6715 172ND PL SW.PDF6715 1*72ND 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
mav 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).
,ow
APPLICATION
The City of
Edmonds
for
EASEMENT NO - ------------ -------------------------------
SIDE SEWER PERMIT
NEW CONSTRUCTION REPAIRS LID NO . .................. . ASMT. NO . ..................
OWNER .. V--4
-- ---
li V--A �—A
: ...................................................................................
<Z
CONTRACTOR ....... --------------- PERMIT NO.
JOB ADDRESS S.-W. LEGAL DESCRIPTION: LOT NO. ------------------ BLOCK NO . ....................................
------------------------------ ---------
..................................................................................................................................................................
NAMEOF ADDITION ------ ---------------------------------------------------- I ..................................................
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-Y.O.F. ED"MY405 SIDE" AER Aff
N,, I US ' EW- JIPERM ...
W!A�r'E'W'SE.WER�,;DEPARTMIEN,-T":
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1� 'the c6nstructior�!.%.
(Cal 1,�.,7,75-,2525, for7,'s!de: 9 e :,I* �qveiing.',an�. rtloh",'o'
?w "nsf�ctions,�BFFORIF
XInspectlonN will��bef�,Pr.6vided''withinl. 24:. hours`after�, reclust!.' NO,'Sit., �Sun.; �or;'holiday' lnspecttonB)�
-AA
AI)PRESS7 LOCATIo ......
PF-CQNSTRU, CT_ION._* ...... ............ .............. ...... ........................................................... ................ .........
& . .......... 7 . . ...............................
LEGA%, .,,DESCRIPTION.'A.^ .. ....... 4 ...................................... ..........
........................ ........... ......................................... ................. ........................................................................................................ .................. ...... ..........................
I, R.,
............................................ ......... ...... �.O W AND /OR BUIL D ....... ............... �r .............................. .....................
WINE
CONTRACTO S'N ADDRESS ----
R! ..... � ...... .......... k ......................... ....................................................
Permission lst'grante& ... ........... F� ................... 19.Y ,for repair and/or 6-ofi r 164he.city, sanitary sewer
... . ... ... nection of a side sewe
systipm In, accordance,w1th1,C!tj'6f Edhiond� ordinances.'
A _,�NTION -IS CALLED TO, THa.FOLLOWINr,:
NOTE No. I —The owners of Ahe� property may obtain a permit to construct sewer Inside property'llne. A licensed Side Sewer Contractor must be employed to.,construct
side sewer 1w street �arew. , -Do, not cover any portion. of sewer before it has, been Inspected'.
NOTE,'No. 2�All 'k, if In city- 'rijht-ofmwa`y, r" I oi�ll
:w9F squirez,an, Invasion Right �of'.Way' Permiti. obtainable, from the City Englneerlst�oiflc6.
pe, oru�e
NOTE'No...' 3—Obtain full� information', regarding, Ordinance 11.16.030'ard'Regulations governini,slde-'i�wers when�'you- get perrhit..
NOT ; E, No. 4—Tolp; of'�_SW6sew'er� rn�st` have . at least 30-inches coverage.at prop erty line and 12. inc�eg'lnsid I e2pf6perty iine; -minimum -grade of 2'%.' No,",b'end's' ini grade
sharper than, be- permitted..
NOTE No. 5,Tren'ches ln-.str6eVmust�.be�-,�ater settled.'and surface of street.restored to originaT. condition., c6ntractors 'shall be., responsible, for,, failure� due� t6-_4'rnproper
work 'which. may�.;Aevelop 'within one, 3�ear;of completion.
NOTE".No. 6-- t� � nl' 'r�:ordol, any otheri work,than is provided. for PC
I is,-u awful, to':-alte In'.. the permit, or ieo� do Einy work, on the.maAn sewer- or its appurtenances exce 'to in-
eertAhe,,plp�ihf6Ahe wye..-
�DISA,PPROVEIY E]' _Dat� ........... Z ....... ..... : By .............
..........
D LD�at ..... ........ ......... .............
APPROVE V �*-�_-'' t
Date:.� . ............. Date.�.. ........................ By' ................
... ............ . .. . .........................................................................................
...........
................................................... ...............................................................................................................................................................................................
...............................................
....................
.............. ...... .............................................. ................................... : ................
.........
�BO e It, Qdpies. MUST Be Signed By Owner of Firm Performing -Constru ction PRIOR To Request For Inspection
.by, ce r-tify that, th e, Sid e sewer in stallat ion co nst s e
I, ...... L.0 .. YL ..... : ..... .... . he, rue'ted under thi p'rmft
(Owner of Contrac ng Firm.Performing Construction),
w4nstalled in:accordance with all governing'ordinances, of,,the,,City, of,'Edmonds.L
Dated, ...... "Y �of__.: ......... ...................... ................ ........... 19 ..........
Check BEFORE. you dig for: Water E],, �Gas.;E], .Tele hone,-.E],,_PoWer.F
_p Sewe,r. Other []i.' V�Iv.
The City of Edmonds
APPLICATION
for
SIDE SEWER PERMIT
NEW CONSTRUCTION F-1 REPAIRS F-1
EASEMENT NO - --------------------------------------------
LID NO . .................. . ASMT. NO . ..................
OVMER ---
-----
. ... ......... ----------------- ------------- CONTRACTOR -------------------- PERMIT NO.
LEGAL DESCRIPTION: LOT NO. ?V -------- 1w ............ BLOCK NO . ....................................
JOB ADDRESS .... ------- --
. .. ... ------- -----
.........................................................................................................................................................
NAME OF ADDITION ..... ......... ...... e, -----------
Approved:
DATE............................................ By ..................................................... ------
It/75
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EDMONDS'- ENGINEERING DEP].
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Permit Address_
Lecal Oes�criptio
REET. FILE
BUILDI'Mr, PERMIT UVIV-1 FNGINFFRT.Nr, nr.PARTf'Fl,lT
CPErK LIST
Zeviewer's
ntial s
1 Septic Tank SYstem nesiqn Approved
2. Sanitary Sewer Availahility)�Sht. of nwn. No. .051
Project: S i de Sewer. Availability:-
3. Any Sanitary Sewer Connection Fees, MD EYV RAff
4. Site Drain I age Checked —(a
5. Storm Sewer Avai labi li ty: Slit. f Dwq. No."14-0-�5
Project:BAT Poadside Ditch
112-ND !T_
6. Gradi . ng & Final Contours. AAQ
7. Sidewalks (Site Inspection 0ows condition of P, xistina vialks" as follows):
C�
.8. - Curbs
9. Curb Cuts.
10. Underground Uiring P( Street Linhtina
11 Street Rinh t-of-walv Rldq. Sp.thacks:R&l Sht.
of Dwq. No. of Official S , treet Map.
12. Existing Utility Fasempnts
13. Access Easements- NONJZ;
14. Oater Mains A Fire Hydrants (Indicate Size !-later tl ain)
4 W
15. Bonds for Site Pork
16. Special Ren.uiremQnts.listed in menio to Bldg. Dept.
17. Commercial A Apt. Requirements form comnleted
18. Drawings sta mped notations made.....&I017up
19. Site Inspection made on
20. All items filled in on Ndg. Permit Application
21. This Lot included in Subdivision (List any spec.i6l requirements):
3/9/76