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7127 182NDIPL SW
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iRERMTT NO: 8416
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SIDE SEWER PERMIT
Address of Construction:) ?- t f,�4
Property Tax Account Parcel No. WN 0C
Attach copies of.all access and utility easements
Owner and/or Contractor: a. &
LID # p
Verified and Approved by
Contractor License #: OQC, d)J i'� 7�- Building Permit #:
-E�—&ingle Family
❑ Multi -Family (No. of Units
❑ Commercial (No. of Units )
❑ Public
Invasion into City *Right -of Way: ❑ Yes ZNo
*RW Construction Permit #
Cross other **Private Property: ❑ Yes o
**Attach legal description and copy of recorded easement.
Owner or contractor signature a0i acknowledgement statement:
By signing for this permit I certify that I have read the City's public handout entitled
oide Sewer Specifications, and shall comply with all City requirements outlined therein.
Date
2 CALL DIAL -A -DIG (1-800-425-5555) BEFORE ANY EXCAVATION W
W`FOR INSPECTION CALL 425-771-0220 extension•329
24 HOUR NOTICE REQUIRED FOR ALL INSPECTION REQUESTS
NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN
INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED.
Job Site Ready YES NO'.. -bate: Initial:
Partial Inspection: Date: Initial:
Partial Inspection: Date: Initial:
FINAL INSPECTION APPROVED: Date: -r 3. 0l Initial:. -PIAI As -built to Street File:
PERMIT MUST BE POSTED ON JOB SITE t�
White Copy: File Green Copy: Inspector Buff Copy: Applicant
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182ND AVE, W.
CITY OF EDMONDS
SIDE SEWER AS -BUILT
ADDRESS
7127 18 2 N D P L SW
PERMIT
NUMBER 9 416
HOMEOWNER BOB ROBINSON
CONTRACTOR HOMEOWNER
DATE
06/01/01
DRAWN BY
ISMAEL ABILA
- 9��6
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).