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ENG20170406-APPROVED PERMIT.pdf�y v CITY OF EDMONDS 121 5TH AVENUE NORTH -EDMONDS, WA 98020 PHONE: (425) 771-0220 - FAX: (425) 771-0221 *PERMIT MUST BE POSTED ON JOBSTTE* STATUS: ISSUED ENG20170406 SIDE SEWER PERMIT (I -Single Family) Permit Number: ENG20170406 Expiration Date: 12/11 /20l 7 Job Address: 9025 218TH ST SW, EDMONDS JAMES FOTI 9025 218TH ST SW EDMONDS, WA 98026-7864 JAMES FOTI 9025 218TH ST SW EDMONDS, WA 98026-7864 (503)887-2093 LICENSE 4 EXP. Y N .JOB DESCRIPTION REPAIR N PROPOSE TO REUSE LATERAL LIDNUMBER: GRINDER PUMP N I PROPOSE TO REUSE SIDE SEWER F N 1 DRAINAGE Side sewer reline, located 2" from house on E side, 40' to street. FASEMENTINFORMATION N PROJECT CROSSES OTHER PRIVATE PROPERTY N VERIFICATION OF RECORDED EASEMENTS COMPLETE DVDEMATTY The Applicant has signed an application which stales 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 ofgranling this permit. CALL DIAL -A-DIG (1-800-424-5555) BEFORE ANY EXCAVATION CALL FOR INSPECTION (425) 771-0220 EXT.1326 24 HOUR NOTICEREQUIRED FOR ALL INSPECTION REQUESTS THIS APPLICATION IS NOT PERMIT UNTIL SIGNED BY THE CITY ENGINEER OR HIS/HER DEPUTY: AND FEES ARE PAID, AND RECEIPT IS ACKNOWLEDGED IN SPACE PROVIDED. RELEA SED BY Printed: Monday. October 09, 201 DATE ❑ FILE COPY ❑ INSPECTOR COPY APPLICANT COPY STATUS: ISSUED ENG20170406 • Refer to City of P,dmonds Side Sewer Infornuiuion 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-ot=way construction permit is required for work within the City right-of-way. • Condition ofthe 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 ofthe existing sanitary side sewerto be verified prior to obtaining approval for reuse. TV inspection required. Video to be submitted to City for review. • Easement and/or permission from adjacent property owner is required prior to entry'workwithin adjacent property. • Applicant shall repair/replace all damage to utilities or frontage i nprovements 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 fromtemporary construction sites as a result of construction activity are exempt from the noise limits of ECC Chapter 5.30 only during the hours of 7:00amto 6:00pm on weekdays and 10:00am 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 granted pursuant to FCC 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 fromthe issuance ofthis permit. Issuance ofthis 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-SEWERASBUILT • E-TV AND WATER TEST • E-Sanitary Side Sewer Inspection PARTIAL INSPECTION PARTIAL INSPECTION FINAL INSPECTION APPROVED ]INSPECTIONS DATE: INITIAL: NOTES: DATE: INITIAL:_____ NOTES: DATE: INITIAL:___ SIDE SEWER PERMIT APPLICATION CONTRACTOR INFORMATION: Company Name: Site Contact: Mailing Address: State License #: Expiration Date: F-e- .1" C-// Phone #: 702 f 7 Af City Business License #: Fax #: c�—OP;7 201 )' Email #: ❑ Liability Insurance ❑ Bonded PROPERTY INFORMATION: r Address: ��% 2 S 2� b Owner's Name: Phone #: ❑ Full Line Replacement ❑ Spot Repair ❑ Pipe Burst P5NReline (PermaLine Only) DESCRIPTION OF PROPOSED WORK (Be Specific) : SIGNATURE i�� 'i DATE �G _ ,Contractor or Agent NO WORK SHALL BEGIN PRIOR TO PERMIT ISSUANCE