20170324101655.pdf��I%/o%/f � EDMONDS
121 5TH A VENUE NORTH-,EDMONDS, WA 98020
CITY OF
PHONE: (425) 771-0220 - FAX: (425) 771-0221
*PERMIT MUST BE POSTED ON JOBSITE*
Job Address: 18427 OLYMPIC VIEW DR, EDMONDS
APPLICANT O.
New Venture Excavating New Venture Excavate
16968 65th Ln NE16968 65th Ln NE
g
Kenmore; WA 98028 Kenmore, WA 98028
(206)799-1927
LICENSE 4: NEW VEVE920KT EXP: 06/21 /2018
JOB DESCRIPTION
-"REPAIR N 'PROPOSE TO REUSE LATERAL LID NUMBER:
N GRINDER PUMP N PROPOSE TOREUSE SIDE SEWER N DRAINAGE
Spot repair near bottom of slope, near property line. Install 'a clean out 100' from clean out at,the home. All with in',the 4",FAS ;,
_EMENT INFORMATION
N I PRnTF(-7 CR"OPW.r, (-)TT-FR PRTVA TF PROPFRTV
—NJ VERIFICATION OF RECORDED EASEMENTS COMPLETE
INDEMNITY The Applicant has signed an application which states he/she holds the City of Edmonds harmless from injuries,
damages or claims ofany kind or description whatsoever, foreseen or unforeseen, that may be made against the City of Edmonds or
any ofits departments or employees, including but not limited to the defense:ofany legal proceedings` including defense costs and
attorney fees by reason ofgranting this permit.
CALL DIALrA-DIG (1-800-424-5555) BEFORE ANY EXCAVATION
CALL FOR INSPECTION (425) 771-0220'EXT. 1326
24 HOUR NOTICEREQUIRED'FOR ALL INSPECTION REQUESTS
❑ FILE COPY ❑ INSPECTOR COPY [:] APPLICANT COPY
• Refer to City of Edmonds Side Sewer Information handout for approved pipe materials, inspections and other requirements.
• A 6" cleanout with 12" locking cast iron lamphole cover is required at the property line.
• Maintain 10' separation between the sanitary side sewer and the water service line.
• A separate right-of-way construction permit is required for work within the City right-of-way.
• Condition of the existing lateral to be verified by the City's Public Works Dept. to obtain approval for reuse. Contact Edmonds
Sewer Division at425-771-0235.
• Condition of the ebsting sanitary side sewerto be verified priorto obtaining approval for reuse. TV inspection required. Video'
to be submitted to City for review.
6: Easement and/or permission fiomadjacent ;property owner is required priorto entry/work within adjacent property.
• Applicant shall repair/replace all damage to utilities or frontage improvements in City right-of-way per City standards that is
caused by or occurs during the permitted project.
• Owner/Contractor to provide Side Sewer asbuilt at final inspection. See City Standards for requirements.
• Sound/Noise originating from temporary construction sites as a result of construction activity are exempt from the noise limits
ofECC Chapter`5.30 only during the hours of 7:00amto 6:00pm on weekdays and 10:00arn and 6:00pm on Saturdays, excluding
Sundays and Federal Holidays. At all other times the noise originating from construction sites/activities must comply with the
noise limits of Chapter 5.30, unless a variance has been grantedpursuant, to ECC 5.30.120.
• Applicant, on behalf of his or her spouse, heirs, assigns, and successors in interests, agrees to indemnify defend and hold
harmless the City of Edmonds, Washington, its officials, employees, and agents from any and all claims for damages of
whatever nature, arising directly or indirectly from the issuance of this permit. Issuance of this pen -nit shall not be deemed to
modify, waive or reduce any requirements of any City ordinance not limit in any way the City's ability to enforce any ordinance
provision.
• E-As-built
• &Sanitary Side Sewer Inspection
PARTIAL INSPECTION DATE; INITIAL: NOTES:
PARTIAL INSPECTION DATE: INITIAL: NOTES:
FINAL INSPECTION APPROVED DATE: INITIAL: