1133 7TH AVE S1133 7TH AVE S
The�City of Edmonds
APPLICATION
for
L SIDE SEWER P RMT
NEW CONSTRUCTION REPAIRS 0
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OWNER V . ....... �l .........
ADDRESS 3... . ..... t7 .... . ....... ....... ------
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IEDMCNOS
NT PLANT, TREATME i
EASEMENT No...........
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CONTRACTOR ...... ...... 'I /L ft .. ........... . ........... PERMIT No
-P, LEGAL DESCRIPTION: LOT Nof..VTR ......* ........................... BLOCK No . ..... q ... I .............................
NAME OF ADDITION ... /jO.L4 ...--I ....... z ......... e
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Approved:
DATE .... S771)— 2.7 ......................... B�Y..- 4— ... . .... . .......
- CITY OF EDMONDS - SIDE WEit PERMIT
WATER -SEWER DEPARTMENT
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PERMIT N?
!Call 7-76-1107 for side sewer inspections BEFORE covering any portion of the construction.)
\Inspection will be provided within 24 hours' after request. NO Sat., Sun., or holiday inspections./
4017
ADDRESS LOCATION OF CONSTRUCTION...... UN...Segexth... A.Y.oI7.iue...SQ1ltb..............................................................................................
PROPERTY LEGAL DESCRIPTION .... Parcel ... ttAtl.....LOt...8,...H1Ack..9 ;...Yost l5...Ist...Add...-to-.Edmonds..................................
................................................................OWNER AND/OR BUILDER.....ULT.-NO.MS .....................................................................................................
CONTRACTOR'S NAME & ADDRESS.B....I..-M...... COnst...... - -----...B.Qz{---205.,...EtBa t� ..H�1gk1tS•......9.$.6.3.....................................
Permission is granted .......... Auggst ... 10........... •............ 19...71, for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City of Edmonds ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—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 1n 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 Right -of -Way Permit obtainable 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 J . 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 main sewer or its appurtenances except to in-
sert the pipe into the wye.
DISAPPROVEDn Date ........................................ By ................ Date .................................... By ................ Date.................................... By ................
APPROVEDDate............................................................... By ...................................... ..... ........................................................................................
Remarks: ......................................... :.....
..................................................••--•---.........................------------............_...--:-----•--..................................................................................................................................
— BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection --
I,••••••••--••..•-•-•••••.••••••.•••.•.••.•••.•............................................. hereby certify that the side sewer installation constructed under this permit
(Owner of Contracting Firm Performing Construction)
was installed in accordance with all governing ordinances of the City of Edmonds.
Datedthis............................day of....---.......................................................... 19.........
J J Check BEFORE you dig for: Water [], Gas [], Telephone [], Power Cj, Sewer 0, Other E] d ,/
77
. FYr n•A,,.. 7..._ Fn f-r•--.�y.*...�,x ZY. ;wa�.rr k ..�y, , ia,E SE�WEIt ;PERM
t` 6 =`';� �` WATER;SEWER DEE.`RTMENT +
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4P }`t'' -/,Call 776=1107 [or,•efde -sewer inspectfons-l'OILE scovering 4any portion of thoa wnstructlon
t\Inspection will be;provlded within 4 hours after rtquest NOl Sa.t faun or holiday inspections 1
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%'ADDRESS LOCATION+ OF _CONSTRUCTION j Z: r
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sPROPERT'Y LEGA+L DESCRIPTIUN ta'trI a " ' t ' t ' J ..f
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r t :..O.WNER' AND/URrBUI'LDER
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:': CONTRtYCTOR:S•.Nt11�1E. 6c•>ADDRESS + ... t r a }.
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iilssionFis`granted t "�.........................�1• - , 19. ' , for repair and/or connection of ;a sule'se��er to the city sanitary sewer
;intaccordance'.with:.City oP:;Edmoilds ordinances S
R ;
pTTENTIONrISr.CALLED''TO THE•FOLLOWING r - - �` f
NOTEi No::1 The,,6wders, of thc..property, may'obtnin',a Permit to construct'selver inside property. line A`li_eensed' Side Sewer Contractor must tie; employed to construct~
.side,'sewer:.1tf street area: Doj.not:cover•,ariy. portion.of,.sewv rr,before •it 'has-:been'dnspectedt-.,, •- - - - - _ - -�
.VOTE,`No -2 All`work -performed-.in city,! right of way. requires' an+invasion. oC Right of -Way Permit;obtamable from'the City.:Engineer s:office
"NOTE:No 3=Otitaln full:. -regarding 'Ordinance 1-It:lfi 030 and`;Iiegulations governing-side#sewers•twhem:you+.get permit:
-NOTE,.No 4=Top--of`'sfde'sewer,must-have`iRt Ieast�30 inchesicoverige.,al Property line-a.nd 12 inches inside Iropertyraine minimumj,grade�ot2/ Notb'enda INigrade..,
., := sharper, than,'& .will be permitted - .. - ,!,. •'� ` '
NOTE;No-•S—Trenches•in,street mustbe.water settledand surface -oL,street restored toy:orJgmn 1 condition- Contractors_shall•;be responsible for failure due to Improper
- 'work.which-may. deveiop within• one'9zar'of `completirin., �• �- '' - - - , "4 + -, £;, _ •-t
NOTED No.. B--lt,is-:un]awful' fo,alter'or it 'a ..other•-work^tlian s;provided.for:'tn,the permit onto do any'wark oh -the maln•sewer�or ita appurtenances except to In
f sertjtfie;plpe intoithe, wye.'.. •- '` - _
'. DISAPPROVED �.' Date...........................................B� ::Date ( 1 ... By Date By
T-:A`PPROVED' . ;. '• Date..,.. lt, ....:1 ..... ..�/ By.. 1, '. .;'': —' ...
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Remarks ..
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................................................ ......... .......... .......
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BOTH=rPerrrllt Copies,` 1.1UST Be Signedk Bv"Ownel -:of Flrm Perfoi lning Constrtiction PRIOR. To Request For, nspection
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hereby certify that the side;sewer installation+constructed' under ails permit• '
t
(Owner of, Contra. . Firm Performing Construction)
was rinstalle&in accordance"with all governing ordinancesrof the City of Edmonds. j
- I Dated+ this .. ..days of + 1
J J Check BEFORE you dig' for Water,0+ 'rGas p; ' Telephone Power
a