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716 7TH AVE S.PDFIIIIIIIIIIII 6980 7167THAVE S 1t ," t.L,. p�j y. p� ''{�1!QJ{�.(y��I�I��yy���!T� - 3RF'6 Siy Y ,,�( ,1.� `� ,}y��,,,�.•2h',',��g%- �.'1� '.-I?i»"✓!*-�i-�'.�5� #S�.^�r� <+"V`T?" �M1 � + �s.'i`�,f�i+h`T5 ^��41Yti ^'A�.��S� �{:'� '#�d�l'.�aa�n�'¢IST% 4.. **REVIBSD PERMIT** City of Edmonds RI - - AY CONSTRUCTION Permit Number. Issue Date: A. Address or Vicinity of Construction: 7.16 7 AV S (9412871) B. Type of Work (be specific): Install New Service 10 C. Contractor: Washington Natural Gas Company Mailing Address: 815 Mercer St Seattle WA State License #: Hill Contact: Frank Swan Phone: 224-2278 Liability Insurance: Bond: $ D. Building Permit ti (if applicable): Side Sewer Permit # (if applicable): E. ❑ Commercial ❑ Subdivision 0 City Project ❑x Utility (PUD, GTE, WNG, CABLE, WATER) ❑ Multi -Family ❑ Single Family ❑ Other INSPECTOR: INSPECTOR: F. Pavement or Concrete Cut: © Yes ❑No G. Size of Cut: 1 ( 2 x 4) H. Charge $ In Paving over,WBter r APPLICANT TO READ AND S GN _ INDEMNITY: Applicant understands and by his signature to this application, agrees to hold�tl ity of Edmonds harmlen1/ro Ziijuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made againstithe City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal proceedings including defensd��cos/ and attorney fees by r�easo of granti (g this permit. �. i� 1 THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPECTION AND ACCEPTANCE OF THE WORK. ESTIMATED RESTORATION FEES WILL BE HELD UNTIL THFFINAL STREET PATCH IS COMPLETED BY CITY FORCES, AT WHICH TIME A DEBIT OR CREDIT WILL BE J'ROCEASEI) FOR ISSUANCE Td"JffE A`)PPFJr ANT. Construction drawing of proposed work required with permit application. A 24 hour notice is required for inspection; Please call the Engineering Division, 771-0220. ` Work and material is to be inspected during progress and at completion. Restoration is to be in accordance with City Codes. Street shall be kept clean at all times. Traffic Control and Public Safety shall be in accordance with City regulations as required by the City Engineer. All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working day; NO EXCEPTIONS. I have read the above statements and understand the permit requirements and the pink copy of the permit will be available on site at all,, ti r inspection purposes. Signature: _ .4Date: May 13, 1994 (Contractor or Agent) CALL DIAL -A -DIG PRIOR TO BEGINNING WORK FOR CITY USE ONLY APPROVED BY: TIME AUTHORIZED: VOID AFTER JVlte Z D DAYS. SPECIAL CONDITIONS: 44�f 6v7 fN :24 b fAvEo J9 3 COMMENTS: RIGHT OF., WAY DEPOSIT DISRUPTION FEE/FUND 111: . RESTORATION FEE:-._ PERMIT FEE: —�3�� TOTAL FEE: RECEIPT FEE DATE: ISSUED BY: NO WORK SHALL BEGIN PRIOR TO PERMIT IS JANCE Engrg. Mv. 1991 FIELD INSPECTION NOTES (Fund 111 - Route copy to Street Dept.) Comments Diagram,: CONTRACTOR CALLED FOR INSPECTION Partial Work Inspection by P W.: Work Disapproved By: FINAL APPROVAL BY: ❑ YES Date: — Date: — ❑ NO V#Ihshkxj Natur5l G3s—.,., AV4f*yvn&vMyCo rMV I • Addendum to -City of Edmonds Right of Way Permit Application __Submitted by: MITCHELL S . • LANKFORD Engineering Aide • gel ��� ( Washington Natural Gas # ' -521 `5246 '6,v S C 1 M ov atz wNG to window Water main depth _ awn •�," gas main 51 fm Key: -w- water -g- gas -ss- sewer $ water hydrant 0 . water valve 3!r h-,.ccr St. 'J, Box '.'�'.:, So:rtic, '.Nf t'411' QC�) 622-•.;67 CE AR 2 a 1pi 'S S " STW Iv 'f ��� i . �3 -DTI �EII �83T� L tQc ' C 9f L C2L v / W CE MAR " •s 2 PE iP S S srw tv v 73 �� +� — p ul ul 2 s l�ia� n r r vc� 02L tilt 2ti t. 3o9'E MT .6 Q AV N S/8"(07'S W ' • \ CE AR , o"U N 'sTry IP is, v jTw I► ZV ul ffVP"T oE1 aaL 7 4' s N � 4+s'w �.. P iP �' S 0 P93-014 - h L /76 3 ;I ; U m � 3^ - .CD - �- 8)L 02L VIE L �Z �_� •iz� '12b 1DD 1•►� O 5/�•0o N = 711 T o aD T C/V b 9 ,/v d• W 6 3 HE MHO N 1 PE %P 2/'9 422 RD a UTfL ESM`T oil- >/ ♦ • a s v� 1 a 4 N 3 Q.T...0 -0 qb(C� .•► S- db.&. fi �� S• LL lit ft 7 L• V — .p lot w � cm, APPLICATION The Cityof Edmonds for SIDE SEWER PERMIT RUCTION CONSTREPAIRS ❑ NEW EASEMENT No ........................................... " ❑ ,A� 106-06100 OWNERJ Q h.. P.e... Le 1th ................................................................ CONTRACTOR..........---------.................--...---...............-----------............................ PERMIT No....................... ADDRESS ........ 71.6... S.eue.n.ti1..Ave...... S.. ................................................ • LEGAL DESCRIPTION: LOT No. NAME OF ADDITION ............. .......................................... BLOCK No. ............................................ ............................................................................................................... .. Dye Tested On Sewer 1972 Approved: DATE------------------------------------------------ BY...----.........----.---.............------------..................... 9 s 0 Form 38150 APPLICATION `cET FILE FOR CARD No. THE CITY OF SIDE SEWER PERMIT CITY ENGINEER DEPART N MAINTENANCE DIVISfON OUTSIDE ❑ INSIDE 0 REPAIRS EASEMENT No. OWNER `�"CONTRACTOR PERMIT No. 1 TFI �TJ STREET 5f HOUSE No. s ___�� AVENUE LOT No. BL •CK No. NAME ADD eZZC)w�,aJ 'D S C( O'ZL y {s } APr MAY 5 BACKFILL WORK ORDER ISSUED SEWER q 11 11 Date I Approved: DEPOSIT, _ DATE I I NS iZ6-F _3 f'zvA"Z F-ry n % c.✓ '1y Al L-J l� Dl4r' S�; cow - .A 53 J SL-1 13 7-4 At Lt /,3 5 zv r T145 Sn 514 ►434, 49 7- 1- P 9 r4 COA.- S