6505 172ND ST SW.PDFiiiiiiiiii
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6505 172ND ST SW
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NOTICE:
No warranty of accuracy.
The information shown on the attached map(s)
was compiled for use by the City of Edmonds,
its Employees and Consultants. The City of
Edmonds does not warrant the accuracy of
anything set forth on these map(s). Any person
or entity requesting a copy should conduct an
independent inquiry regarding the information
shown on the map(s), including, but not limited
to, the location of any sewer stub shown. Such
sewer stubs may or may not exist and may or
may not exist at the location shown. Neither
the City of Edmonds nor its employees or
officers shall be liable for the information given
on map(s), nor for any one representation
provided based upon said map(s).
t.-I
APPLICATION
VtW�f wr
SEDE SEWER PERNaT
for
EASEMENT No . ..........................................
The City of Edmonds
NEW CONSTRUCTION REPAIRS 0
- � (= I:-- E?> (nu_rlF=Acx___ L-.%.E) 11�51
OV*rNER ....... 4.; f- .... 4.� ...... V7,71.C.—... ...................................... CONTRACTOR ........ ................................................ PERMIT No.
ADDRESS -7—%7Z
LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
---NAME OF ADDITION ---
� - - _Z� - - ---------- ---- ----------------- ----------------------- -- -- ---- --
4
DE";;":E:W1,ER,
UTT� F iElD,,MQNiD.S,"...-�,-"�s.!;I! (,PERIMIT
!WAThW-SEWER,,DEPARTMENT
p
Y.,
41 J*
PE, 11
`4 " ' 44, 8
RMIT,
construe I
17 -side sewer Inspections:, BEFORE' -covering, ai
ly portion of tithe I. on
�J�Sjli 7-76�1,107t for I - : '�oi,'holld'ay inspections., )�
n pectibn.,will �be �provlded: withim. 2C:hours,,af ter request.. NO),W_',Sun.,�
i ek,_ n r)
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ADDRESS.LOCATIONDF, CONSTRU CTION ....... ............... ................................................................................................................................................
"PAOPERTY LEGALMESCRIPTION ........................ lot r.e...L.a n.e..'Add i.t.j.p.m....'10 ...... 5 .......................................... .......................
. ........... .. .. .. .... .. ........... .. . .. .. ..... .
. ....................................... ............. 1 ........ ............ I ...................................... ........................... .................................................... 1.� ....... ...... ......................................
U111 ER .......
........ 0, ElIt AND/OR, B LD ..... .. . . ...... ; ...... .............................................................. ...........................
................................................
.................. ...... ................ Q .......................................... ...................... : ............................................. ......
CGNTRACTOIIVS� NAME, & ADDRESS ---
August 23
Peradssion, is granted ...................... 7 ....................... ........... 1 197A.'. for repair and/or, connec�tio n* of' a side seWei to, the -city sanitary sewer
systeniAn accordance with,City of Edmonds, ordinances.
Af TON IS CA-LLED, Tb--THE FOLLOWING:
I —The owners -of the'property ma.� obtain a �drmlt to. construct -sewer Inside' property ' line. A .11cense& Side Sewer Contractor must'be employed! W construct'
side sewer in �street- area. Do; not cover any portion of sewer.; before it has beenAnspected�
NOTE No. 2—All work perfarme& in city right-of-way, requires,an, Invasion, of RJght-of-Way . Permit obtaInable-from-the City Engineerts office.
and�'-Regu*latlo ' et permit.
NOTE. No. 3—Obtain, full inforniati6n,,regarding Ordinance 11.16.,030 ns, jovern�ing.slde sewers. whem,you �g.
NOTE No. 4--Top of side gewer must have at least 30 inches coverage aX property' line and, 12AnchesAnside,property line: minlmu= grade, oV2.%. Na�bends, In grade
shaxp6r, than % Ill be,permitted'.
for' fail r�due� to 'improper
NOTE No. -5—Trenches ln,,street must be water settled and surfaee,of street. restored- to,. original,,conditiom Contractors shall be res
ponsible u
m
work which ay Aevelop within, one year of completion.
NOT.M. No. 6--It is unlawful 'to alter or do. any other. work',than is provided, forrin, the,,permit, or toi,dwany,work on, the main sewer or its appurtenances, � except to in
sert the pipe Into, thewye.'
F .........
DISAPPROVED,, e ......... ...... ... ...... ........ /.;
Dai ............... By! ................ Dat6 ..... By ................ Date; .............. .................
... ....... . .......................... .................................
APPROVED j Dal Y ........ A I . .................. .....
Remarks: . ........... ....................... e ............................... ........
............................. ....................... ... ... . . .................... ............. ..................
..................................................... . .................................................................. ............................. M ............ I ........ .......... : ....................................................... .........
BOTH Permit,C pies MUST'Be Signed By -Owner of Firm Performing, Construction PRIOR To Request For Inspection
I,. ............ ... hereby certify that��the, side! sewer installation, cbnstructed(under this, pe�mit
W f Contra. -I'
... ner- 0 .... * ' c ��ngiirf truction)
W staIlled in accordanc6 with -,all governing'ordinances of :the''City � of,.Edrn(5nds-.:-
day -,of ...........................
Dated% this: ....... 0, ......
Check BEFORE, you dig for: Watek, �E]� Gas, E], Telephone� I o w r Sewer Other -E]:
P 6. El V1
The City of Edmonds
"PLICATION
for
SWE SEWER PERbM
NEW CONSTRUCTION [] REPAIRS
OWNER ---
ADDRESS ..... -Y ..... ..................
..... ... ( 0 P ir- U/ k)i?i P15 )
, No . ...............................
10 1 q1 —,&�
CONTRACTOR ........ O-E,(-F�
.......................................................................................... PERMIT NO . ......................
LEGAL DESCRIPTION: LOT o . ..... ..................... ......... BLOCK No . ........ 7-if .. .......................
NAME OF ADDITION -7...
. . . ......... . S ..................................................
fe
Approved:
TIN,
DATE................................... ------------ By ---