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STRE`�"_'_,_Jl" FILE
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Date October 27, 1978
MEMO TO: John B. Mitchell, Supt.
Water/Sewer Division
FROM: Fred F. Herzberg
City Engineer
SUBJECT: SEWER CONNECTION CHARGES
654 View Place
(Street Address)
(L e g a 1 —03�n- �er
Single Family Residence X Subdivision Plat P.R.D.
Multiple Commercial
LEGAL DESCRIPTION:
Lot 7, View Manor
Z.F.F. Calculation:
70.78 Z.F.F. x ( 5.50
Lateral x(
) Unit(s) x( $25
cc: Owner
APPROVED BY: 42,-4
Leif 4 Larson
Director of Piibli.c Works
$ 389 . 29
$ 25.00
$ 10.00
Connection Fee
Lateral Charge
Equivalent Count
(when applicable)
Trunk Charge
Permit
$ 424.29 TOTAL
10/78
CITY OF EDMONDS
PUBLIC WORKS DEPARTMENTj ENGINEERING DIVISION
APPLICATION FORRIGHT-OF-WAY CONSTRUCTION PERMIT
THIS PERMIT MUST BE AVAILABLE AT THE JOB SITE FOR INSPECTION PUR.POSES
Applicant to Complete Parts A and B
A. Permit to be issued t o : IA16 /Li IC e
For Work at:(address or vicinity) cly L) I IP
Type of Work to be done: CC( -A -C 7�-r e f 1 -!�e,-Jfr
(attach drawing when applicable)
Time Required -- Start: /0,,Po Finish:- /,,.30
Owner:
Name
Mailing Address
City State Zip Telephone Number
Contractor:
Name
15rw'� - 2
Mailing 4ddress �A
City State Zip
State License Number
f 1.2 x
Telephone Number
U
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE **
B, INDEMNITY: Applicant understands and by his signature to this application, agrees
to.hold the City of Edmonds harmless from any injuries, damages, or claims of any
kind or description whatsoever, foreseen or unforeseen, that may be made against
the applicant or the City of Edmonds, or any of its departments or employees,
including or not limited to the defense of any legal proceedings including defense
costs, court costs, and attorney fees by reason of granting this permit.
Upon issuance of this permit, the contractor is responsible for workmanship and
materials for a period of one year following the final inspection and acceptance
of the restoration by the Engineering Division.
Funds held from the Security Deposit (estimated restoration fee) will be held until
the final street patch is completed, at which time a debit or credit will be
processed for issuance to the applicant.
Work is subject to inspection.and restoration in accordance with City Code. A
24-hour notice is required for inspection by Engineering. Call 775-2525, ext. 220.
I understand that this permit must be available at the job site for inspection
purposes at'all times.
r
Signatu Date: / o 1 -7
Owner o—r Agent
C, TO BE COMPLETED BY ISSUING AGENCY:
Date Issued:--101--o-7 hr--:->- P e r m i t N o . --1<!E5-2j F e e
Security Bond:
Time Authorized:- 9,
APPROVED BY
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