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14846
15725 75TH PL W
ESUHA _• •
ADDRESS: Az Y V
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS:
DISCRETIONARY PERMIT #'
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DA'
SEWER LID FEE $:
DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
LID #: 2,10
SHORT PLAT FILE: / LOT: BLOCK:
q 1 SIDE SEWER AS BUILT DATED: — /A ���
SIDE SEWER PERMIT(S) #: !�75`T/
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSTs\Forms\Street File Checklist.doc
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CITY OF EDMONDS
PUBLIC WORKS DEPARONT FOR INSPECTION CALL* permit NO.
SIDE. SEWER PERMIT-2.52°5 Ext. 22Q Issue Date e, 1417 ;
* PERMIT MUST BE POSTED ON JOB SITE * ,
�� LYNNWOOD LINE
1. Address of Construction /�7 ,; - j/j - .,� 'yt�
2.. Property Legal Description ( include all, easements) `
3. Single Family Residence
Commercial
4. Owner and/or Builder s
5. Contractor & License No.
Multi -Family No.'of Units
6. Invasion into City Right -of -Way: No .-"-"Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (WTPM) before
excavation) . 1-000-454-5555
7. Cross other private property: Yes No V Easement required -
i
attach legal description and county easement number.
READ THE FOLLOWING AND SIGN:
a. Property owners must obtain -a permit to install side sewers on
their property. A licensed side sewer contractor must be employed to
construct side.sewers in the public right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year.
C. Commercial establishment requires a minimum of a six.inch (6")
side sewer line.
d. Side sewers may not be installed closer than thirty inches (30")
to any structure.
e. Side sewer lines must be laid at a minimum grade of 2% (1.15°)
and maximum grade of 100% (450).
f. No turn in side sewer greater than 45° (1/8,bend) is0allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and Wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h.." Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered.,until inspected and approved
by the City.
J . Inspection during normal working -hours only. Two (2) working
days notice required.
DATE':��
I certify that I- have read
and shall comply with the above
PERMIT FEE: o.0 DISAPPROVED By: Date:
U W —Ti LA ylk C` `7q rc{e • Date:
CONNECTION FEE: APPROVED By : , , Date • -
w * PE IT MUST BE POSTED Ori JOB SITE *�,�/'"
The City of Edmonds Side Sewer Drawing EASEMENT NO_ ----------------------------- --------------
NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO. -Q-1-0--- ASMT. NO. ------------------
OWNER ---------- PORYnIM10 ------ F ------- P-CA-3-0-^j ------------------------- CONTRACTOR ------------------------------------------------------------------------------------ PERMIT NO.
JOB ADDRESS ---- 1-5-72-5 ----- ---.--75 ----- PL ------ W ------------------- LEGAL DESCRIPTION: LOT NO - -------- - A --a-7 ------------------ BLOCK NO. ___
(W& 'l/e, U)bq. I' wc� —7.5 PL S. W.
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ale tie a 4 we. is lvjzrm?
11/75 (REV-11/78)
NAME OF ADDITION -------- - -------- -----------
bArple
(Lk'%-4 W�c C-A, I' tleep,)
Approved:
DATE*)4_-------B----- ------------- --------------- ----------- -------------
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