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ENG20140320.PDFIIII�lIII a CITY OF EDMONDS 121 5TH A VENUE NORTH - EDMONDS, WA 98020 PHONE: (425) 771-0220 - FAX: (425) 771-0221 *PERMIT MUST BE POSTED ON JOBSITE* STATUS: ISSUED ENG20140320 Permit Number: ENG20140320 Job Address: 7109 OLYMPIC VIEW DR, EDMONDS E & D EXCAVATING 24931 115TH AVE NE ARLINGTON, WA 98233 Expiration Date: 09/29/2014 E & D EXCAVATING 24931 115TH AVE NE ARLINGTON, WA 98223 (360)435-5605 LICENSE #: EDEXCI*088KA EXP: 04/04/2016 N N REPAIR N PROPOSE TO REUSE LATERAL LID NUMBER GRINDER PUMP N I PROPOSE TO REUSE SIDE SEWER r—N71 DRA INAGE Connect side sewer to city stubbed lateral. Work is on private property. Septic abatement required. EASEMENTINFORMATION N PROJECT CROSSES OTHER PRIVATE PROPERTY N I VERIFICATION OF RECORDED EASEMENTS COMPLETE 1AVEMMTY.• 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 DIAL, -A-DIG (1-800424-5555) BEFORE ANY EXCAVATION CALL FOR INSPECTION (425) 771-0220 EXT. 1326 24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS THIS APPLICATION IS NOTA PERMIT UNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN SPACE PROVIDED. Printed: Friday, June 27, 2014 BY DATE �ECOPY ❑ INSPECTOR COPY APPLICANT COPY STATUS: ISSUED ENG2O14032O • Refer to City of Edmonds Side Sewer Infomnation 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 at 425-771-0235. • Condition of the existing sanitary side sewer to be verified priorto obtaining approval for reuse. TV inspection required. Video to be submitted to City for review. • Easement and/orpemussion from adjacent property owner is required prior to 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 of ECC Chapter 5.30 only during the hours of 7:00am to 6:OOpm on weekdays and 10:00am and 6:OOpm 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 granted pursuant 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 permit 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-Septic Abatement • E Sanitary Side Sewer Inspection • &CONTRA CTOR TO PROVIDE A SBUILT • &Engineering Final PARTIAL INSPECTION DATE: PARTIAL INSPECTION DATE: FINAL INSPECTION APPROVED DATE: INSPECTIONS INITIAL: NOTES: INITIAL: NOTES: INITIAL: SIDE SEWER PERMIT APPLICATION CONTRACTOR INFORMATION: . Con4)hny Name:_1-�-�— Site Contact: Phone.#: 3 6 u^- -5._ _5 6 ©z Mailing Address: �2 y�3/-//� State License Expiration Date: e /._ Email#: City Business License #: LiaUility Insurance Bonded PROPERTY INFORMATION: Adch•ess: —�/ O �— � <<- 2 Owner'.s Name: Phone #: Till Line NvpbuVITMILKII/ ❑ Spot Repay ❑ Pipe Burst ❑ Reline (PeimaLine Only) DESCRIPTION OF PROPOSED WORK (Be Specific) : ,g slA-// A16,,.) ��— SIGN ATURE�� DATE on , ctor rAgent NO WORT{ SHALL BEGIN PRIOR TO PERMIT ISSUANCE