The URL can be used to link to this page

21003 84TH AVE W11111111 lill 11 15396 21003 84TH AVE W The City of Edmon cSTREET FILE APPLICATION for SIDE SEWER PERMIT EASEMENT NO - -------------------------------------------- NEW CONSTRUCTION REPAIRS LID NO . ........... ASMT. NO . .................. OWNER ------------------------------------------------------------------------- ----------- CONTRACTOR --- ...... ................................... PERMIT NO. JOB ADDRESS ....... ....... ....... .... LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO - -------------- I .................... C--= . k<L-.c2)l c-nF=- 7-P-1 7-'VAV—= !S - =-7-cE>' -T�4T—=lZSnF= .................................................................................................................................................................. NAME OF ADDITION .... ........ I=b ................................................................ 0 0 21 4 t Approved: DAT . ............ i NOTICE: f\-I*n w-a rra n. 1 - ri (' V. I The information'shown on the attached iled for use by the City of map(s) was comP Edmonds, its Employees and Consultants. Th,,e City of 'Edmonds does not ' warrant the accuracy of anything set for.th on these map(�_). Any person or entity -requesting a copy should conduct an independent -ation shown on inquiry regarding the 'nform 0 _tFe -map(s), including, but not limited t th-e lociation 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 Edmo-nds nor its empto-yee-s o-r office.rs -sh-a-l'i be I.-Ja.b.-IFe for -11-he information given on this Map(s), nor for ion pr 'ded based any one representat' ovi upon . said map(s). CITY OF EDMONDS SIDE SEWER PERMIT WATER -SEWER DEPARTMENT PERMIT Call 775-2525 for side sewer inspections BEFORE covering any portion of the construction.) Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections. ADDRESS LOCA17ON OF CONSTRUCTION ........ 2100.3 --- ................................................ ........ .......... . ........................................... The E. 1631 of Tract 7� = Block 1, AU&zrwqsa� PROPERTY LEGAL DESCRIPTION ....................... --- - ---- - __ .. . .... ... .................................................................. .......................... excent the S. 27SI thers3f .................................................. . ...................... . .................................................... . .................................. . .................................. . .................................................. ................................................................ .,"/OR BUILDER ..... ................................... .................................. . ................... CONTRACTOR'S NA3M & ADDRESS ................ (11PATER .......................................................... . ............................... .. . .. . ................................................... ------------- Permission Is granted ........... . . 77n,'hy-jary 4 - - ------------ 19.77., for repair and/or connection of a side sewer to the city Sanitary sewer ........................ sr tn In accordance with City of Edmonds ordinances. �_j ATTENTION IS CALLED TO THE FOLLOWING: NOTE No. I —The owners of the property may obtain a permit to construct sewer Inside property line. A licensed Side Sewer Contractor must be,employed to construct side sewer in street area. Do not cover any portion of sewer before It has been inspected. NOTE No. 2—All work performed in city right-of-way requires an Invasion of Itight-of-Way Permit obtadnable from the City Engineer's office. NOTE No. 3--Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit. NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade sharper than % will be permitted. NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper work which may develop within one year of completion. NOTE No. 6—It is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the maln sewer or Its appurtenances except to in- sert the pipe into the wye. DISA.PPROVED E] Date--- ......... By ............. D te .... . ... ............... . �� -Z . . ................ Date ........... 'BY ---------------- ....................... ..... . .. . .. . .............................. . ....................................................... APPROVED 0 Da,te././,rKr_:::Z5 B;Y�' Remarks: A-umit Epartment ........................................................................................................................................................................................................... ..................................................................... . ........................................................................ ............... . .................................. . ....................................................... BOTH Pe Copies MUST Signed By Owner of Firm. Performing Construction PRIOR To Request For Inspection ....... ... , hereby certify that the side sewer installation constructed under this permit (D I ---- Firm, ...... P-e**' o,r`m'_in,g_C,*o'nstruction) ing ordinances of the City of Edmonds. was instal eef-in accordance with a-111 4�eQng or inLe, Datedthis ............................ day of ................................................................. 19 ......... Check BEFORE you dig for: Water F], Gas 0, Telephone 0, Power C], Sewer C], Other 0