23711 78TH AVE W.PDF11111111111111
15216
23711 78TH AVE W
001:000-00-
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
'tic.
March 23, 2000
Tom Belt
7705238 1h St SW
Edmonds, WA 98026
Re: Address Change
GARY HAAKENSON
MAYOR
This letter is to inform you that due to the recent subdivision in your area, the City
will need your address changed. All of the new addresses, including yours, are to
be add ressed off of 781h Ave W per the City E ngi neer. You r new add ress wi I I be
23711 781h Ave W. I will inform all City Divisions including Fire, Police, Utility
Billing, Public Works and Building.
It is your responsibility to inform the Post Office and all other interested parties of
this correction. We apologize for the inconvenience this may cause you and greatly
appreciate your cooperation.
Thank you,
1011
IM/A -
Lara Knaak
Development Services
Cc: Fire Department
Police, Department
Uti ity Bi ing
Public Works
Building Official/Street File
Incorporated August 11, 1890 0
Sister City - Hekinan, Japan
G
CA FILE NO.
Critical Areas Checklist
---------------------------------- 7 ------------- -------------
Site Information (soil s/topography/hydrology/ve getation)
1. Site Address/Location: -Ti-Q-5- 2, -3 k,
-a-21
2. Property Tax Account Number: 2
3. Approximate Site Size (acres or square feet): 7, 000
4. Is this site currently developed? __)� yes; no. -
0 v\9 5 V(,q- J
If yes; how is site developed?
5. Describe the general site topography. Check all that apply.
Flat: less than 5-feet elevation change over entire site.
Rolling: slopes on site generally less than 15% (a vertical rise of I 0-feet over a
horizontal distance of 66-feet).
Hilly: slopes present on site of more than 15% and less than 30% ( a vertical rise of
10-feet over a horizontal* distance of 33 to 66-feet).
Steep: grades of greater than 30% present on site (a vertical rise of 10-feet over a
horizontal distance of less than 33-feet).
Other (please describe):
6. Site contains areas of year-round standing water:
7. Site contains areas of seasonal standing water:
What season(s) of the year?
; Approx. Depth:
Approx. Depth:
8. Site is in the floodway floodplain of a water course.
9. Site contains a creek or an area where water flows across the grounds surface? Flows are year-
round? Flows are seasonal? _ (What time of year?
10. Site is rimarily: forested meadow -shrubs
p mixed
urban landscaped (lawn,shrubs'etc)
11. Obvious wetland is present on site: �\ n(
DETERMINATION
RECF.WEID
AMR 2 2 1999
City of Edmonds FERMIT COUNTER
CRITICAL AREAS CHECKLIST
The Critical Areas Checklist contained on this form is
to be filled out by any person preparing a
Development Permit Application for the City of
Edmonds prior to his/her submittal of a development
permit to the City.
The purpose of the Checklist is to enable City staff to
determine whether any potential Critical Areas are, 'or
may be, present on the subject property. The
information needed to complete the Checklist should
be easily available from observations of the site or
data available at City Hall (Critical Areas inventories,
maps, or soil surveys).
An applicant, or his/her representative, must fill out
the checklist, sign and date it, and submit it to the
City. The City will review the checklist, make a
precursory site visit, and make a determination of the
subsequent steps necessary to complete a development
permit application.
Please submit a vicinity map along with the signed
copy of this form to assist City staff in finding and
locating the specific piece of property described on
this form. In addition, the applicant shall include
other pertinent information (e.g., site plan, topography
map, etc.) or studies in conjunction with this Checklist
to assist staff in completing their preliminary
assessment of the site
I have completed the attached Critical Areas Checklist and attest that the answers provided are factual, to the
best of my knowledge (fill out the appropriate column below).
Owner/Applicant:
cc
Name
UJ
Street Address
city State Zip
D 0 G - C., 5 0 - 7 a
T7eleone
ne
in a"*e"
z6-
Date
Applicant Representative:
Name
Street Address
City State
Telephone
Signature
Date
Zip
=eceptiWj anakad. doc
(over)
't —�— z
-r? C. 1 S9
April 30, 1999
Craig Halpin
7705 238,n St. S.W.
Edmonds, WA 98026
CITY OF EDMONDS
121 5TH AVENUE NORTH - EDMONDS, WA 98020 - (425) 771-0220 - FAX (425) 771-0221
DEVELOPMENT SERVICES DEPARTMENT
Planning - Building - Engineering
Subject: Determination regarding Critical Areas Checklist # 99-115
Dear Applicant:
BARBARA FAHEY
MAYOR
Enclosed please find a copy of the Critical Areas Checklist you submitted. The "DETERMINATION" reached by the City
is located on the reverse side of the form (bottom of page).
It is very important for you to retain a copy of this Critical Areas Checklist "DETERMINATION" for your records.
OATA . N I T .1 INFORMATION TO TED:
PLEASE EXAMINE THIS "DETERMINATION" FOR ADDITIONAL REQUIREMENTS. you MAY NEED To SUBMIT
ADDITIONAL INFORMATION SUCH AS AN ENVIRONMENTALL CHf�C�S � OR CRITICAL AREAS STUDY.
__q
The 'DETERMINATION' for the Critical Areas Checklist you submitted is a site -specific determination not a
project -specific determination.
You must submit a covy of the CRITICAL AREAS CHECKLIST and DETERMINATION INITH ALL .41111111
PERMIT APPLICATIONS or YOUR APPLICATION WILL NOT BE PROCESSED.
Permit applications include the following:
Building Permits
Conditional Use Permits
Subdivisions
Variances
Applications to the ADB* Land Use Applications
Any other development permit applications.
Enc: Critical Areas Determination
*Architectural Design Board
Thank you.
Shada Graham
Planning Secretary
C:Reception\.Jana\CRLTR.d0c
Incorporated August 11, 1890
Sister City - Hekinan, Japan
DA ZoneK N.E. 1/4, SEC. 31 T27N.9 RA E.W.M. 006
7-myofflowymmTol
s4 234 'r" ST.
05, IV z 0 OD 25401 '"061
-i- 00 pi-09
It 00 234)Z 2-31
3419 WAIM r- — t, g341-4 ?342
SA LL -134t8 23,q 17
bi OFFICE
Z3405
23
4f J425 OD ice 2351, Co. 23,121
'Jo r,
PARX 2342 23493
23432'
i, ;�� 2M39
AP'r5, r- r-
EDMONDS
3419
hRolrc-v liCEL in
CO 'w 23509 40 V) f, Q, 006
54
cm
L'rRAI R I'-,
PAAK AVD RIPIF OURT a, 0'
;�520 3450 577
Z3530
1235e6i 3456 Z3530 !n
236"r"
4 Lit-U.
ST W. T
2 36 T* S-w
36011
Olp 360) ly-;q Q 60
A `F
Z367S 01 3 3 )5 04 60419 3603
SAFEWAY C 03607 f� 4 ;7. IL 23414
d" . iv#slr al 01 A, 23624
29633 -4 68 IR 07 17 11 28
J77Z3635 23709 237/0 04 J$08 '3607
07 ORO,- AURORA as(.117 3705 3G 3 -s7d 7700
ffpftRIQpA� Mft9KVTpLPAE
23717 23711 237122 2371 ZXSI 79 3700
9 2363Z 23725 - 77//
237)91 s FAMILY PAPIC499 2371.;5'
u
I Z37/3 23709
a ol N 0, tu 372 -P
>
zn37Z3
238 Z 3-9��
T 23M
2-NO" a 3807 23804 V.2JUT ZIO03 2 3807
3 9 7-1 42NQZ ca -L Z
23830 ?3
12387-7 1.4 818
RD ok T 9 38/0 t
238as Z38 mll 45 821
-A-- -%
Y923 23930
2n.38
X- MISSION TACO 'r. "Amell WL#SE
I ?3qo4 OTC&. 4- 1 23 0 01 Z39DI
. 21 23910
MUT L. aD qL 2,5911
T&O
Ulf ��
A
13
i� 19 tia
-3�21
LL-1
u 2.4 0 ST
24020 to
V,
0 -0 THAY- 40
N611t
14� eq 024
0/
401f
—24032 40/7
ZI 104 24103 t 241060
Z40YI 021 0/9 to
a, Zf109 24 110 109
W 119
24119 44119 24117 24IZ2 >
7,
a, 01 129 24126 JU
24130
S. W.
z4zo(,
+ N !� -
4z. "
00
24212 Z42/3
?- �4
go 9 Z4207 24206 24205 qP]
2421 ic
24219 24Z/9 242ig 01219
Avro RiFpAiR A F24-2 2 0] X 2428
24Z2(- 40 2429T 24226
; r 24Z3l 2,1303 R,
CAMPSaL 33
0
UJASH P. 4305 313/?
A Vr& LISED CL LOTT ANWlk
R 14UYVA
Cc BANK 313
esy i GAS
&RiL-L LA
STA.
DO
....... .......
L AOF M ALL. N. 2 C4, PL.
-N -
204 L
V�, -. ;
New Area Code (425)
Effective April 27, 1997
CITY OF EDMONDS BARBARA FAHEY
MAYOR
7110-21 OTH ST.S.W. 0 EDMONDS, WA 98026 - IM 771-0235 FAX 00 744-6057
COMMUNITY SERVICES DEPARTMENT - PUBLIC WORKS DIVISION
<�' S t . 189 \3
May 29,1997
STREET ADD.P60S FILE
A. L. Lowell
7705 - 238th St. SW
Edmonds, WA 98026
Subject: Water Leak Credit (#506925)
Dear Resident:
I have reviewed your account and will allow a credit for the billing between
February 19, 1997 through April 17, 1997 period in accordance with our City policy.
The policy states that the customer will be billed at the retail rate based upon the average
water consumption for the same period during the previous year. In addition, the excess
water lost from the, leak will be billed to customer at the City's wholesale rate with a 15%
surcharge added for administrative cost. Only one leak credit will be granted in any three
year period.
Should you have any additional questions after you receive your new billing, please
contact Ilene Larson, Utility Billing Clerk, at 771-0241.
Sincerely,
Scott Highland
Acting Water/Sewer Supervisor
RH/Ik
cc: Ilene Larson
Utility Billing Clerk
wordata\waterkredit96W506925
Incorporated August 11, 1890 0
Sister Cities I.nternational — Hekinan, Japan
IRA
INDUSTRIAL SUPPLY DISTRIBUTORS
932 FIRST AVENUE SOUTH 9 SEATTLE 4
RIGHT NEXT
TO OUR
SALES FLOOR
(?all 9&&& 0052
CD TTPLU 13 7QC
T & T INSTRNT PLUMBING - HEATING -SEWERS DATE _6�A;_Ar-7
PLUMBING SEPTIC SYSTEMS -PUMPS
8020 180TH ST S.E. WATER HEATERS AND MORE...
SNOHOMISH, WA 98290 SINCE 1979
(206) 743-5000 (206) 338-0494
HOME PHONE S-7-�io7_-2, (206)486-3029 HOMEPHONE :722R-IVIV6��Z
WORK PHONE
WORKPHONE
SOLD TO:
JOB ADDRESS:
NAME - da?
0,67 Z_ C_ 110
NAME 4WIDE-L—t-
ADDRESS
001,-/ t^jt-1--f
ADDRESS
`R7--
CITY--
V
611-4-0111--1-- Ole - `7 7
CITY-
8C —
A2 if)
DIAGNOSIS/ SOLUTION
WORK AUTHORIZATION
AUTHORIZATION TO PROCEED WITH DIAGNOSIS/SOLUTION
1, the undersigned, am owner/authorized representative of the
T�
premises at which the work mentioned above is to be done. I
hereby authorize you to perform Diagnosis/Solution as you deem
advisable. A monthly service charge of 11/2% will be added after
10 days, up to $1,000.00 and 11/2% over $1,000.00. 1 agree to pay
reasonable attorney's fees and court costs in the event of legal
action. If your check bounces, you could be liable for 3 times the
amount of the check or $100.00 whichever is more, plus the face
value of the check and court costs. I have read, agree to, and
have received a copy of the contract and Notice to Owner on
reverse side.
I hereby authorize you to proceed with the work at a preliminary
contract price of:
C.) 7— C.) f—IC- jjAL_ rj,�57 Pq
A-,OiQ? C>� D_
0.0
c-- 7-;9 4- -7 _a_ 0
Ionic, -727— ap-
M6rAVff1ff=�IIIIIIIlIIMWA0WA
�1-1 :4 - VA lei =1 V qP161 iv, I ivi I =1 ON 111 :11
00
I If_ 0 Ct\1 I
I WATE'R PRESSURE PSI: I CUSTOMER INFORMED El I
WORK AUTHORIZATION
AUTHORIZATION TO PROCEED WITH SERVICE RECOM-
MENDED — 1, the undersigned, am owner/authorized represen-
tative of the premises at which the work mentioned above is to be
done. I hereby authorize you to perform Service Recommended
as you deem advisable. A monthly service charge of 11/2% will be
added after 10 days, up to $1,000.00 and 1112% over $1,000.00. 1
agree to pay reasonable attorney's fees and court costs in the
event of legal action. If your check bounces, you could be liable
for 3 times the amount of the check or $100.00 whichever is
more, plus the face 'value of the check and court costs. I have
read, agree to, and have received a copy of the contract and
Notice to Owner on reverse side.
I hereby authorize you to proceed with the work at a preliminary
contract price of:
$
Signature
.0
CONTRACT No. 33823�
E]CASH %CHECK OC.C.
CHARGE APPRVD BY —
TERMS — CASH unless preauthorized. Net ten (10)
days, or per contracted terms, with an approved
account established with T & T INSTANT
PLUMBING. In the event of default in the payment of
any amount due there will be added a service charge,
e qual to the legal maximum allowed, and an
additional charge equal to the cost of collection
including agency and attorney fees and court costs
incurred as permitted by law governing these
transactions.
WARRANTY
(Details on reverse side)
ACCEPTANCE OF CONTRACT — I find the service
and materials rendered and installed in connection
with the above work mentioned, to have �been
completed In a satisfactory manner, and hereby
authorize T & T INSTANT PLUMBING to bill any of:
my credit cards for the goods or services being
provided, and I agree to perform the obligations set'
forth in the applicable card holder agreement with the
credit card issuer. I agree that the amount set forth on -
this contract in the space labeled 'total" to be the total
and complete contract price. I agree to pay
reasonable attorney's fees and court costs in the
event of legal action. I acknowledge that I have read..
and received a legible copy of this contract. , .
Authorized Signature
S.C.
FLAT RATE
SUB TOTAL
TAX
5_3 A
-7 01
TOTAL
LESS DEPOSIT
[AMOUNTDUE
Pament Due U[)on Comoletion
9
City of Edmon&
critical Areas Checklist
'Me Critical Axeas Checklist co ntained on
this form is to be filled out by any person
preparing a Development Permit
Application for the City of Edmonds prior
to histhcr submittal of a development permit
to the City.
'Me purpose of the Checklist is to cnablc
City staff to determine whether any potential
Critical Areas are or may be present on the
subject property. The information needed to
complete the Checklist should be easily
a 'lable fi-orn observations of the site or
vai
data available at City Hall (Critical Areas
invcntorics� maps, or soil surveys).
B.1
YTzcelvzo
JON 10 1993
PLANiviN(j I)EPT
An applicant; or his/her representative. must
fill Out the checklist, sign and- date it� and
submit it to the City. The City will review
the chec3dist, make a
. precursory site visit,
and make a determination of the subsequent
steps necessary to complete a development
Permit application.
With a signed copy of this fon33, the
applicant Should also submit a vicinity map
of the parcel with enough detail that City
staff can find and identify the subject
parcel(s). In addition, the applicant is
encouraged to include any other pertinent
information or sttidies in conjunction with
this Checklist to assist staff in completing
their preliminary assessment of the site.
I have completed the attached Critical Area Checklist and attest that the answers provided -are
factual, to the best of my knowledge (fill out the appropriate column below). .
Owner / Applicant:
IRENE M._LOWELL_____,
Name
OWNER
Fide
7705 - 238TH ST. S.W.
Sftmt Address
EDMOND 778-4447 *
City, State, ZIP Thone
Signature Date
Applicant Representative:
.LOVELL—SAIJEgLANp & ASSOUATES.—Mr-
Narne
Title
19400 - 33RD AVE. M-- —SE-M-Z . O-Q—
Street Address
LYNNWOOD a _WASH1NGTOR__j%LU _215_15
_ _U
City, State, ZIP Phone
JUNE 10, 1993
Signature Date
9, . I
Critical Areas Checklist*
k�. I F11
Site Information
LOWELL SHORT
ProjectName: - SUBDIVISION Permit Number
7705 AND 7729
SiteLocation: '238TH ST. S.W. Property Tax Account Number. 312704-4-001-0108 AND
312704-4-001-0009
Approximate Site Size (acres or square feet): 68636 SO. FT.,
Have you filled out a Critical Areas Checklist for a project on this site before? NO
General Site Conditions
1. Has the site been cleared or logged? PARTIALLY Date of most recent action: UNKN
Soils / Topography ALDERWOOD-URBAN
2- In the%Snohomish County Soil Survey, what is the mapped soil type(s)? LAND COMPLEX (2-8 AND 8-15%
SLOPE,'
3. Descnibe the generals.itc topography. Check all that apply.
Flat less than 5 -feet elevation change over entire site.
X Rolling: slopes on site generally less than 15% (a verfical rise of 10 feet over a
horizontal distance of 66 feet.)
X �Iilly: slopes present on site of more than 15% and less than 300/,p a vertical rise
of 10 feet of horizontal distance.)
Steep: grades of greAW than 30% present on site.
Comments. NO EXCAVATION, GRADING, OR SITE ALTERATION OF ANY KIND WILL OCCUR IN
CONNECTION WITH -THIS PROPOSAL.
Hydrology/Vegetation..
4.. Site contains areas of year-round standing water NO
C/
stu.. y.: s:mnot required.:'
Rev'iewer "t
D6termination.Number 1,,L.fLA)
Planner
Rey 3/27/92
City of Edmonds
Critical Areas Determination
Applicant: I Irene Lowell Determination #: I CA 93-155
Project Name*: I Lowell Short Plat Permit Number: N/A
Site Location: 7705 and 7729 238th St. Property Tax Acct #: 312704-4-001-0108
SW and 312704-4-001-
0009
Project Description:
The critical areas assessment covers two properties,- including a
generally square shaped 10,682 s.f. parcel located at 7705 238th
St. S.W. and a larger recta ngu la r-shaped 55, 875 s.f. parcel,
which encompasses the smaller lot, and- is located at 7729 238th St.
S.W. Both properties contain a significant amount of mature
vegetation.
Waiver Criteria (all criteria must be found to apply):
xx There will be no alteration of the Critical Area or its required buffers;
xx The development proposal will not impact the Critical Area in a manner contrary to
the goals, purposes, objectives and requirements of the Critical Areas ordinance;
xx The development proposal rneets the minii-num standards of the Critical Areas
ordinance;
XX—. The above- findings are based on the following conditions of approval:
1. The proponent shall prepare a tree preservation plan and coordinate the
preservation. plan with the site grading plan for submittal with the subdivision
application. Tree cutting shall be limited to. building pad areas, driveways, and
reasonable yard areas.
CA93155.DOC
CA 93-155
June 21, 1993
Page 2
Based on the above findings and conditions, the requirement for a Critical Areas Study
associated wi ' th this development permit is hereby Waived, as authorized by Chapter
20:15B. 150 (B) of the Edmonds Community Development Code.
0, C/ -12�dry'
C// -C' L'Z'�4 Y? (� dll�3
Vame 6�-' Signature �ate
R
FREDERICK J. CLARK
WESLEY W. HANSEN
ILI
p.
N 88-33-26- W
>
a,--
30'
10
W
(j
2
P.C. ESSELBACH
3
LLJ C�
no
9'
SCME
0
CIJ
Uj
Ix
U)
109.00,
GAR.
&
z z'
0. 25*
50' 75' 100,
0
U.
0
ZW a)[ EX. HSE.
L�m _j
101
WlW
go
W 7.8'
00
C) A
p
co G
LU
Uj
a
_(�L34.50 -10.681 sq.ft. b
0) 0
LAWRENCE FREY
W
o6
z
30'
0
109.00'
_j
40' 1
238th
STREET7S.W.
b NON-EXCLUSIVE ACCESS
C� -0: EASEMENT FOR PARCEL A
0
(i�� —
— —
, -
I
N 88*33*26" W
MRS. OTTO DITTRICH
I I
PRELIMINARY SHORT SUBDI)ASION
EDWARD R.JOHNSON FOR
-IRENE LOWELL
IN t_E�4
7N.,R.4 E.,W.M.
CITY OF EDMONDS
SNOHOMISH COUNTY, WASHINGTON
LER
Lovell— Sauerland & Associates, Inc.
Engineere/Surveyors/Planners/Development Consultamts
19400 33rd Avenue T., Suite 200 Lynnwood, TA 98036 - (206)775-1591 - (206)340-0830
CHI DAIT F.B. P.53 1 SCAIZ ME No.
J.T.T. 5--21-93 408 1 .—W
P: 1 93-2080.01
T.
!tN
320.00'
B
55.875 sq.ft.
t-,,"_��R,C I A__!IC CARTY
_j
MICHAEL J. MANOR
330.00'
C�
00
C14
EDWARD L SNELL
f------- I
ri
EX
HOUk.
CAR.
L ---- j L
280.00'
330.00'
RUSSELL OLSEN
BEN BATES
0
-12
CHARLES B. COLLINS
X
�'j � tj
JOSE G. MARTINEZ
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 lia-bl-e for the'
information given on this map(s), nor for
any one representation provided based
upon said map(s).
The City of Edmonds
r--!q , I:: --
APPLICATION
for
SEDE SEVEM PERNEIT
OUTSIDE [:] INSIDE n REPAIRS 0
P,D,u 'PL7, ,
u
�1'6 /0
CARD No . ..........
EASEMENT No - --------------------------------------
OWNER ......... ........... ........................................................ CONTRACTOR ........... ................. ZC-6.1 4� cl-
STREET ........................................... PERMIT No<�o -----
HOUSE No . ......... ...... . - AVENUE DOT No . ...................................................................... BLOCK No . ...............................................
............ .. ... . .................................
NAMEADD . ........................... ..................................................................................................................................
4f
t--j
Date Approved. 7
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
SEWER �VPRK ORDER ISSUED .......................................... DATE J ........ BY .... 40a"at.-
�T"'A' 1�76'3
I*
APPLICATION CARD No . ..... -: ---------------------
for
The City of Edmonds SEDE SEWER P;71( EASEMENT No . ............ : ...........................
OUTSIDE E] INSIDE REPAIRS F1
(19 lof
...................................................... CONTRACTOR ......... PERMIT No.
OWNER ......... '00000.4k.`.00. . '.0. - - �Cf -----------------------------------
STREET .7
HOUSENo . ........ -------- ------------ ............. AVENUE LOT No . ................... -------------------- ------ . .......... BLOCK No . ...............................................
NAMEADD . ...........................................................................................................................................................
NUM
WROVED
2 5 1963.
Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
SEWER WORK ORDER ISSUED ..................... ...... DATE)'_Aj-/ 13Y
---------------
VA Y3
A-:PA.1 F 4XPIR,��5 .(9
CITY OF EDMONDS SIDE SEWER PERMIT
PERMIT N —0 9123
Address of Construction: 7 Av (_ \/V
P 173 Property Legal Description (include all easements):
VIA BALLINGER
LIFT STATION
Owner and/or Contractor: TO M L-E
State License No. F-43 14)4- /71 W�A Building Permit No. —AIIA—
IXSingle Family
El Multi -Family (No. of Units-)
0 Commercial
El Public
� VY
Invasion into City Right -of -Way: & No 11 Yes
RW Construction Permit No.
Cross other Private Property: K No 0 Yes
Attach legal description and copy of recorded easement
I certify that I have read and shall comply witA all city requirements
as indicated on the back of the Permit Card.
Date
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE USE ONLY
FOR INSPECTION CALL 771-M2, PUBLIC 0 K DEPT.
OR
Permit Fee: Issued By
Trunk Charge: Date Issued:
Assessment Fee: Receipt No.: /,c 3 2—
Lid.No.:
Partial Inspection: Date -Initial -
Comments
Reason Rejected: Date -Initial -
Final Inspection Approved: Date,5- -91' Initial
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Revised 3!90
The City of Edmonds
Side Sewer Drawing
i
EASEMENT NO . .........................................
NEW CONSTRUCTION REPAIRS E] LID NO . .................. . ASMT. NO . ..................
OWNER ........ �..Qrn ........... SP-117 .................................................... CONTRACTOR ...... 6.+..(Yl ....... GDci:t!7 ....................................... PERMIT NO.
JOB ADDRESS ..... 2371i ........ :7� ....... AV.e . ..... (; .......................... LEGAL DESCRIPTION; LOT NO . ...................................... BLOCK NO . ........... ........................
PWW-0001-1 1175 (REVA 1/78)
..................................................................................................................................................................
NAME OF ADDITION
. D " b e-ep
Su r-�c�c-&
('jN
& Lt
3, t)e-ep
Approved: co" i-c�-hcrcil
DATE....!5.7..RIP� ................ By .....
- r- ......... ....................................