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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 ------------------ ------------------ 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):