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580 12TH AVE N
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APPLICATION
01TREET FILE for
The City of Edm SIDE SEVVER PERMIT
OUTSIDE E] INSIDEg REPAIRS E]
OWNER.......... .................. .................................
HOUSE No . ..........
. ... ........................... jef . ....... 44 ...
CARDNo . .......................................
EASEMENT No . ............... 71�. ..................
............ CONTRACTOR .......... --- ------------ ................. PERMIT No.
STREET
............ AVENUE LOT No . ........... 1-f ------------------------------- BLOCK No . ...............................................
6-4
NAMEADD . ............ i ---------- ---------------- i�— ... --- / .....................................................
Date Approved:
BACKFILL WORK ORDER ISSUED ................. ................. DEPOSIT, $ ..............................................
SEWER WORK ORDER ISSUED .......................................... DATE ........ ... By
.................................... ...................
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CITY OF EDMONDS
CIVIC CENTER — WATER -SEWER DEPARTMENT Call PRospect 6-1107 when work
Is ready for Inspection. (No inspec-
SIDESEWER PERMIT tions Saturday, Sunday or holidays.) N2 1194
ADDRESS .......... _5�QQ ... !��elf tb—Amen.qe ... N.o.rt.h ...................................
OWNER ........... Lyle ... Zapara -------- -------------------------------------------- CoNTRACYTOn .... ..........................
Permission Is granted ... . .... ........... 19-64., for ...................... daysp 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 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.
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.
NOTE 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-
purtenances except to insert the pipe into the wye.
'Z�"0-1 5z;
PEPT. (IMCK LIST
li'VILDING PEP�UT
TRF;:T
--A --� a I EL I —
Street PdVht-oF-1-:a-%r ExistinF
Access 1-asemmits Existing REM
N 1-5:
Utility Eascincia Existina-M n ME PJ70!)
Lot Per Suhdiv4sion Plat N, Assessor 1'ap
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11,111hok requircd
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B (o) n cl Requirc(I for Rib Improvements,
Street N"'111 .'MI 'Re(iiired
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