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623 ALOHA WAY.PDF1111111111 lill 10150 623 ALOHA WAY PARM JUN 10 1960 ............. . .... . .. . ... District ' 0 City of Edmonds --- Water Department'. TAP CARD .. IqEG-- MeterNo ............................... Tap I No .................. .............. . ..... I.Size . ............................. Size ................ .................. Mfgrs. ....... . ... For ....... �07., i. , ................................ ----------------- - --------------- ----- .................................................................... ................. ......... ....... LotNo ........................................... Blk. No . . . ....... .. .................... Add. .................................................. . ....... ........ . . ....... Service Location ....... . ld..A-5 ... ............ ...... Zia. M� �L�.. Meter Location MakeTap ............................... ...................................................................................... . ............ w ........... Pressure ..................... . ........ lbs. Test ....................... ............ % SendBills to ............................................................... ................. ........... Date of Work ..... . ....... W. �; 7. A& fA- Foreman Guar. Voucher No ........................... . .............. $ ........... . ....................... . ..... Remarks: ......... . .................................................................................................... .................................................. . ................ . ..................................... . . . ...... ... ........................................ . .............................................................. ....... ................... ......... . ........... .. . ............... . .................................. . ...... . ..................... . .. .......... . . ................................................................... . . ................ . ....... ................. . ................... ............................................................ ......................... .......................... .... ............ OUTGOING Index ......... Reg ....... Route Bk ........ Stencit.-.—CardL.— INCOMING Index ......... Reg ....... Route Bk ......... Stencfl--.--Car&..-... terial Chargeable to Installation NO. ZE DESCRIPTION RATE AMOUNT 3�vl —. /— z ----- .. .... .......... eter . ...................................... Meter Box .... ......................... .............. .............. . . ....... ............... ........... Meter Plate ............................ .............. ............. . . ....... -------------- ---------- Check Valve .......................... .............. . . .... . ... .......... .............. ......... Pipe, Galv. Screw ................... .............. . . ......... .......... ............. .......... Nipples .................................... .............. . . .... . ... .......... .............. .......... Bushings .................................. .............. .... �7 ....... .......... --------------- .......... Plain Ells ................................ .............. ....... .......... ............... I .......... St. Ells ................................... ... .............. ............ .......... .......... . ... I .... ..... - . Tees ..... .... .... ..... ... ...... . . .... .. ..... ... - ------ --- ............ ... ............... ............ .. .... 7. .......... . ......... ......... ............ .......... ... ............... ...... ....... ............. ............... .. ... ............................................. ........ - ... .............. -------------- .............. ......... . . ............ ............ ........... . Material Chargeable to Taps Connected NO. SIZE DESCRIPTION RATE- AMOUNT ............. I .......... Pipe, Black Screw ...... ............ ---------- .............. .......... Pipe, Galv. Screw .................. ............... ............. ......... .............. .......... Lead Connections .................. .............. .......... . ......... ...... ...... C b Cocks ........... ­ ---- I ....... CoIrPD. Cocks .............................. ** ------------ .............. ..... ...... '727 .............. .......... Unions --------------------- ...... .............. .......... Saddles ................................. ... .............. .......... . .......... .............. .......... NipPles .................................... ............... .......... . ......... ............... ......... Bushings .................................. .............. .... . ..... .......... ............... .......... Plain Ells ................................ ............ ............ * ----------- .............. .... ----- Street Ells .......................... ... ............. .......... .. .......... ------------- .......... Tees .......................................... ............... ... . .... . . .......... .............. .......... Curb Boxes ............................ .............. ............. .......... ........... .. .......... S. 0. Extensions ..................... ........... .. ............ .... . .... ............... .......... Gates .............. : .......................... .............. ............ ........... .............. .......... Plugs ......................................... .............. ............ . ................ .......... Couplings ................................ ............... --------- .............. .............. .......... .......... Gate Boxes ............................ .................................................... .......... .............. - .............. ............ ..... ---- .......... -m ..................................................... ................................................. ......... ............... ............. ...... - - ----- .............. .............. .............. .............. .............. .......... . ........ . . ........ .......... .......... ........................................................... ........................................................... ............................................................ ........................................................... ........................................................... ........................................................... ............. * ............ ............ .............. ............... .... ..... . ---- - - -.1 ............ ............. ............ ......... 94 .......... .............. ............... ............... .............. .......... .......... .......... - - - 16'iC: I .......................................................... ........................................................... Hours Time —Day Men ........ Hours Time —Monthly Men ............... ............... ............... ............ .. ....... . ... 7- .......... . ..... .. ----------- .............. - - I .......... . .. Hours Time —Auto ............ ... .............. .............. ....... . ....... .. .............. .......... Superintendence ........... " ---------- I --- - ------ **' . 1�� 0 . ............... .......... . Total .................. ............... ADDRESS: TAX ACCOUNT/PARCEL NUMBER: BUILDING PERMIT (NEW STRUCTURE):19 0 t 2a I COVENANTS (RECORDED) CRITICAL DISCRETIONARY PERMIT DRAINAGE PLAN DA PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DA' SEWER LID FEE SHORT PLAT FILE: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: DETERMINATION: []Conditional Waiver E] Study Required E] Waiver q WATER METER TAP CARD DATED: (-01 w b 0 OTHER: LID #: LOT: 4 BLOCK: LATEMP\DSrs\Forms\Street File Checklist.doc AM: A— ' G A VW, wh �T, --------------- AppVN, .... ... . . .. BUILDING TERVIT APPLIpejmk. Deparl"I'le . CITY OF EDMONDS V;ith Abr_acolm� "-'I ct tbe following —k- 'n'_1Co6A"_ APPLICATION is hereby made for & perMit to consm 40 wbutimd hde-11th for -PP-YaL . . . . . . . . . . . any' set' ae p ing pl�. and specifications. T Off -St new.. ............ . ...... ... . . . ....... .. . ...................... Work addr, repair .................... 7 Uk Const- type ............ occupancy Add ......................... Addru . ......... .... ....... septic tank ............... 4 Lot frontage ...... Lrea. pw.. ........ r. side .......... ........... 1. side ........ front V.dg. set-b-As N......... Ad TeL.Na.- Addr — - ---------- . ......... Builder ................... W. Tel.- .... Addrm ................. ......... . ..... .Plans by ....................... ................ .................. . . . ... .............. Remarks....................... . ....... . ..... .... VIV . ................ . ..... ............. ..... ...... .......... .................. ........... ............ ................. .7 .......................... .... . . . ....... . ............................................. 'A State "ws teg tmg. with an applicable Codes d I agree to —Ply ne above is a co�rect statement. all N work Da Signed Owner/Agent—__ the above Londiti-os, -0 for the aN, work is hereby approved. subject to en %,,,,proved plans and specificItilm and Buod'ng Departm t notations tbereom Pr. MIT Aap ........ Reo(L ..................... - Dal— Iding Departintr1tv By ... ........ or Elearical .nst�-- This permit does not cover Plu"d�'ilg- Sewer 7�1 1 A 4­_ APPLICATION The City of Edmonds for EASEMENT NO - ----------------------------- -------------- SIDE SEWER PERMIT 214-09400 NEW CONSTRUCTION F1 REPAIRS El LID NO. .— .............. . ASMT. NO. -- .............. OWNER Mrs. M. F. Lorenz ...................... ---- CONTRACTOR ................................................................................. ... PERMIT NO - -------------------- JOB ADDRESS .... 623 Aloha_l�qy ................................................. LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------- . ...................... --------------------------------------------------------------------------------------------------------------------------------------------------------- NAMEOF ADDITION ----------------------------------------------------------------------------------------------------------------------- E 40 Yj 0 DYE TESTED ON SSIVER - May 6, 1976 By Jim Jensen Approved: DATE............................................ By ............................................................ 11/75