE C] INSIDE E] REPAIRS M
CARD No . ..........
EASEMENT -No. ___
OWNER..4Z4 ........ 21--< . ......................................................... CONTRACTOR ........ a! --------------------------------------------------------------------- PERMIT No - ---- -- ---
STREET
No.
............. ........... . ............ AVENUE LOT .................. ................................. BLOCK No. -,I.a3 ................................
HOUSE No . ..... ------- 2� --------
NAME ADD. 1:2 . .... 424 .........
uj .....................................................................................
j
LL. -
I—
uj
Lu
co
BACKIFILL WORK ORDER ISSUED .....
SEWER WORK ORDER ISSUED ............
Date Approved:
.... DEPOSIT, $ .............................................
.... DATE .. .................. By
PERLDIETR*
7w 71-1,
HUM$
CtTY OF EDMONDS.
CONSTRUCTION PERMIT APPLICATION
ID!
L2PROMWO ---- A.W.-
W
541: 0
cs No
94 SPONS"feAA FOR LAO SION
cy:,
am;<.N$ MTIE
aw C
6?cn
CT*N
t vc O� PMIED
76 v%AwxNcE:cAcu 0
c)
COT CATE 0 C3 wO
sl A:;s -,GH1
5,EPA H:Vlviif F-0 L id
up DEMPT Ff to
jAx &,rCA�41 PALACTI L �Q;
P rTj
1. OT CrVE14AGE F'RON'
rl
REsocuML [3 pt.U%W4 I WCH ftlowto Fqo%�T SIDE RESP
m
0
0 At3CITON 0 C ER� L o =='Z, PAtIKMO Anso, PLA%W
MOD
0 APAMVENIT 0
m
m
0
-In
or"E'.
C
>
f"-x
o 0
0 TK
0 T-rE
0 M,
!-�PE OF ulsl:� euviess OR
z occcmsl
I SVLOLALimncm� IOAJ)
L%WJ'"-a,
m M
%Pat$
OCAE FIKS I- -MSPECnON Rr-IWD
C 0),
YvGpvc TO IK
jjoM PER UBC,ld&TMA
0)
^%t, VALUATION f-tE
co
Z,
sw
EAT scumcc
0
M
PLAN 14ECK NO:
t. ;WC,4 7--11 ;USLUIC
ot sr
SUPW=tgvwssIcm.
ppWrAmpucanoft.
Lmff. I TfAp - VIR3VICIED Via'"
suaAccor vmc p1pial N' :EE
ra 6--loe A`%' j 'if
lNrl
NG
CL SHEC'; 0`1 OSr*
=r,50ALL, EE PLAN -
QW1 PF.WQ P.Or-14171.7 I
195
'OSIN"'COCE AVOWN-1 CIA
APP CATION APPROVAL
PRO- ,Vill byl..
m CALL
"NIC=1
L.-S
FOR INSP ECTION Mf- -1 6"vw;
CrT
(42-5)
771-0220
EEXT 1333 ------
USE 01 OCCUPY A WL0046 Oft 5W'Rvc'�UqE- 771-0221 P IL
VT IS W%A�N�FUL;o
j 40 a�PPq
;,EE, ADE,%, :
,_j I . aJAL
KAS; tr"y FAX
FVIAL INSPEC"Ton.
occut:'1,14Y?4As BE EN GpAul E D., usc
V,
AIJer 5tre.
717 -i,
VN
I N
N: cs
42 0
v-
d 112AG.0 fl."
120.00,
13YOF ro" F�C
CONNECTITO
ALLEY
EX15TING C5
*ritical Areas Checklit FMENO
------------------------------------------------ -------------
Site Information (soil s/topography/hydrology/vegetation)
I Site Address/Location: 10�1 101611-
'Y
2. Property Tax Account Number: 2�2_ 102-3 OD �7, 0002-
3. Approximate Site Size (acres or square feet): —
4. Is this site currently developed? yes; no.
If yes; how is site developed? -51kL51_1e__ EZ2�4_t�z
5. Describe 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 1 0-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
I 0-feet over a horizontal distance of 3 3 to 66-feet).
Steep: grades of greater than 3 0% present on site (a vertical rise of I 0-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: h/01 ; Approx. Depth:
7. Site contains areas of seasonal standing Water: IVV Approx. Depth:
What season(s) of the year?
8. "Site is in the floodway Al/0 floodplain of a water course.
9. Site contains a,cree.k or an area where water flows across the grounds surface?'Flows are year-
round? Ab Flows are seasonal? _ (What time of year?
10. Site is primarily: forested ; meadow :shrubs mixed
urban landscaped (lawn,shrubs etc) PC
11. Obvious wetland is present on site:
C!, 's
..... .. .. . ... .....
ap 01
S�C�
.5. Wetland'-yi
ven ory. qr.
.. .. ..... ......
t! k6a" 0, "It
s e torydr. �A..'�*"':'*'*"'8'6iiis*�tiiic�l-*.* ns e
SiieW!thin..d-esi :'d irth.' bs�*'
gna.t.e... su ..i.4edde.' i�dslide
.. ...... . .
gite-d6si nAt6d.6n* d i S .... :Utive A�*Ma
ens
RECEIV
�F f t
The, Critical "i
An 'Or Vh—
_ATpAs: CheQklis.t,,,60ntained;'-O'n:.th.is.-f, 41
,,orrn 'fdS e 'rep
T-: reFs. fitkive, =st—fill out
'it to: the,
dh "Id.; t''
to.., be filled., 'Out by," an ��pe son''
PrqPa4A9.?4,,. ec is,,,,,,�sign and�s
Development,- Permit
Cit 6hecklisi, dke a
C Y,! M
enf�,"-�'precuisor "site, _'make� a -det ffiati -on of
Edmonds- prior, jo his/her'.8fibmittal": of"'' ' 5
Zevelopm' d
permit to the City. ,the
zd�velopmien
sar ete
y.,t6,`6orfipl
.:perniit*qppHc
4 �I.
The purpose bfthe Checklist is to: -enablb-,Ci
wi, e signed
rM e enti �Eri&
dete-' ine-- '*al gl Ar b jn�aj;�'al'ong' - th th
Wh e.as�-are,�� f 'thi' 'R 4sisj.-.C-ity%: t�& j�,,-.,.fn
OOK'� "PPPY, to I`
s ding.and
may. be, `pre'se".nt'_'o_n e' sU �j e c t:
proper
:T4e �.:-.Joca in&, e..- s eci �:q�jpiqqp f_
p o, property destribed- on
infbrmation:need,e,d to.complete'the Checklist." In ..addition;
should, 'this.fiormi: cant shall. include
be �easily available - from-''obser-vations7of- the 'site the -pe ��h hf
or o _ r, ent i oi mation-_.(e. sit
- 1 - '... 1 1 1 e plan, topogr:qphy
t
data �available- at- City HalF(i"_ritical7A-reas- " :L-:
inven ones,, niap, etc.,- �or, stu es- in c6i -this'
di i `
maps, or soil surveys).' =on with- Checklist
:-td: assist ".-staff- 'in -:",c g_.
minary
preli
assessmenfofi.the.site.:. _'�1;
41 '4 "I,_ A
I have completeid the'attache'&CHticall-
heeklist-.and �ttest that'Ui6 answers provided are- fadtual", to the
best -of my knowledge _(fill,f oufthe'',
appro
V!,
71;
Owner/A 71
�.,Ap�liciint�Repres*entative:*",�--o�'--,--��� C�
4�
?
Name
..Narne
j -7
74710 7
7_
Street -Address-
tri
1�3`U-A'S et-Addf6s�4 "i":,
64, �_;'
City .:.;State..,-:.. _1P City SWe.
IP
-U.
Telepho ----- - Telophone
Signature.
ig�q.atur;...,
Or,
Date
Xte,
creceptio nVaWcapf.doc .,'(over).,