7006 175TH ST SW.PDFiiiiii lill 11
1073
7006 175TH ST 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 LID NO - ------------------- AsmT. NO. ----------------
OWNER ------- . ........ � ---- CONTRACTOR ------ ':::Z� --VV2,L=.(D-F?�PERMIT NO.
at c—
JOB ADDRESS LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
0
............................................... ------------------------------------------------------------------------------------------------------------------
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NAME OF ADDITION ---------- ........ FA—!:�� ......................................................
Approved:
DATE ..... By ... ..... .
71
CITY
Call 775-2525 for side sewer inspections 33EFORE, covering any portion- of the construction.),
Inspection will be provi ded within 24 hours after requst'.! .,NO Sat., Sum, * or holiday, inspections.
ADDRESS., LOCATION OF,CONSTRUCTION ....... 7. 7.Z. 7 7 /
............... ....... ......... m ......... . . . .................... : ................................
PROPERTY LEGAL DESCRIPTION. ....... . ...................
................................................................................................
..........................................................................................
............................... I .............................. ...................................... I .................................................................
............... D/OR BY IL DER ... ....... ...... ........................
................................................. OMINER:AN .... ..
CONTRACTOWS NAME.& ADDRESS ........... ............................ .......................................................
4� 7'
......... ior-repalr�ajW/or connection of a sidesewer to the,city sanitary sewer
Perinission Wgranted ....... 4v!� ......... i ......... ...... . ........
'imliniapoqrd*ance��,.W'it4,'Cit§�,of.Eariiond-s7j-rdinances.,"--
ATENTIOM IS: CALLED TO,1THE FOLLOWING:
NOTE 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 isewer in,street;area. 'Do not cover any portion of.s.ewer before,I t has been Inspected. , .. '. I
NOTE No. .2�All wor k performed In city right-of-way, requires an Invasion of -Mght-of7Way Permit obtainable from the City Engineer's office*.
NOTE, No. .3—Obtairl full*Information regaxding* Ordinance 11.16.030 , and Regulations' governing,sidb sewers, when you get permit.
NOTE,. No..,4—Top of* side sewer must have at least .30 Inches coverage at property� line land;. 1 2, inches inside 'property I Ine; minimum,grade of 2%. No bends In grade
sharper than 'A will be.permitted.
NOTE No.��5--Trenches.ln street must be -water settled and -,surface of street restored to original condition. *,C.ontraetors shall be,rpsIonsible for failure due to improper
work'which may develop within oneyear of completion.
NOTE] NO..6—If IsunIawfui,.t6.:iIt6r 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 -
.Bert the pIpe,jnto the.-wye.
DISAPPROVED, n:,'Date ................... By_� ...... ....... Date ............. ,
BY ................ Date .................................... By ... ......
APPROVED I ......
By ...... ........... . ................................... ...................... ............................
. .... . . ........
lneniarks:, ...... .............. .......... ................................... ................. .. ... ........ ................ ...............................................................................................
7Z ............................. I ........................................... m ............................... ........... ; ................................................................................ : ...........................................
'B 0,Tii'�"P�r;x�t-',O�Pies'jM,UST Be Signed' By Owner� of Firm: Performing Construction. PRIOR To Request"For Inspection
'tify,thdt the Sid6 sewer installation cons tructed under this permit
... ... ............. ...... .. . . ................ ................. .... hereby cer,
k '_ -
'(Owner. of !Con*tracfin. PI Perforniing Construction)
m�iC�'�insi�'E�l(�d-in�acdordande 'with, all, governing -ordinances of the,City !of:Edffibnds.
Dated,, this .......... .............. day of ....................................... ........................
19 .........
-Check,-'BEFORE you,dig for:, Water'�,[], Gas 1[Dt, TeIe ho e E3, !lower �E], 4Sewer E]? Other
.n
APPLICATION
I
The City of Edmonds for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMrr
NEW CONSTRUCTION E] REPAIRS 0 LID NO - ------------- -ASMT. NO - ------------------
- -M. - ------------------------ ------------------------- PERMIT NO. 4�
OWNER ........ CONTRACTOR -------- rl
-7
JOB ADDRESS 4-77-9 .. Al ----- LEGAL DESCRIPTION: LOT NO. ----------------------- BLOCK NO - ------------------------------------
......................................................................... ---------------------
NAMEOF A ------------------------------------------------- ------------------------------- * ------------------------------------
ViLl z
By---------------------------------------------
IODS.�10
PUBLIC WORKS DEPARV J;W
BUI1,DING PER1-,1IT REVIEW . -
,W,r_-j C11 �p
ST,
kaddress)
(date
Streewp; uisting
REQD
Z
Access Easements Existing
p4
Utility Easement Existi
REQD
Plat 7
Lot Per Subdivision Assessor 14a
Site Plan Checked for Accuracy
Z
Underground 14iring Reqd.
Check Accuracy of Description
.Z
Review by JjAa��D�ate
-Iola
Existing Water Main Size
Water Main Required 0A%
Service Line Required ,ay
Hydrant Size, Existing,
P4
Hydrant Reqd Per Fire' -Code
Size
Detector Check Meter Reqd.
Cross Connection Inspection AJO
Fire Department Comnents
Water Meter Charge Reqd. V;
Review by.
Date �9&Z2 E,
K.K.K.
I
Septic Tank Design Approved
Date
Septic Tank Permit Reqd._
Permit No.
Sanitary Sewer Availability.
Proj_
Drawing No. XXy4
File No 7_7—/SS_
Side Sewer Availability,
�,3 P_r
Sanitary Sewer Connection Fee Reqd.
:3:
Review by
Date �431
ILK.K.
Oe
Open Ditch
'-Peqd.
Culvert Re d.
Size
P4
Catch s* Reqd.
?!
;
Indicate on Site Plan
0
ul der dra inage maintain collection on
swale open runoff
P
.
U)
Manhole reqd. 415E�:
Indicate an Site Plan
Soil Conditions and Ground Water Field Checked
Review,by
Date
. Revisea:'MO-1977�� `//_ --- -
4,�� 0�104n- �
P a-g e 2
Street Paving Reqd..:.
E-4
Curb and Gutter, Reqd.
Sidewalk Reqd.— AOL-
f v /Vi2
N Curb Cutfor Driveway Reqd.,&4 t"2
p4 Right -of -Way Construction Permit Reqd.
Bond.Reqd. for Public Irrprovenents
Street Nam Sign Reqd.--
Other Signing Reqd.
'Pre Permit Site Inspection made on
z
F 4 BY: S94ER
WATER
PA
z STREET
ENGINEERING
Special'Requiren-ents listed in memo to C onumity Developinrant Department,
Building Division
BY Date
o All items filled in, M Building Permit Application
P4 BY Date
0-4
Drawings, Stamped and Notations �hd,e
A4 BY Date
Approved by Public Works Department
-0
Revised: 1v 10-1977