6617 170TH PL SW.PDF963
6617 170TH PL SW
a
APPLICATION
for
The City of Edmonds SEDE SEWER PERMT C
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EASEMENT No . ..........................................
ED CONSTRUCTION REPAIRS E]
......... -VAP"at-A PERMITAAS.27
OWNER -rim 4!51s:�KCD CONTRACTORO!:�HNM%'��$./. Or . ................................. ...... ..... ......
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ADDRESS4� �- ... 1.7 ...... —.If-? 74 ...... Ptr��-s ... .... LEGAL DESCRIPTION: LOT No . .............. :=P ........................ BLOCK No . ............................................
.... .... ------- -
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NAME OF ADDITIONOCUE&LE 00 RNN4" NZ10%,na4*3
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The City of Edmonds
APPLICATION
for
SIDE SK"WER FEBMT
NEW CONSTRUCTIOW REPAIRS
EASEMENT
Jf—
CONTRACTOR PERMIT No.
ONMER ....... .......... 96 ......
S,,e7
-4.J * No* BLOCK No . ..... ....... . .... ............
....... LEGAL DESCRIPTION: ------------- %3 -------------------------- -------- ---- --
ADDRESS .4.,,1p-xo.7 ------------ -- ---- - ------ ------------------
NAME OF ADDITION ............
70 k 7-
Approved:
RECEIVEr,
NOV 7 1973
DATE
13Y----------------------------------------------------------------------
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).
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 ------------ 6617 - 170th PI ace SW ......... .... . ..................... ...................................
----- .... * ---------- * ------------------------------------------------------------ --------
Double DD Ranch Addition #3, Lot 3
PROPERTYLEGAL DESCRIPTION ------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------
.................................................. . ...................... . ........................................................................................ . ................................... ..................................................
........ OWNER AND/OR BUILDER ........ TJ.T --- S-'.S-k.0 ........ . ................................... .......................................................
....... . ...............................................
R'S NAME & ADDRESS . -Ch-a-n.,b.e-rs./-De-H-a-v-en --- C-o-n-s-t-ru-c-ti.o-n ...... 17545 .... F-i-r-s-t ... Ave.--A-E-, ---- S-ealtl-e ....... 1eJ1-a-s-h-.-,--'.-
98155
Permission is granted ........... . .. No.yeTbe.r --- 7 ..... . ............ 19 ... 73, for repair and/or connection of a side sewer to the city sanitary sewer.
system in accordance with City of Edmonds ordinances.
A"—'T,TION IS CALT D TO THE FOLLOWING:
N . __,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 Ordi * nance 11.16.030 and Regulations governing side sewers when you get permit. rade of 2%. No bends in grade
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum g
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.
DISAPPROVEDn Date --- - ----------------------------------- By ................ D ..... 0 ......... * .... Date ................ ................... . BY ................
By .. ............................ ....................................................... .....
APPROVED - - - -------------------
............... . .............. . .................................................
Remarks: ------- - ------ - -------------------------- - -- - ---------------------------- ............
..................................................................... . .............. ......................................................................... . .................................. . .. ....................................................
BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
.���he�reby certify that the side sewer installation constructed under this permit
(ow de�on�rac-&-n. rfrrming Cons rue on)
"installed in accordance with all governing ordinances of the City of Edmonds.
�7
ated this....
/ ---- I ............................... 1973
D ... . ........... day of
Check BEFORE you dig for: Water E], Gas E], Telephone 0, Power Sewer , Other
El El C1