641 BIRCH ST.PDF11111111111
10322
641 BIRCH ST
ADDRESS: 3
—b— ql c
TAX ACCOUNT/PARCEL NUMBER: T) 05�5 q r0-600 JUI)Q
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS:L/ DETERMINATION: 0 Conditional Waiver 0 Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID
SHORTPLAT
SIDE SEWER AS BUILT DATED: �/ I q
SIDE SEWER PERMIT(S) #: /Yfl
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
LOT: I (p — BLOCK:
L\TEMP\DSTs\Fomis\Street File Checklist.doc
The City of Edmonds
APPLICATION
for
SEDE SEWER PERMT
OUTSIDE,E] INSIDE REPAIRS E]
CARD No . ......
EASEMENT No.
OWNER ...... -TRACTOR ..... c F/_�7 ............... PERMIT No.
...... SY
.............................................. ................ ................. CON ..................................... ................
HOUSE No. ........... STREET
........................................................... AVENUE LOT No.
........... ........................................... BLOCK No . ....................
NAMEADD_/ .. ........... .......................................................
.. ........
IF-
Lu -
ui
Date Approved:
BACKFILL WORK ORDER ISSUED ..................... ............. DEPOSIT, $ ..............................................
SEWER WORK ORDER ISSUED ......................................... DATE .... I.—Y ...... 6 .. ............
............... . ....... .... ..........
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re ion.is gran;eq
'7 7.7 -------- . .................
ers III ....................... tR, REPAEP. dr CoNiVE
.'With.Cit�, Sew Ys
qance�.Wjth appiieafion-bn goVp g� CT..a side sewer
Me aAd
'ATTEN+10N
WING.z,
e owners of: Pro"%
may �biij
b6 employed to co" cr PF0Per!Y line. -
. . Ct side'gew in,�stnreae��ttt to, construct sewei,-'Insi& ': - A lic=,ide. se*er
No�� No -2t-qbtaln info ]DO ]lot c6irer,a-ny-.�p'o-r-tion Of Sewer before It contractor MUBt
r63a g 1:t
Pon rej*6 Inspected.
..16.030 and lFlegulatjons rnlng side sei�ers
gove !!h— y�yu Fe�:Permjt.
-sev;ex�--0144.liave at-ies� -30 inches . e6ve
PP�qf side
rage at property line and 12
,e Property line: minim *grade of 2%.
7inches, insid
diW;td !mP�Oppr'work vihe�e "ace of street
-11�aY.;Oevelop One Original condition. Contractors
restored to shaU be. responst
year� o,
t�i .. t1- -1 - . 1 -1 1 I�,;�omplePo ble f or,
6 r 40 �'an Y 0 er-'*WotkL_ fo
isift , ' L, ' - than is pro,�Ided r
n Jhe�pipe,ijjto tlie:, the permit, io:do,;any'work
9 t4ie* main sewer or its,'
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