6710 172ND PL SW.PDFiiiiiiiiii
989
6710 172ND PL SW
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 Edmonds for EASEMENT NO . ............................................
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS F� LID NO - ------------------ ASMT. NO. - ..............
OWNEP - ----- -!E ------------------------------------------ CONTRACTOR ------------------------------------------- PERMIT NO.
JOB ADDRESS ... F=,L--
- ------- LEGAL DESCRIPTION: LOT NO - -------------- <m ------------------ BLOCK NO - ------------------------------------
.
NAME OF ADDITION ...... ............... z
...................................
11
DATE .............. B .............
y ..
P
M N$
F E RM T
ER
,W itL§i�WWER, DEPARTMENT
PERMIT 5484
114
fbr sewer, Inspections, BEFORE 6overink: any,: Portion of the con'stiuction.
G hspection w 11 1 be provided withl n. 24 hours after requst NO Sat Sun�, or �hollday Inspections
�DRE iVOrWCONSTRUCtION ......
.................. .............................
�." 1 1 .......... ...............................
................. ..........
PR UP, k RT Yy t-eeAU'6i S MIP -TT ON ............. ......... ..........
...................................... .. ........... .........
....................... .................... ..... .........................................................................................
.......... ....... ................................................
................. ..................... 0"ER ANWOR BUILDER ................. .... .................... ........
........... 7' ......... .......................................
ADDRESS ........ A nYN.
:00 TR'A'C'TC4VS,,`44?:�kME &
N . .. ... .........
.............................
,Is gi.
19.1(4for rep�air and/or connectio- sanitary sewer
PeiffiNsion ifitcd..-_� ...... . ........... ................ I ........... n of a side sewer -to the city
-OMAW ac6lrdax�& w1th,:0ty of Edmonds ordinances.
`ATTENTION IS C.�LLED To; THE'FOLLOWJNG:
NOTE No. - 1—Th e own'46 , 6 _j , "th e,,Property may obtain a permit to construct sewer' Inside property line.' Alicensed Side Sewer . Contractor must be employed to construct
Do not cover any portion of'sewer before it has been inspected�
side sewer In, street"area.
NQTE No. .2—All.wbrkrioerformed�;in.dity, right-of-way requires. an Invasion. of Itight-of-Way Permit, obtainable from the City En
gineer's office.
140TE No. Ordinanc . e 11.16:030 and Re ulations governing side sewers whIin�you get permit.
3—'ObtaiWiull�*,'Irf.ri"tion regarding 9
us
N0, No .4' Top c� , s, 'L _ sewerl,m , t have at lcast'30.-Inchcs� coverage'at property. line aAd 12 I,nches Inside line; minimum grade� of �2 No bends in grade
sharper than; -A-,willl,�be permitted.
'NOT 5--Tr6nche
-E No. ' �ifi,str�et'tmust be water settled. and, surface of street restored to, briginal' condition. Cohtractors shall be responsible for failure due to Improper -
work wfilch'ma�_ de7yelop. within one yeai of completl6n�
OTE �No:,, 6--It ls:,un,1�1�-,.,!p.al,ter or d6,any other'work thaxv,is pro Ided-for In the permit :or ;to do any -work, on the maln. sewer or its appurtenances,;except to ln-�
iertAhe -wye.
pipe �into the
ED Date� .... By.o .... ........ Date ......................... .......... . By ................
WSAPPAOV E] ......... .......................... By..: ... ...... Date...
APPROVED- Da .......
B .......... ........................................................................................
Y: .. ...
P..... .................................................................
teniarks:
................... ......................... ..................................................................... .............
............................ 7 .................................................... ...............................................................................................................................................
nii ��Cop_
FiOTHI Pei e ics, MUST'Be Signed By Owner, of Firm Perforiniing Constructioii PRIOR To Request For Inspection
....... ... ...... .. hereby certify that,the side cons tructed,urider: this permit
Perfo
�Fir P�erfoon"stCruction),
was. installed in adcordan6dWith all governing ordinafices,of thd,,City' of'Edmol�&'.'.
A; .
Dated, this,.!; ...... ;VIA ,.day :of ........ .......... ......................... ...............
Water Pow
E]'.t Gras Tcle�phone, er.
Check,", EFORE you'Aig, for El,
�Sewer: E],,. Other E]
APPLICATION
a
The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION E] REPAIRS E] LID NO. A&MT. NO - ------------------
OWNER ----
__/..... --- --------
.. . ... -------- 5 ---------------------- CONTRACTOR j�!�A)t�L-P ------ PERMIT NO.
JOB ADDRESS ---- i�Zl - — ---- 17 5y4E��d4
,42--4/ S 4Y
yp__,P -------------- LEGAL DESCRIPTION: LOT NO . ....... 4� -------------------------- BLOCK NO - --------------------------
------------------------------------------------------------------------------------------------------------------------------------------------------------------
gv C-
NAME OF ADDITION ----- ------- --------- - ---------------
RECEIVED
MAY 26 1976
Public Works DePL
Approved:
DATE-------------------------------------------- BY ---------------- - -------------------------------- i . iyyg
F0,
tp dhibhd
C 0- z: ibd
J e
eas,.,.'C. h cklist
2-�,;� �L M.,
c th6'City-�`-The
al-A�eas' Che&listc6nt�
it
on this form is'to be' filled'out*by,-*any.-�-,,-i-,,.-i'�t-�,,�, ievieW the c'h&kiist,'maike�'a',
pment Permit. �;�precursory site visit, and make a
person preparing a Develo
Application for the City of Edmonds determination of the subsequent steps
prior to his/her submittal oi a', necessary to complete a development
development permit to the City. permit application.
The purpose of the Checklist is to 6nable'
City;staff to- determine whether any, ,..� . �
potential Critical Areas are or may be
present on the subject property. The
information needed to complete the
Checklist should be easily available
from observations of the site or data
available at City Hall (Critical Areas
inventories, maps, or soil surveys).
An applicant, or his/her representative,
must fill out the checklist, sign and date
Witl� a signed copy of this form, the
applicant should also submit a vicinity
map or plot plan for individual lots of
the parcel with enough detail that City
staff can find and identify. the subject
parcel(s).. In addition, the applicant
shall include other pertinent
information (e.g. site plan, topography
. ..... ,.map, etc.) or studies'in conjunction
with this Checklist to assist staff in
completing their preliminary
assessment of the site.
I have completed the attached Czitical Area Checklist and attest that the answers
provided are factual, to the best of my knowledge (fill out the appropriate column
below).
Owner/ Applicant.-
. c Jqkc e- m o q in
Name
71
Street Address
G State, ZIP -L_ Phone
A -
Date
Applicant Representative:
Name
Street Address
City, State,.ZIP Ph. one
Date
CA FILE NO.
...... st
Critical Areas Checkli*
------------------------- -
Site- Irif a on
orm ti .(soils/ topography/ hydrology/vegetation)
1.'. Site Address/ Location:
"'t"' y T A
, ax . 'dcount Number: C, 4 16
3. Approximate Site Size (acres or square feet):
4. Is this site currently developed? )d yes; no.
jf yes; how is site develope4? Li:
5. Describe the general site topography. Check all that apply.
Flat less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of 10-feet over a'
horizontal distance of 66-feet).
X' . Hilly: slopes present on site of more than 15 % and less than 30 % ( a vertical
rise of 104M over a horizontal distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over
a horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water: 0 Approx. Depth:
Site.contains areas of seasonal standing water:
What season(s) of the year?
__ C) Approx. Depth:
___8. Site is in the floodway- floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are
year-round? Flows are seasonal? _ (What time of year?
10. Site is rimarily: forested /1-i * meadow
p 01 shrubs 1c, mixed /V-
urban landscaped (lawnshrubs etc) >, ___
11. Obvious wetland is present on site:
STREET FILE city of'Edmonds
RIGHT-OF-WAY CONSTRUCTION
& 9 0 . 1 9 '�) I -
PERMIT Permit Number:
Issue Date: /0
A. Address or Vicin0ZLOO&R21CF111a: -SW
B. Type of Work (be specific): Instal.1 New Service
C. Contractor: 815 Mercer St.Seattlp,wn Contact: Frank Swan
Mailing Address: 98111 Phone: 224-2278
State License #: Liability Insurance: Bond!,-$
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. "F-1 Commercial F] Subdivision E] Ci ty Project FX] Utility (PUD, GTE, W`NG, CABLE, WATER)
R Multi -Family F] Single Family Other
INSPECTOR: INSPECTOR: vj�ItA.
Pavement or Concrete Cut Yes []No G. Size of Cut:(2) x 4 H. Charge$
water
APPLICANT T 0 READ N
INDEMNITY. Applicant understands and by his signature to this application, agrees City of Edmonds harmlessfrom injuries, damages, or
claims of any kind or description whatsoever, foreseen or unforeen, that may be madeag"ainst the City of 6dinonds, or any of its departments or employ-
ees including or not limited to the defense of any legal proceedings including defense 'ani;
uorneyfees by reason ofir 'p'g,A;s"permit.
,y>,'
4d a
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MAYERIALS FORYPERIOD OF ONE YEAR FOLLOWING TUE FINAL INSPECHON
AND ACCEPTANCE OF THE WORK ES77MA7ED RESTORA77ON FEES WILL BE HELD �)�flDTHE FINAL STREET PA WH-9- C6WEETED BY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application.
'20;
A 24 hour notice is required for inspection; Please call the Engineering Department
.
Work is to be inspected during progress and at completion.
Restoration is to be in accordance with City Codes. 771-0220
Street shall be'kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day;
NO EXCEPTIONS.
I have read the above statements and understand the permit re ts' and the pink copy of the permit will be available
on site at all timesfor inspection purposes.
Signature: Date: November 5, 1992
(Contractor or Agent)
CALL. DIAIA-DIG PRIOR TO BEGINNING WORK
. .. . ........
.. . .... .... .. ...... ..... ..... .......... ..... .
. ......... .... .. . .............
T.OT
.... ........... .... ...... . .......
..... . RECEIPT.NO:
p... ....
'UN D .:: I I I
. ............ . .... - .... .........
........... . . ..... ......
............... ... ... . ........ ......
....... I ............. .. ...........................
. ...... ........... ....... ....... ... . ........................
PRIOR TO PERMIT ISSUANCE
Engrg. Div. 1991
FIELD INSPECTION NOTES (Fund I I I - Route copy to Street Dept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION 0 YES 0 NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 11
MoWng.ton AMMMMP-�
Naftniad�iW
AVAdvVwBwWCarparvV
60 ?10 1-7 2, p(_ -S L,,_)
Addendum to City of Edmonds
Right of Way
Permit Application
Submitted by: Rjc�k4,Fo �tiu-kQD
Engineering Aide
Washington Natural Gas
622-6767 x2761
pager q(.9 - I(OBG
�2 ( S X -1) 0' (3k Ps E 'O-re
5
%-111 WcaL.C", IJLYU.LCU16
0 water valve
815 Memer St. (P 0 - Box 1869), Seattle, WA 98111 (206) 622-6767
Permit Addres S
40 - (� I 10,,1
Legal Description-t6t (0
FILE
STREET
BUILDING PERMIT REVIEW - ENGINEERING DEPARTMENT
CHECK LIST
Reviewer's
Intials
1. Septic Tank System Design Approved
2. Sanitary Sewe� Availability Sht._ of Dwo. No-J4!r-)---J,)
Project: Side Sewer Availability: '<EG
3. Any Sanitary Sewer Connection'Fees
4. Site Drainage Checked
5. Storm Sewer Availability:'��� Sht. of Dwg.
Roadside Ditch
Project:pLi�,� M )t
6. Grading & Final Contours L!:)n
7. Sidewalks (Site Inspection shows condition of existing wal.ks as follows):
Oki ouirm-sl DE OF
8. Curbs-
9. Curb Cuts
10.. Underground Wiring Street Liqhtinq1"S)Q 2!2- anstal
a
11. Street Right-of-way & Bldg. Setbacks: R& en Sht.
of Dwg. of Official Street Map.
12. Existing Utility Easements
13. Access Easements
14. Water Mains & Fire Hydrants (Indicate Size 'Water Main)
c
15. Bonds for Site Work
16. Special Requirements listed in memo to Bldg. Dept.
0I.)
17. Commercial & Apt. Requirements form co leted
18. Drawings stamped notations made
19. *Site Inspection made on [2, 7
20. All items filled in on Bldg. Permit Ap plication ILL
21. This Lot included in Subdivision (List any speci6l requirements):
3/9/76