6703 172ND PL SW.PDF987
6703 172ND PL SW
0
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).
APPLICATION
the City of EdmondsSTREET FILE for EASEMENT NO . ............................................
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS LID NO . .................. . ASMT. NO . ...................
OWNER
.......... : ................................................................................... CONTRACTOR -��1-4NPC::$=' ------- ..................... PERMIT NO.
JOB ADDRESS ----------------- LEGAL DESCRIPTION: LOT* NO . ........ ... BLOCK T-40 . ....................................
.........................
E
0
........................................... : ......................................................................................................................
NAME OF ADDITION ----- ....... 5 ---- ft..e2 ...........................
i px
'Izffit ZIEWMER ftkMATT"
71
rAA
y;A
-".t�,:�V,.t�T��'�'EWER"'D�EPAIRTI E T
MIT
'PER
Icali-J.7s,25m. for side,,�icwer,. -inspections ISE FORE'..�coverlfik Any, portion the. construction.,
a
4ct�c�n will be provided within hours after.-requst. Notts t Suh,.,,,,or holiday, inspectibris.
7z, -1
a P
P4ES9..L"O'iDk.n6:��OF�'.CONSTRUCTION. ............................................................ . ........................................................
PROPERTY LEGAM-7, n4
DEgiDRIPTION ................................ x ......... ............................. ..............................................................................................
...................................... ..................................... I ......................................................................... .................................................... ..................................................
................... ............................................... OWNER AND/OR BUILDER ............ .................................... ... ... ......... . . .......................................................
'�iDDRESS ........
�GONiRACTOR'&NAME"& ....... --- kO�A ............. 7 ............ ... .... . .......... .......................................................
P6rmiSsioSII 19 �jian� e y ....... ................ 'for repair and/.or connection of a side sewer to, the city sanitary, sewer
systeltiI a`,ccordance`w1th`-,!City of Edmonds. ordinances.
��__,ENTION I 'i6k
Tq,TiIE FOLLOWING:
NOTE, No., I Tliqo�"ers�o, �theipropertymayt obtain a permit to construct sewer Inside property, line. A licensed Side Sewer Contractor -must be employed, to. construct
side sewei, in street arew. Do, not cover any portion of sewer before it * haw been �Insbdcted.
�'2.—�kNil.�w�,'r*rk�Aperf�rm . in, city right-of-way requires an Invaglon of Itight-of-Way Permit obtalriable from the City Engineer' s",Vince.,
rf ej _
I -g6vernlrij sldbsewerif,�when- you it.
t
�o I I
O�r�;� 40TE No._3- fu I information regarding Ordinance 11�16bMand Regulations get Perm
N
'd 6)�e�liitiujt, have at 1east'30 inches: coverage at, pioperty**Iine anit-12, Inches inside property llne;,minimum� grade,of 2 or bendst;tlln grade
-A snsrper than�/s '-will be,'permitted.
"I z � _ a
'ches'7 water settleit an
'RP'street must'�6' it rs shall: be responsible. for failure due to. improper.
Fri it surface of street restored fo,wiginal. con Ition. Contracto
16 develop within one year of'completion.
work'wh ch�may
NOTE.No.� 6-- brilawfulAwalter or do any other work thaxt Is provided for: in� the pe ritnit, orlo do any work on. the, rn&ln.�sewer or -ifs appuftenances, e?�cept, to in -
ye.
iierits the'plije into th�e w'
DIS"PROVED' b, Date .................. z .................... By ................ Date-*, ...... By ............... Da to ........................................ . By .............
By
APPROVED- ... .................. V .............
........ ....... .....................
,[f]eD te.. 7 ... ....... ............... .............. .. . ................
Reinarks: ............................................................................................................................................................... ..........................................................
lk. . ........................................................................................................................ : .......................................................................................................................... .........
7
BOTH Perinit-,,C6pies, MUST Be Signed By Owner of Firm- Perfon-ni hk Construction PRI OR To Request For Inspection
hereby eertif3f that the side sewer installation constructed, under this permit
............. ...
?6 acting Firm Performing Construction)
cnYa,
r� �._J installed in accorUbLnce with all governing ordinances of the -City, of".Edmonds.
Dated, this .............. ............... day .......... . ......................................
Of ....... .. 19...
C
V V� 4�heckj� BEFORE. you dig for: Water C], as' ff, TelephorlI Power. Ej,.. Sewer Other C], V
4
APPUCATION
The City of Edmonds for EASEMENT NO - ------------------
SIDE SEWER PERM
NEW CONSTRUCTION F-1 REPAIRS LID NO - ------------------ - ASMT. NO - ------------------
OWNER --R --- — -- lof-I ------- ------- CONTRACTOR ---- ----- ----------- �0 71-e — ----- PERMIT NO.
----- ----- -------------- -----
----- --------- -----------------
JOB ADDRESS67!0:!��- ---- ----- ------ 3 ----- k) LEGAL DESCRIPTION: LOT NO.�t ------- -.,t ----------------- BLOCK NO - ------------------------------------
.................... ...................................... ---------------------------------------------------------------------------------------------------
NAME OF ADDITION ---
Approved:
DATE-------------------------------------------- By --------------------------------------------------- VUVE
Permit No 57
q-Y5 5
City of Edmonds'
q
RIGHT—OF—WAY CONSTRUCTION PERMIT issue Date:
6703 172nd PL SW
A. Address or Vicinity of Construction:
B. Type of Work (be m.ecific):INSTALL A 21, PLASTIC PIPE GAS MAIN DE 172 AW Aw MID 152 RE, SW
TIE INTO WXISTING MAIN @ +/-12' S' +/-29.3'E c1l AND RXTEND +/-5991.9 Jn SRRVR TARGETS
PER JOB #10700601<Z__-\
REZ MV`�If
C. Contractor: BOWIUSOUND y Contact: DOUG USTIPA1.0
DEC 2 U 19n.
Mailing Address: 1122 75 ST SW Phone: (425) 356-7529
State License #: Liability Insurance: Bond.A.
D. Building Permit # (if applic able): Side Sewer Permit # (if applicable):,'
E. r_� Commercial E] Subdivision 0 City Project [—] EUC (PUD, GTE, PSE, CHAMBERS, OVWD)
Multi -Family E] Single Family F1 Other
INSPECTOR' WQ-/
F. PAVEMENT: YES RNO G. SIZE* OF CUT 2' x 3 H. Charge: $
CONCRETE CUT: YES NO
APPL,ICANT TO READ AND SIGN
IDEMNITY. Applicant understands by his/her signature to, this application helshe holds the City of Edmonds harmlessftom injuries,
damages or claims of any kind or description whatsoe I ver,* foreseen or unforeseen, that may be made against the City of Edmonds or
any of its departments or employees, incl ' uding b ' ut not limited to the defense of any legal proceedings including defense costs and
attorneyfees by reason ofgranting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL
INSPECTION AND A CCEPTANCE OF THE WORK ESTIMA TED RESTORA TION FEES WILL BE HELD UNTIL THE FINAL STREET PA TCH IS
COMPLETED B Y CITY FORCES, A T WHICH TIME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
* Traffic control and public safety shall be in accordance, with City regulations as required by the City- E�ngineer. Every
flagger must be trained as required by (WAC) 296-155-305 and must'%have certification verifying completion of the
required training in their possession.
+ Restoration is to be in accordance with City codes. All street -cut trench work shall be patched with asphalt or City -
approved material prior to the end of the workday — NO EXCEPTIONS.
* Three sets of construction drawings of proposed work are required with the permit application.
I HA VE READ THE ABOVE STATEMENTS AND UNDERSTAND THE PERMIT REQUIREMENTS AND ACKNOWLEDGE
THA T I MUST MAKE THE PINK COPY OF THE PERMIT A VAILABLE ON SITE A T ALL TIMES FOR INSPECTIONS
Signature:
12/13/1999
jContractor or Agent)
CALL DIAL -A -DIG (1 -800-424-5555) PRIOR TO BEGINNING WORK
FOR CITY USE ONLY
Approved by: ci4, L-i Right-of-way Fee:
'old,
Time Authorized: After M& IS 2-coo Disruption Fee/Fund 111:
,Special Condition s1; Restoration Fee:
Total Fee:
Receipt No: A J
.Issued.,by1;...,..,-.
UPON COMPLETION OF PERMITTED WORK, AN ENGINEERINGTINAL
INSPECTION IS REQUIRED PER CHAPTER 18.00 OF THE EDMONDS
COMMUNITY DEVELOPMENT CODE.
FINAL APPROVAL OF PERMITTED WORK.- CZM
INSPECTOR'S SIGNATURE DATE: Tzoz
For inspection requirements see Engineering Information Handout.
------------------------------ NOTES -----------
1. CALL 2 DAYS BEFORE YOU DIG 1-800-424-5555
2. CITY OF EDMONDS:
50t
172
^11 "M T" 19 A T1kT 4 r
r� 0 kL
Maintain a minimum of 51 horizontal
and 3' vertical clearance from all
city utilities and appurtenances.
Cuts in paving are shown as Im
- 11 __ cuts in paving anticipated.
Notify Engineering Division24 hrs
prior to construction - 425-771-0220
3. PROJECT MANAGER: DOUG USITALO -425-356-7520
4. NO AS -BUILT INFORMATION FOR JOB # 107007320
EX. 2" PE IP ...... . . ....
EX. 2" PE 19' S 107-0 0
'TE13-145
L
50, END MAIN + 214'E,12'S�j
WOOD FENCE
ROPE TO FOLLOW PAVING
6703 6611
END MAIN ____'N ----'W E-IL i Q, FH
> (FIELD LOCATE) 2" PE IP MAIN 17'S C
�ETELEP
00 00�
co END SDWLK
7s
M \11 M
"_/'A"TELEPHONE
\�L\�OPE TO FOLLOW PAVING
2"\PE IP MAIN 17'S
ROPE ------ I
ROPE ITO FOLLOW PAVIN
i 1 661.6
6706 6620
V
L---------------- --------------------
------------------------------------------- ---- PRELliviMAFRY ONLY
Not for Construction
GAS MAIN INSTALLATION/RETIREMENT
I R
SIZE
LENGTH
TYPE
MANUFACTURER-
1
2 //
825'
MPE
1
11, 4 If
MPE
CALL 1-800-424-5555
2 BUSINESS DAYS BEFORE YOU DIG
THIS SKETCH NOT TO BE RELIED UPON FOR EXACT LOCATION OF FACILITIES
----------------------
REAL ESTATE/EASEMENT
-------------------------
PERMIT
----- EDMOND'S
4
P5
3
FUNCTION
NAME
PHONE NO
DATE
2
--
--------
----- — ----------
PROJECT MGR:
I1,._!LS1TALQ
(425 3-5-6 -7-5-ZO
1"?./ 9-9
--
--------
----------------------
ENGINEER:
REV#
DATE
BY
DESCRIPTION
DRAWN BY:
_C_ B ------
--------
12/02,,99
COUNTY
EMER SEC
WorK Center
- - -
CHECKED BY:
-?V=:F
--------
-- -_ / -_
APPROVED BY:
------
ffM� -----
(4 2-5) 3 5-6- - 7-5 ZO
I " 2V -99
1/4 SEC
SE - 08 - 27 - 04
OP MAP
156.068
PLAT MAP
159.071
-------------
— -----
--------
--
U-MAP# (POWER)
- - - - - - - - -
CIR MAP#
I -------
C I RCU I TU
- - - - - - - - -
-------------
-----------
A ��PP I N�G .
-----------
JOINT FACILITIES
ARRANGEMENTS
UTILITIES
-------------------
-------------------
I ----- --
------------------
CONTACT
I -- -- — -----------
------------------
PHONE#
-------------------
I ------------------
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PUGE-r 2" PE IP MAIN EXTENSION TO SERVE:
SOUND 6616,6620,6611,6703, AND 6706
ENERGY 172 PL SW EDMONDS,WA
INCIDENT#
----------
DRAWING#
- 107008017
SAP SUPERIOR ORDER#
10700801.7
SCALE: 1_,, __5Q_1 1-1- / _L
0— 1
Permi t Address
!evi ewer's
intials
15W
1/9/76
S V=DW&
0709M
1-MU FILE
Lecial r)escriptiotcz
BUILDING PERMIT UVIRI - PIMNURTMr, DFPARTPFNT
CPECK LIST
1. Septic Tank System nesign Approved
of Dvin A031
2. Sani.tary Sewer Availability sht.—_ No*.
Project:R39 Dwap—P Side Sewer Availability:
3. Any Sanitary Sewer Connection F e e s,.
4. Site nrainage Checked
— --F AF-
5. Storm Sewer Availahilit.v:)IZ5 Slit. _—L—of Dwq. Mo.-A-0--5�p
Project:?_L&T __Poads'i dp ni tch-
ON 11ZND5r___-
6 . Gra'ding &.Final Contours A+J
7. Sidewalks (Site Inspection shows condition of Pxi s t i n n . wa 1 k s'. as fol 1 ovis
8.. Curbs
9. Curb Cut.s_4P!K Agm'11�1*
10.. Underground. I-liring Street Liqhtinrl_Ra��_D
I'l.. street Rinht-of-viav A Rld(i. 'Sptha cks :P/A/ Sht.
of Dwq. r1o. of Official Street Map.
12. Existing Utility Fasemp nts
13. Access Fasements RW
14. I -later Mains A Fire Hydrants (Indicate.Size Yater Main)
15. -Bonds for Site Pork MOT la952 Y----).
16., Specia,l RequirpmPnts listed in memo to Bldg. Oept.
By
17. CommerciaI P, Apt. Requirements form completed
1 8. Drawings stamped notations made,
19. site Inspection made on
20. Al 1 i tems f.i 11 Pd i n on N dg. Permi t Appl i cati on (P . 0
14 1 V
21. This Lot*included in Sub . division (List any-spec.iAl requirements):