22620 HIGHWAY 99IIIIII IIIII IIIII IIIII IIIII IIII IIII14040
22620 HWY 99
CITY OF EDMONDS Permit No,
PUBLIC WORKS DEPARTMENT Issue Date
RIGHT - OF - WAY CONSTRUCTION PERMIT
A. •Address or vicinity of Cons'truKpon ;
22620 HWY 99 i
i--Ow.ner o �'al TOephone Co of the N10
Name ATTN: Paul Delong
P.O. Box 5124
Mailing Address
Lynnsood, WA 98036
City,
• Contractor:
Name
State, Zip Code
Mailing Address
• Permit Issued To: Ceneral Telephone Co
of the 41
• Type of Work to be Done: Rep I ace Seryi ce drops
adth aerial cable, & set anchor.
• Work in Connection With:
❑ Sub or Plat ❑ Single Family
® Comml. / Ind. ❑ Apt. Condo.
• Pavement Cut: ® Yes ❑ No
210W2802182 C601,C602
State License Num
UCity, State, Zip Code Telephone Number
a NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE.
a
d B. APPLICANT TO READ AND SIGN
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
O from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
u� against the City of Edmonds, or any of its departments or employees, including or not limited to the defense of any legal
a proceedings including defense costs, court costs, and attorney fees by reason of granting this permit.
O
v Upon issuance of this permit, the contractor is responsible for workmanship and materials for a period of one year
co following the final inspection and acceptance of the restoration by the Engineering Division.
O
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 to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering.
Call 775-2525, extensionoax 259. Uork to be completed 7/1/82.
I understand that this permit must be a vail bl/at the job site for inspection purposes at all' times.
�T' 61P
Signature:
Date
Owner or Agent
�t THIS PERMIT MUST BE POSTED AT THE JOB SITE FOR INSPECTION PURPOSES �t
CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
Time Authorized: Void after _
Special Conditions:
Ammendments:
Permit Fee:
Security Deposit: _
Receipt No.:
Fund 111 Fee:
Street Cut Dimensions
X _
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
Fnrt niv noocmhcr 1g7A
CITY OF EDMONDS Permit No.
PUBLIC WORKS DEPARTMENT Issue Date
RIGHT - OF - WAY CONSTRUCTION PERMIT
i
A. •Address or vicinity of Construction • Permit Issued To: General Telephone Co
22620 HWY 99 of the NW
i�� Owner:--- Cene�ral Telephone Co of the N14 • Type of Work to be Done: Replace service drops
Name ATTN: Paul Delong with aerial cable, & set anchor.
P.O. Box 5124 Work in Connection With:
Mailing^Address ❑ Sub or Plat ❑ Single Family
Lynnsood, WA 98036 IN Comml. / Ind. ❑ Apt. Condo.
City, State Zip Code • Pavement Cut: ® Yes ❑ No
9 Contractor: ;'' 2100-2.802182 C601,C602
Name
Mailing Address State License Number
F-
UCity, State, Zip Code Telephone Number 4 HOUR!
NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE 4EFORE YOU DI
B. APPLICANT TO READ AND SIGN 1 - 800 - 561-647
INDEMNITY: Applicant understands and by his signature to this application, agrees to hold the City of Edmonds harmless
Q from any injuries, damages, or claims of any kind or description whatsoever, foreseen or unforeseen, that may be made
u� against 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.
O
U 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.
O
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 to be inspected. Restoration to be in accordance with City Code. Traffic Control to be in accordance with Traffic
Section of City Code. Street to be kept clean at all times. A 24 - hour notice is required for inspection by Engineering.
Call 775-2525, extension MX Z 09. fork to be completed 7/1 /82 .
I understand that this permit must e avail le, t the job site for inspection purposes1-Y�
at al' times.
1 it'll, .�c� 'f F/LL'Z_-D PAM- �'.�Date�ySignature: r �^''� � / n,
Owner or Agent ;<
�k * THIS PERMIT MUST BE POSTED AT THE JOB SITE FOR INSPECTION PURPOSES' ,k
1 CALL DIAL - DIG PRIOR TO BEGINNING WORK
C. Issued By:
>- Time Authorized: Void after
Z Special Conditions:
w
Ammendments:
U
ays
Permit Fee:
Security Deposit:
Receipt No.:
Fund 111 Fee:
Street Cut Dimensions
X_
* * NO WORK TO BEGIN PRIOR TO PERMIT ISSUANCE * *
Eng. Div. December 1978
APPLICATION
The City of Edmonds for -
SIDE SEWER PERM EASEMENT NO- ---------------------------------------
NEW CONSTRUCTION REPAIRS [] LID NO- ------------------ - ASMT. NO. ----.----_------__
OWNER------------------------------------------------- — -------------------- -------------------- CONTRACTOR ---------------------------------------------------------------------- ------------- PERMIT NO. ---------
JOB ADDRESSQ,-7.:.Qg/ - ------ ----------------------- LEGAL DESCRIPTION: LOT NO. -------------------------------------- BLOCK NO. ------------------------------------
............ I ............................
Lu NAME OF ADDITION
—j
0-mmm
U.
ui
Lu
cc
co
Approved:
DATE-------------------------------------------- By ...........................
APPLICATION
The City of Edmonds for
SWIM SEVVIM PERMIT
NEW CONSTRUCTION El REPAIRS 0 EASEMENT No......------ .....................
OWNER .... Kanyon ..... Primilrvck --- c'-0 ...................................... CONTRACTOR .................................................................................................. PERMIT NO
ADDRESS -22.(6.2.0 ...... H.I'qtiw.o..y ---- !;.ct ..................... .............. LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................
NAMEOF ADDITION ....... L . . .........................................................................................................................
U.
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Approved:
DATE............ ................................... By ...................... ...............................................
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