The URL can be used to link to this page

612 ALOHA WAY.PDF11111111111111 10146 612 ALOHA WAY AM ------- - ---- - - City of Edmonds --- Water Department TAP CARD D ateo MeterNo .................. I ............ Tap No .................. ............... ...... .............................. size . .............. . ................... Mfgrs. No .............................................. ..... For................... ........ . ...... ...................... . ........ . . ................ ....... LotNo ............................................ ilk. No ........................................ . .... . Add. ..................................................................... ........ . ........... ..... . Service Location .................................................. . w ..... ...................................................................................... . ....... . ....... . ...... . ............... MeterLocation ............................................................. ........ . ..... MakeTap ........................................................... . ....... ........ . ........... . .......... . .... — .................................................. . .................................. . ....... . . ....... Pressure .............................. lbs. Test ....... . .......................... % SendBills to ........................................... ........ ....................... ................................................. ........ ........ ........................ . . . . . . .......... Date of. Work ...... ....... :H?2� ..... 4 P_ .... 6-1 ----------- - .................................... ! ....................................... . ................................... Foreman Guar. Voucher No ................. ......... ............... $ ... .................................... Remarks: ......... . ........................................................................................... ...... OUTGOING Index ......... Reg ....... Route Bk ..... —StendL_Car(L_ INCOMING Index ..... ... Reg ....... Route Bk ... . ... StenciL...-Card..._ ;0100, 1 -riai %-.nargeaDle to Instanation qI2Z rs N 0. E DESCRIPTION Meter ...................................... RATE ......... . ... AMOUNT ------ . .... . ... ------------- ---- ----- Meter Box .............................. ......... 4 .......... d.4 ............... .......... Meter Plate ............................ .............. .. . ......... . ....... ------------- .......... Check Valve . ........................... .............. . . .... . ... . .......... .............. ......... Pipe, Galv. Screw .................. .............. .. . ......... .......... ............. .......... Nipples .................................... .............. . . ......... .......... -------------- ---------- Bushings .................................. .............. ............. .......... ............... .......... Plain Ells ................................ .............. .. . ......... .......... -------------- j ---------- - --- ---------- ----------- St. Ells ................................ ... Tees ......................................... .............. .. . ..... .. .......... -------------- ............... ---------------------------------- .... ..... ............................ ................. .......... ..... .................................... ............... ---------- -------------- .......... ........ ---------- .................. ...... ........... ......... . .. ... . . . .... ...... ........... ............ ...................... ---------------------------- ------ .............. .............. .............. .............. ------- 11 ............ ....... ........ r ......... .. ------------ j .......... ........... ........... Material Chargeable to Taps Connected, NO. , SIZE I DESCRIPTION RATE AMOUNT .............. I .......... Pipe, Black Screw ................... ------------- ............. ..... ... .............. .......... Pipe, Galv. Screw .................. ........ ; ...... ............. ......... -------------- ---------- Lead Connections .................. .............. .......... . ......... .............. ------ / ...... . :4 ------ . Curb Cocks ............................ Corp. Cocks ... ........... ............ ............... .............. ............ ..... � ......... .............. .......... Unions .................................... .............. ............. ............. ---------- Saddles ................................ ... .............. ..... .............. ............ Nipples . .................................... ............... ........... . ......... ............... ......... Bushings .................................. ............... ........... .......... --------------- ---------- Plain Ells ................................ ............ ............. .......... -------------- ---------- Street Ells .......................... ... ------------- ---- - ---- -- ----- --- .............. .......... Tees .......................................... ... ......... . -' ---- - - ---------- .............. .......... Curb Boxes ............................. .............. ------------- --------- .............. .......... S. 0. Extensions .................... .............. I ............. .... . .... ............... .......... Gates ........................................ .............. ............ ........... ....... ...... ... Plugs ............. ......................... ............. ............ I ----- ------- Couplings .... :2�� ------- -------------- ..... / ..... .......... ............. .............. .............. .............. ...... ............. .......... .......... .......... .......... .......... .......... Gate Boxes ............................ ..................................................... .................................................... ............................................................ ........................................................... ........................................................... .............. ............. .............. ............. -------------- .............. ............. ............ ............ ! . ......... -- . . ....... ............. .... . . ........... .......... .......... . ....... . ....... ------------- .............. .............. .............. ............... ............... - --- ........... .......... .......... .......... .......... .......... - -------- ........................................................... ........................................................... ........................................................... ........................................................... ................ 7 .......................................... ........................................................... Hours Time —Day Men ........ .. ----------- .............. ......... .... ............... .............. ............... ............... ............. ............ ............. ............ ............ ....... . ... . ........ .......... . ........ . .... . .. ....... .. ----------- ..... -------- 7 3 .... Hours Time —Monthly Men .. ............... ---- ** - --- ----------- ............... I ---------- 1 Hours Time —Auto ........... ) ... .............. - - ---- - --- ---------- J------- 1,3 ..... I Superintendence .................... ... ------ * ............... ------------ - - ------- ............... I .......... ; Total .............. ... I ............ .......... TAX ACCOUNT/PARCEL NUMBER: BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) FOR: CRITICAL AREAgt-r� DETERMINATION: Conditional Waiver E] Study Required Ej Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN. DA PARKING AGREEMENTS DATEE EASEMENT(S) RECORDED FOR:. PERMITS (OTHER): PLANNING DATA CHECKLIST DA SCALED PLOT PLAN DA' SEWER LID FEE $: LID SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED-- 611DIA0 SIDE.SEWER PERMIT(S) #: GEOTECH REPORT DATED - STREET USE ENCROACHMENT PERMIT #: WAT ER ME -TER TAP CARD DATED: U) OTHER: LATEMP\DSTs\Forms\Street File Checklist.doc APPLICATION The City of Edmonds for EASEMENT NO - -------------------------------------------- SIDE SEWER PERMIT 214-09050 NEW CONSTRUCTION F-1 REPAIRS E] LID NO - ------------------ ASMT. NO - ------- I .......... OWNER ............... Arthur Tu rner ----------------------------------------------------------------------------------- PERMIT NO - -------------------- -------------------------------------------------------------------------------- CONTRACTOR . JOB ADDRESS ------ 61-2 ... Aloh-a-Way -------------------------------------------------- LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------ 0 -------------------------------------------------------------------------------------- I --------------------------------------------------------------------------- NAMEOF ADDITION ----------------------------------------------------------------------------------------------------------------------- DYE TESTED ON SEWER - May 6, 1976 By Jim Jensen Approved: DATE............................................ By ............................................................ 11/75