20130 MAPLEWOOD DR-Side Sewer.pdfpity of will
SIDE SEWER PERMIT
Address of Construction:
PERMIT NO:
PERMIT EXPIRES
Property Tax Account Parcel No.;_'',,,,,,",-,,,',',,'',,,',,,,,,
a
Attach copies of all access and utility easements Verified and Approved by
Owner and/or Contractor:
Contractor License #: Building Permit #
Single Family
❑ Multi -Family (No. of Units
❑ Commercial (No. of Units )
Public
Invasion into City *Right -of Way: ❑ Yes ❑ No
*RW Construction Permit #
Cross other **Private Property: ❑ Yes ❑ No
**Attach legal,description and copy of recorded easement.
Owner/Contractor
e
Owners or contractor signature and acknowledgement statement: Date
By signing for this permit I certify that I have read the City's public handout entitled
Side Sewer Specifications, and shall comply with all City requirements outlined therein.
CALL MAL -A -IVIG (1-800-421-5555) BEFORE ANY EXCAVATION
FOR INSPECTION CALL 425-771-0220 extension
24 HOUR NOTICE REOUIRE ICOR ALI., INSPECTION RE,OIJESTS
Permit Fee $ Repair Fee Issued By:
Trunk Charge $ Date Issued:
Assessment Fee $ Receipt o.
City Permit Surcharge Fee ;IMS Total Fees Paid
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 Date: Initial:
Partial
Partial
FINAL INSPECTION APPROVED: Date: G I(? (y�- Initial:
L;temp;bl dg;forms; ssperm itj lg4/00
Initial: -
.As -built to
nitial:,A-builtto Street File: ❑
PERMIT MUST BE POSTED ON JOB SITE t�
White Copy: File Green Copy: Inspector Buff Copy: Applicant
CASCADE
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ADDRESS
20130 MAPLEWOOD DR
HOMEOWNER CONTRACTOR SCALE
CLASSICO HOMES NTS
DATE DRAWN PERMIT
01-18-2005 IBY SIBREL NO. 9934