Engineering Permit FormSEWER NEW RESIDENTIAL
PERMIT
City of •
• •
www.cityofedmonds.gov220
Description: NEW SS CONN TO EXIST LAT (OK PER OPS) WITH SFR BLD2020-0866
ISSUED: 03/19/2021
Address: 7115 174TH ST SW EDMONDS WA 98026-5229
EXPIRES: 03/21/2022
Permit Type: SEWER NEW RESIDENTIAL Permit Subtype:
Parcel Number: 00513100013804
NAME TYPE NAME
ADDRESS
PHONE
APPLICANT DAVE NOLAN
502 92ND ST SE, EVERETT WA 98208
(425)582-1016
CONTRACTOR HOME DEVELOPMENT COMPANY,
BOW WA 98232-7232
(425)471-1054
INC.
OWNER HOME DEVELOPMENT COMPANY,
BOW WA 98232-7232
(425)471-1054
INC.
FEE INFORMATION
DESCRIPTION
AMOUNT
PAID
ENGINEERING INSPECTION FEE
$110.00
$110.00
SIDE SEWER PERMIT - NEW RESIDENTIAL
$110.00
$110.00
THIS DOCUMENT IS NOT VALID UNTIL FEES ARE PAID AND THE CITY ENGINEER OR HIS/HER DEPUTY HAS SIGNED BELOW
RELEASED BY DATE
Printed: Friday, March 19, 2021 4:12:36 PM 1 of 2
CONDITION TYPE
CONDITIONS
NOTES
SEWER 10' SEPARATION
10' SEPARATION BETWEEN WATER AND SEWER
SEWER ASBUILT
SIDE SEWER ASBUILT
SEWER ESC REQ
ESC REQUIRED
SEWER INSP PRIOR TO
BACKFILL
INSPECTION PRIOR TO BACKFILL
INSPECTION TYPE
DATE
COMPLETE
• •
RESULT
LIM
E-2 SEWER PRESSURE
E-9 SEWER ASBUILT
Printed: Friday, March 19, 2021 4:12:36 PM 2 of 2