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7103 175TH PL SW
-CITE( OF EDMONDS
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•
❑ ADDITION
❑ RETIREMENT
FORMATION SHEET
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ASSET NO. C3 G G S
ADDITION TO ASSET NO.
DESCRIPTION
./1 v ;-
SERIAL NO.
LOCATION DEPT. NO.
�3 B7S L 5ua 6's'o
**PURCHASE ORDER NO. _
PURCHASE ORDER DATE
COST
*PROJECT NUMBER 6-0 .1. 6 2—
PROJECT COMPLETION DATE 1-2
COST q e •
B.A.R.S.A000UNTNO.
• ESTIMATED LIFE 2 s
INITIATED BY DATE APPROVED B�
**SUBMIT ASSET INFORMATION SHEET WITH FINAL PAYMENT REQUEST
*SUBMIT ASSET INFORMATION SHEET UPON CLOSE OF PROJECT
ACCOUNTING ONLY
EADEPRECIATE
MONTHLY DEPRECIATION AMOUNT
ANNUAL DEPRECIATION AMOUNT
• G.L. ENTRY
REFERENCE
DATE
W�
VERIF16D EN
PROCESSED
BATCH NO.
INITIAL
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DEPARTMENT FILE
CITY OF EDMONDS
PUBLIC WORKS DEPAR,
FOR INSPECTION CALL rmit No. _.
SIDE SEWER PERMIT 775-2525 EXt. 220 Issue Dateea t'
1* PERMMIT MUST BE POSTED ON JOB SITE 1. Address of Construction 4� ' " ' / r ,. 4 , �STREET F'
2. Property Legal Description (include all easements)
3. Single Family Residence ',. Multi -Family No. of Units
Commercial
-,
4. Owner and/or Builder,,, -.-•
5 . Contractor & License No. / Al 1
6. Invasion into City Right -of -Way: Now_ Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
7. Cross other private property: Yes No:fy Easement required -
u attach legal description and county easement number.
a READ THE FOLLOKT,.NG AND SIGN:
a. Property owners must obtain a permit to install side sewers on
>-I their property. A licensed side sewer contractor must be employed to
construct side sewers in the public right-of-way.
w b. The side sewer contractor assumes full reponsibility for each
Ei installation for one year.
a c. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
v d. Side sewers may not be installed closer than thirty inches (30")
to any structure.
M e. Side sewer lines must be laid at a minimum grade of 2% (1.150)
and maximum grade of 100% (450).
H f. No turn in side sewer greater than 450 (1/8 bend) is0allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and Wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
1 through other than granular soil.
1 i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required.
DATE r r° i ?V4) %+
I certify that 1--have rea
` and shall comply with the above
PERMIT FEE: DISAPPROVED By: Date:
By: Date: _
CO N CTI"� ON"F "E: By:
By:� Date:,��� l—
* PERMIT MUST BE POSTED ON JOB SITE
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).
i
The City of Edmonds Side Sewer Drawing EASEMENT NO . ............................................
NEW CONSTRUCTION ..� REPAIRS ❑ LID NO . .................. . ASMT. NO...................
OWNER ....... %OM%f/�r....................................................................... CONTRACTOR ............. M..$---zr
.....•............................................. PERMIT NO. . ��.3..._
JOB ADDRESS ._...7��3.......�7..�n1�6..Sw.......--•.................... LEGAL DESCRIPTION: LOT NO....................................... BLOCK NO. ....................................
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PWW-0001.11175 (REV.11/78)
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........ . ...............................•..-•--•----................................................. _...:.---........-•-•-•--...
NAME OF ADDITION ..........
1103
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Approved: .4
DATE.. ...Z ............. By ...