636 HEMLOCK WAY.PDFIIIIIIIIIIIIII
11489
636 HEMLOCK WAY
CITY OF EDMONDS — SIDE SEWER PERMIT
WATER -SEWER DEPARTMENT
PERMIT
Call 775-2525 for side sewer inspections BEFORE covering any portion of the construction.
Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections.)
ADDRESS LOCATION OF CONSTRUCTION .... (n.:a.6x ..... I.J., C-:- A.- A__L(A.Ck ..... WA ... y ................ . .......................................................
PRO?ERTY LEGAL DESCREP17ON ..... LaT ----- C .......... G. 31. (in .... AFM.L.0..C..k ...... \A/
...................................................
..........................................................................................................................................................................................................................................................
................................................................ 01VNER,1%ND/OR BUILDER ...... LtF,?.0 ....... S.. 14_/�.LD --- 0-M ..... . .......................................................
CONTRACTOWS NAME & ADDRESS ....... ------------- S.-F)ALF-J� ........................ . .......................................................
Permission Is granted ..... A (J. 3,L) ........................... 19.2?, for repair and/or connection of a side sewer to the city sanitary sewer
system in aeeordanee with City of Edmonds ordinances.
ENTION IS CALLED TO THE FOLLOWING:
E No. I —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—All work performed in city right-of-way requires an Invasion of Right -of -Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line axLd 12 inches inside property line; minimum grade of 2%. No bends in grade
sharper than % will be permitted.
NOTE No. 5--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. 6—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 appurtenances except to in-
sert the pipe into the wye.
DISAPPROVED 0 Date ... . ....... i ............................ By
APPROVED Date
--- ---------
Remarks: ....... . ...... . ........................... . .. . ............
.......... Date ......... . B y__ X ............ Date ............... . ................... . By ................
.......... -,Z ---- ff-+. 4 , ..............................................................
..................................................................... . ............................................................................................................................ _ .......................................... .........
BOT Permit Copies ST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
'S
i,irm
r
. .. .... ...... .. .... .. ... .. . ..... ... r .......... .... hereby certify that the side sewer installation constructed under this permit
f-rn`u
v
w, r or
(9wnr A�ofContracting Fnlrm rforming Construction)
el
install Tdin accordance with all g verning ordinances of the City of Edmonds.
Datedthis ............................. day of .... 4 ............................................. 1 19.,
V V Check BEFORE you dig for: Water 0, Gas E], Telephone E], Power E], Sewer [3, Other E] 4 -4
APPUCATION
A* City of Edmonds for EASEMENT NO - ---------
SIDE SEWER PERMIT -----------------------------------
NEW CONSTRUCTION REPAIRS LID NO - ------------------ - ASMT. NO - ------------------
OWNER --- -------------------------------- CONTRACTOR
.............. PERMIT NO.
JOB ADDRESS --- -------- ----
...... LEGAL DESCRIPTION: LOT NO - ----------- c�"
-- ------------------------ BLOCK NO - ---------------------
........................................ ................................. --------------------------------- ....... ............................................
NAME OF ADDITION
CO
Approved:
DATE ....... --.7,7 .......... � By.
---------- A-
4
The City of Edmonds
APPUCATION
for
SIDE SEWER PERMIT
EASEMENT NO - ------
NEW CONSTRUCTION 0 REPAIRS E] LID NO - ---------- ------- - AS1,4T. NO - ------------------
OWNER 477-±F-ER 1-2—
........................................... CONTRACTOR ------------------- PERMIT NO - ------- * ------------
------------
JOB ADDRESS -----
............ --------- ......... LEGAL DESCRIPTION: LOT NO. --C ------------------------------ BLOCK NO - --------
1�1
NAME OF ADDITION --------------------------------------
Lk) 41
Appro-ed:
DATE
By--------------------------------------------------- iiyfg
�I �� ��.- � -��� �� �� ������ ��
L_��x] [� J ~-~
|X:PT. (ITT[ LIST"
Utility Exscmnnt
Site Man (11ccl.ed for Accuracy
- .
_-
| U ----------�--�
� [xisd/ig �xtcr�Inio Sizc
\jLcr .aio rrcoircJ A/A �
�i7c isci'l!
-
,.
Pecccrnr ("`(,c" �ctcr Rc�t4rc6 AIA
-
�
, -'__--__--_-_--__----'----_--'---_�----__--__'-_'-_---___'
suurncy '
[
�
Fuc
~ /
Sjdc )c�crArxi].-Ihil{c'
,-__---_
So-nr (}xxncctiou Foo Pc/!oirod
} � --------'--'---'---------
nx1c.
c'
'
o Culvert -/ rc /�4 rro
/
�
uuu.Indicate — !7' - Plan
�o} ion \n �LcmJ/�
'�2/' -- |
/Un�r` /
|!,1/1,11olc rcnilircd ludicntr m1 Site plo`
Soil. CmnGitimx Ground Kutor Field
}(cvio: Dxc .
' | -' -------- ----^--~~�--"��----------- ' |
|-_�--_JL'_-_---___--_- --------- ---------------------------
---------------'
�
.o'
«��
AMIL 1
USE _RMIT
!"BUIXONG DEPARTMENT"'mp Applicant Fill ZONE NUMBER
PERMIT APPLICATION Inside Heavy Lines JOB A � —6
�MF)(OR NA(tE OF BUSINESS) ADDRESS
VARIANCE OR COND. USE NO.
ADB NO.
HEIGHT
MAIL. G AD ESS
z
PWVPe9e15'-YARDS
COVERAGE
I
ILOT
CIT
TELEPHONE NUMBER
FRONT SIDE
REAR
��Ll C
SIGN AREA
ENVIRONMENTAL REVIEW
L1
ALLOWED PROPOSED
-1 COMPLETE EXEMPT
E
NAME
REMARKS
W ADDRESS
PLANNING DEPT. A
U
It CITY TELEPHONE NUMBER
I
LEGAL LOT
LOT AREA
DIV15ION NO.
WYES 0 NO
I 15UB
S-25--71
NAMg��,
":'S
STREET R/W
/'q-P-//1
0:
EXISTING STREET R/W 3C- FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W 3c) FT. FT.
0 ADDRESS
I-
U
<
a: CITY
TELEPHONE NUMBER
REMARKS
Driveway slope not to exceed those
I'_
z
indicated on Standard DrawinQ 103.
0
CHECKED BY
U SMATE LICENSE NUMBER
CITY LICENSE NUMBER
z
0
CL
i
U
V)
W
0
.J
S
.J
Z
CL
E
U
In
W
0
R
wo/ P/) rl—. '?Ct
IV,r
04�er.7�f
:I
/_? - 00 <'?
I ji 3V
Legal Description of Property (Sho BeloW or Attach Four Copies)
STREET AND/OR UTILITY WORK
REQ'D. IbYES ONO
R/W PERM I T REQUIRED
49 YES ONO
UNDERGROUND
WIRING REQ'D. '%YES ONO
TYPE CONNECTION
SANITARY SEWER
* YES IVERIFIED
0 NO
By
W=
SEPTIC SYSTEM
APPVO BY CITY ENG.
0 YES
9 NO
PERMIT NUMBER
REMARKS
METE7R;'SIZE,, ISERVICE
SIZE
ICLEARANCE
CHECKED BY
REmARRS
NEW RESIDENTIAL
NON-RESIDENTIAL
ElADD ELI
DEMOLISH
F�ALTER EXCAVATE
OR FILL
0 REPAIR PRE -MOVE
INSP.
GAS
LINE
SIGN
RETAINING
DWALL
FENCE
1:1 (_ X—FT)
swim
E] POOL
FIRE ZONE
TYPE OFCONSTRUCTION ICODE
I
SPECIAL INSPECTOR
REQUIRED
0 YES 0 No
JAREA
jOCCUPANCY____7
GROUP
LOOCAC DO P A N T
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED' 31,04,
REMARKS
NUMBER OF STORIES
(�Z_
NU BER OF
DWELLING
U IT
I N M S
—
NATU., F WORK TO B E D 0 N E..
/7.
PLOT PLAN (INDICATE BUILDING SETBACKS,
ABUTTING STREETS)
VALUATION FEE
PLAN CHECK
NO.
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
Z
Z
W
W
Z
W
m
W
I-
0