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CITY OF-EDMONDS iob 51A% Permit No. 9D— 45Z
A, OVIAUNITY SERVICES DEPARTMENT
RIGHT-OF-WAY CONSTRUCTION . PERMIT issue Date 9 14 —90
Washington NAtural Gas Company
A.'* Owner: B. 0 Contractor:
Ng 1rT y Mercer Street Name
ddress Mailing Address
Nh'ai'Me WA 98111 4,
City State Zip City, State Zip
State Licenst.Y)?�ker Telephone Number
703 Main Street 41-
C. o Address or Vicinity of Construction:
Type of Work to be Done: Install Mew Serf ice
D. 0 Work in Connection With: 0 Sub or Plat El Single Family 0 C�tpp_rojects
El Commercial 0 Multifamily Xx Utility
E. 0 Pavement Cut: F0 Y -0 N F. 0 Size of Cut: 2 X 4 1) @ Gas
APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his sign'ature toXln City of Edmonds
c
harmless from any injuries, damages, or claims, of any kind o d7s9c`AI5tion whatsoever, forseen or unforseen, that may
be made against the City of Edmonds, or any of its departments or employees, including or not limited to the defense
of any legal proceedings including defense costs, court coq�'2and attorney fees bby reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKM*NSHI� �L 1'4�01QALS FOR A PERIOD OF ONE
YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK.
Estimated restoration fees will be held until the final street patch is completed by City forces, at which time a debit or credit. will be
processed for issuance to the applicant.
o 24 hour notice is required for inspection; Please call Engineering: 771-3202
,to Work is to be inspected during progress and at completion.
,o Restoration to be in accordance with City CoRe
0 Street to be kept clean at all times.
Traffic Control to be in accordance with City regulations.
o All street -cut ditches must be patched with asphalt or -City approved material prior to end of working day;
NO EXCEPTIONS.
I understand the above and that this peimit must be available at the job site for inspection purposes at all times.
Signature: Date:September 17, 1990
Owner or Contractor
This Permit Must be Posted at the Job Site For Jnspection Purposes
Call DIAL -A -DIG Prior to Beginning Work
AP PROVED BY: -Ba( WHI-TC-L)TT
Tin Authorized: Void afterNN1_"�()19CL_dft-
Special Conditions: NA -1
PERMIT FEE:
Restoration Fee:
Receipt No.: rm 65trRPOOR r0r9
Fund 1.11 Fee: I Jrr
Street Cut Dimensions:
RELEASE D BY: ALL,, Date9 —1) t 9P INSPECTED BY Date
NO WORK TO BEGIN PRIOR TO PERMIT I�SUANCE
tng. uiv. rviarcn ijzsv
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 1985
Addendum to:
City of Edmonds
Permit Application
Engineering Aide : Kerry Walsh
Washington Natural Gas
622-6767 x 2588
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(CQx--4j- (Fr
VVATOR- MAIN
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41/ C-�3AS AAA4&4
KEY:
-ss- sanitary sewer
-s- storms
-w- water
0 water valve
CITY OF EDMONDS
16 ENGINEERING DEPARTMENT
APPLICATION FOR RIGHT-OF-WAY CONSTRUCTION PERMIT
(Applicant to Ca-molete A & 5 and Subrmt in DunZicate)
A. Permit to b�e issued to:
ILA- I A M aQ
For work at: (address or vicinity) :70 -?S - MA I
Type of work to be done: '2EMC)VE
(Attach Drawing When Aoplicable)
0-, - 1%
Time Required 5tart:
— 70 --3,- M A t
Mailing Address
eomooq3' U)As-ti. '7 7 &- 2-7 2-:3
City I State Telephone Number
Contractor: AL-,kKJ-5 -T-P-OEF %MOU,4t
Name State License lNumber
Mailing Address
City State
Telephone Number
B. INDr-NITY: Applicant understands and by his signature to this application, agrees
to hold the City of Edmonds harmless from any injuries, damages or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or employees,
including but not limited to the defense of any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance
of the restoration by the Engineering Department.
Vork subject to inspection and restoration in accordance with City Code. A
24-hour notice is required for inspection by the Engineering Department.
Call 775-2525. )( a.XC>
Signature:
Ouner or Agent
Date Signed
C. DO NOT WRITE BELOW THIS LINE (To be completed by Issuing Agency)
Permit Issued (Date)"7*1—URO Permit Number alm
Fee: NO PSW Bond:
Time Authorized:
R
4
0
APPLICATION
for
The City of Edmonds SIODE SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS 0 EASEMENT No . ..........................................
102-03600
OWNER ...... I.I.J.] ... I.J.a. ... M ... S..Qn.q,..jjarqjd
..................... ..................................... CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS ..70311ain..-St . ......................................................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
f NAME OF ADDITION ................................................
-0
Dye Tested On Sevier
July, 1972
Approved:
DATE................................................ By ....................... ................ .............................
0 . A-, I -
0 F
A
July 24, 1963
Mr. Harold Williamson
703 Main Street
14monds, Washington 98020
Dear Mr. Williamson:
Pursuant to our recent conversation,, forwarded herewith as
enclosure 11111 is the cross section showing the existing grade and
proposed gredes for your driveway. ( 'X� JZ—� X-a-,V
LIM/Ic
encl.
Yours very trulyq
, CITY OF EDMONDS
LEIF Ro IARSON
City Engineer