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625 ALOHA WAY.PDFIIIIIIIIIIIIII 10151 625 ALOHA WAY JUL City of Edmonds --Water Department - TAP CARD Date - P221. 19 L .2.. L12.6-1, No................ .............. No ............ Meter Tap size . ....... ......... ........... ........................ I- I Sim ....... . Mfgrs. No ............ ...... . .. S�yle ................. .............. For ........ ?Z) . ...... ................................................................... .............................. . . .......................................... . ....... . ................ . .. . .. . ....... . ....... . ..... !7;tr .. 7= ..... - Lot No.- ............ Blk. No ........ . .. ......................... Add . ..... .... . ....... ...... . . ... . .. .. .. ... Service Location ........... 4? k. .. Meter Location Make Tap ....................... . ... ..................................... Pressure.............................. lbs. Test .................................... % SendBills to ..................................................................... .................... .. Date of Work ......... - ........ . .... . . . ...... . ......... .. ...... ........ ..... Foreman .................................... ... * ............ . . 4� Guar. Voucher No .......................... ... ........... $ .. . ....... . .... . ............... . ..... Remarks: ......... . ....................................................................................... ... ....... .......................................... ......... ........................... ......................... ..... .......... . . . ... . ...... . ....... . ......... . .................................. . ........ ....... . ....... OUTGOING Index ......... Reg.....Jko - ute Bk .... —.StendL._.CarcL INCOMING Index .... . ... Reg ..... Itoute Bk ... . ... StenciL.._Cu&.._... & terial Chargeable to Installationaters; NO._ ...... -SIZE DESCRIPTION , RAT��_ AMOUNT Meter ....................................... .............. .......... Meter Box ............................... I .......... . ... .......... Meter Plate ---------------------- * -- --------------- .............. .......... Check Valve -------------------------- ------------ -------------- ......... Pipe, Galv. Screw ............... .. .............. . ......... .......... ............. .......... Nipples ................ " ............. t --- -------------- — ---- - --- ---------- ............. .......... Bushings .................................. . ............ .. . ......... ......... ............... .......... Plain Ells ................................ .............. ....... ....... St. -Ells _.: ...... .. Tees ........... .. .............. ............... .. . ........ --- --- ---- ----- ---------- . .. ...... ....... ... .. ......... . ............... .............. . .. -------------- /_d� ---- . ---------- -- A10--__ ------------ .. ... .... ................ 7 ------------ ----- --- ---- --- ... .. . oer .... 62- W .............. .............. ........ ................. .... ............................. .................................. ................. .............. ......... . - ....... ........... ...... Material Chargeable to Taps Connected No. , SIZE DESCRIPTION RATE AMOUNT .............. I .......... Pipe, Black Screw .................. ... . ......... ............. ... .............. .......... Pipe, Galv. Screw .................. * -------------- -------- --------- .............. .......... Lead Connections .................. . ....... " ---- ----- -"'— * ------- .............. ........ .... ....... .. ... Curb Cocks ............................ Co . Cocks .......................... rp ................ .............. ....... ........ 3 .............. .......... Unions .................................... .............. ............ ......... ---------- .......... Saddles ................................ ... .............. ..... . .. . ......... .............. .......... NiPples .................................... ............... ......... — ............... ......... Bushings .............................. ... .............. .... . .. . .......... ............... .......... Plain Ells ................................ ............ .......... .. ...... ... -------------- ---------- Street Ells . .......................... ... ............. _._7' ------------ - .......... Tees ........................................... ............... ......... .. .......... -------------- ---------- Curb Boxes ............................ .............. .... . .... .. .......... -------------- ---------- S. 0. Extensions .................... .............. ............ .... . .. . ............... .......... Gates ........................................ ............... ............ ........... .............. . Plugs ........................................ Couplings. .. .............. ............... ------- - .... __7_.. ---------- .............. .......... Gate Boxes ............................ ............... ..... . ...... .............. .............. ............ .......... .......... .......... ..................................................... .................................................... ........................................................... ---------- ............... ......... . .. .... . ......... .......... ........... .... ........ 1� .............. .............. .......... �.� ... ........................................................... ......................... 2t�: -------- .............. — ---- ............. .............. .............. . ........... ------------- .......... .. ............ ............. . ... ... . ........ . .... . .. .......... .......... .......... .................................... ................ ........................................................... .............. ............. . ..... .......... .......... . ........ ........................................................... ........................................................... ........................................................... Hours Time —Day Men ........ Hours Time —Monthly Men .. .............. .............. .............. ............... .... i .......... ............ ....... . ... ............ ..... . ........ . .... . .. .......... -- ------- — ....... .... .... Hours Time�Auto ............ ... 'Juperintendence ...................... ... ... .............. .......... TOW ------------------ ----------- --- I - 111-7 4Y �—_�S-773 ADDRESS: TAX ACCOUNT/PARCEL BUILDING PERMIT (NEW STRUCTURE): COVENANTS (RECORDED) CRITICAL AREAS'c/ — DETERMINATION: E] Conditional Waiver Ej Study Required F] Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED FOR: PERMITS (OTHER): Aqui wo PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: c 5 BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: WATER METER TAP CARD DATED: -1 OTHFR:��n q�o-2-ACF, LATEMP\DSrs\Fbnns\Street File Checklist.doc 7— 'APPUCATION BUILDING PERSJ.� CITY OF EDMONDS WcOng Depwftneo Ap pl. Mi.' pe;inlit lin� APPUCAlrION is herclay made for a pm= to ommtr= a, fdt.,ng: ,k. in acoardanm� with tbee acccc-6�'� panying plans and Vecificatimm. -T,.a sem am hu,,fth fr Ppm,,L ied nf.w _"' alter repair ......... Off-SL Woek addn ................ Parking Occupancy ....................... Consc. Use zcmt.._�� Fire zone.._ --- Address ......... Lctn��L Blk ........... Addr Lot inxitage .......................... ... ... septi, "OL., '41" B14. &M+=6 front -------------------- r. L 0, Addr-zis. ....... .'TeL'N . . . .. ... Builder........................... .... . . . . ................. TeL No . . .. . ......... Plansby ............ ...... . .............. .................... Tel. N o . ......... Remarks ............ .............. .... ................................. . . . . ............. .. . ....... �4 1 2gMe �O CDMPIY With 211 71e ibovt is I Co. - e-t statement, a work. VPH.W Codes avid -State laws rtgulati;i Sign--d Owner/Agent.::, PEWbT for the abow. work is hereby app"d. subject to the above mr-clitions, and to 0= the'a psaved plans and spedficationg, znd Building Department not2tioto thereon. P--a;,t Rocd, 14 Valuation _51 Building Depar-rient, NM. Th does done in th tt 01C not c""Cr blumbing, sewer. or electrical *utaUarjow C Rig t of Way areas. Dv;��ways and w4waY, must he Planned t ii� uia�rk 9A ' i—, 'Of and alleys, "d Plaw fOr future sidewalk demloponent. 41 A� A APPLICATION The City of Edmonds for EASEMENT NO - -------------------------------------------- SIDE SEWER PERMIT 214-09300 NEW CONSTRUCTION E:1 REPAIRS E] LID NO . .................. . ASMT. NO . .................. OWNER ............... E�4&gp!�� lamson ------------------------- ---------------------------------------------------------- PERMIT NO - -------------------- __Lt ... A.c ----------------------------------------------------- CONTRACTOR 625 Aloha JOB ADDRESS ------ --------------------- !�-qy -------------------------------------------------- LEGAL. DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------ 0 ........................ ----------------------------------------------------------------------------------- ..................................................... NAMEOF ADDITION .......................................................................................................... ---------- - DYE TESTED ON SEIVER - May 6,, 1976 By Jim Jensen Approved: DATE............................................ By ............................................................ 11/75 City, of Edmonds* RIGHT-OF,WAY CONSTRUCTION % ay PERMIT Permit Number. 161 -6kll Issue Date: -"*?0- '9651 A. Address or Vicinity of Construction: .625 Aloha Way qTE to place, operate, and maintain a DUNN -Se—rvice -T of Work (be specific): w'i re f rom exi sti n' pol e #1408 1 ocated at 625 Al oha Way tAW 9 .8 9 0 -1 9 C) an north to a residence at bZb Aloha way. UIL to plow 90 teet, pusFone driveway and no roads.. Mary A Bower, Permit Coord. C. Contractor: GTE Northwest Incorporated Contact: Dennis Alexander 771-9036 or mobile 388-1358 2312C W Casino Rd Phone: Mailing Address: Everott, WA 98204-14 0 Mary 20GA88-1628 oc 710-4130 State License #: Liability Insurance: _ Bond: $ D.. Building Permit #0f applicable): Side Sewer Pe rmi t # (if applicable): E. 0 Commercial E] Subdivision El City Project [3 Utility (PUD, GTE, WNG, CABLE, WATER) E] Multi -Family [:] Single Family E] Other 2100-9POOlDB 242310 INSPECTOR: INSPECTOR: F. Pavement or Concrete Cut 0 Yes QNo G. Size of Cut: H. Chargq�� Please see attached ske EAD AN43- MN APPLICANT TO R 7 INDEMNITY. Applicant understands and by his signature to this app0ation, agrees to hold the"City ofEdmond8 harmless from injuries, damages, or claims of any kind or description what80eVer, foreseen or unforeseen, that -",be made against the City ofEdmondg, or any of its departments or employees, includingornot limitedto the defense of any legalproceeding8 incluXngdefen8ecost8, andattorneyfee8 byrea8onofgrantingthispermit. THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIAIS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK ESTIMATED RESTORAT[d�V FEES WILL BE HELD UNTIL THE FINAL STREET PATCH - IS COMPLETED BY CITY FORCES, AT WHICH TIMEA DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THEAPPLICANT Construction draMng of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220. Work and material is to be inspected during progress and at completion. ReA,oration is to be in accordance with City Codes. StrE�t shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. Ihav*e read the above state ents arpd-witierstand the permit requirements and the pink copy of the permit will be t all 1 tl available on site a i e for Date: Signature: John H. Stewart September 12, 1996 (Contractor or Agent) Oprns Supv-�OSP Engrg. CALL DIAL -A -DIG PRIOR TO, BEGINNING WORK FOR CITY USE ONLY, APPR OVED BY: RIGHT OF WAY DEPOSIT TIME AUTHORIZED: VOID AFTER DAYS SPECIAL CONDITIONS: Or COMMENTS: DATE: DISRUPTION FEE/FUND Ill: RESTORATION FEE: �1 PERMIT FEE: TOTAL FEE: 0 d ISSUED BY:' MOO., M ad NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE Eng. Div. 1994 FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.) Comments: I Dialzrany: % PONTRACTOR CALLED FOR INSPECTION El YES NO Partial Work Inspection by P.W.: Work Disapproved By: Date: FINAL APPROVAL BY: Date: f-e-W, - LEGEND PERMIT SUBMITTED BY GTE PEDS a POLES 0 ROAD BORES OVERHEAD LINES— I.D.UTILITY P21V E C:3 ,�br .T__7 UG TRENgHl j yj V r ,)O'p'Oo -- - - - - - - - - - - - - - - - - - - - - R LONA WRY - -- - - - - - - - - - - - - - - - - - - - - r -f \ ft,lt% -.1c ,Nsli- %01111 R.O.W. EOP CD -Q -K i cn 'HE FOLLOWING INFO TO BE PROVIDED Z 11GHT OF WAY LINES.EOP OR FACE OF CURB. EXISTING SIOEWALK. POLES. ROAD CUTS AND THE UTILITY UNDER ROAD CUTS, -p cn X�l i,80VE GROUND FACILITIES.(Ie.-) PEDS.BOXES.CABINETS. E TC.,UNDER GROUND TRENCHING AND OVERHEAD LINES. :j 'OOTAGE OF WORK IN R.O.W. 0-0-il I LEGEND PERMIT SUBMITTED BY GTE PEDS a POLES 0 ROAD BORES OVERHEAD LINES I.G. UTILITY P?jV ,�GbLf 1=3 UG TRENCHRA GT- -------------------------- �ock\ L. ofi A ui ff ---------------------- 'r -f \ ftp -Ir ic:�st SNP 0 v Dk 0) R.O.W. 0 EOP 'HE FOLLOWING INFD TO BE PROVIDED i z IIGHT OF WAY LINES.EOP ORFACE OF CURB.EXISTING SIDEWALK. POLES. ROAD CUTS AND THEUTILITY UNDER ROAD CUTS, -p Xhl i,80VE GROUND FACILITIES.(Ie;) PEDS.SOXES.CABINETS. ETC..UNDERCROUND TRENCHING AND OVERHEAD LINES. -OOTAGE OF WORK IN R.O.W. U *V , 890 . 19 C� 40 CITY OF EDMONDSSTRER FILE LARRY S. NAUGHTEN 250 - 5TH AVE. N. - EDMONDS, WA 98020 - (206) 771-3202 MAYOR COMMUNITY SERVICES: PETER E. HAHN Public Works 9 Planning 9 Parks and Recreation 9 Engineering DIRECTOR December 20, 1990 Eugene L. Adamson 625 aloha Way Edmonds, WA 98020 Dear Mr. Adamson: 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% applied to the excess only. Only one leak credit will be granted in any three year period. Should you have any additional questions, please contact Ilene Larson, Utility Billing Clerk. Si ncerely, z-) I.. U Ron Holland Water/Sewer Supervisor BM/l k cc: Ilene Larson Utility Billing Clerk #113400/TXTWATER 0 Incorporated ALI-qUSI 11, 1890 9 Sister Cities International — Hekinan, Japan ov 2�� S— D p 10 07 a o-S 67-S IV (2.0 A.). ./k/O C, L n--m �,D Ilu la-, /F F T -5 4 9.P --f 7 /u, o fl / '� p ;r' / 5' 9 o -t OC- fr, 7-C vL 7— r x-� c--- �7 4E 7,7 6 oz c) /F r7-4z e (_6 e4 13 R -).D P, 7 14->, 0 T L) U yz c o ve 1 0 Li 4c-7-- Y c -7 7