21124 76TH AVE WIIIIIIIIIIIIII
15181
21124 76TH AVE W
The City of EdmATREET FILE
APPLICATION
for
SIDE SEWER PERbIIT'':.
OUTSIDE ❑ INSIDE ❑ REPAIRS ❑
CARD No . ................•
EASEMENT No . ......................................
L/0 //9
OWNED`.obert.. B..Porterfie.ld.-Rex.. Strickland....... CONTRACTOR .P rkS•-LaiidSCap ng .................. PERMIT No........:`T�::: %.
444-446-448-450 25th Ave. So.} STREET
HOUSE No. ................ AVENUE LOT No. NOI'th...6Oft...o.f...S205.--ft.... BLOCK No.Tract 1•
dmonds, Washington.
NAaIE ADD. Wllowd.ale.-..hardend-...D�.vi.�.i9x�...�iQ..l-----------------------------
I
I o
Date
BACKFILL W K ORDER ISSUED ................................... DEPOSIT, a.............................................
SEWER WORK ORDER ISSUED :............................:::..........
I APPROVED,
1964
..................... _
Approved:
DATE-.. �.... ........... By .......j ..... . .................. I...............
I
NOTICE:
No warranty of accuracy.,
The information shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of Edmonds does not warrant the
accuracy of anything set forth on these
map(s). Any person or entity requesting a
copy should conduct an independent
inquiry regarding the information shown on
the map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs mayor may not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
employees or officers shall be liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
CITY OF EDMONDS
��LE COPRYBARA FAHEY
MAYOR
7110-210TH ST.S.W. • EDMONDS, WA 98026 • (206) 771-0235 • FAX (206) 744-6057
COMMUNITY SERVICES DEPARTMENT - PUBLIC WORKS DIVISION
4c�St. 189'
March 19, 1997
PORTERFIELD PARTNERSHIP.
21124 76TH AVE W
EDMONDS, WA 98026
Account # 449900
SUBJECT: CROSS CONNECTIONS/IRRIGATION SYSTEMS
Dear Property Owner:
An irrigation/sprinkler system located on your property may
be in violation with the State of Washington and City of
Edmonds Ordinances related to backflow prevention. To
protect the drinking water supply, an approved backflow
prevention assembly is mandatory on all irrigation systems.
In addition, certain types. of backflow prevention assemblies
must be tested annually to ensure proper operation.
To assure that your system is in compliance with State and
City codes, please call the Water Section at 771-0235,
extension 644 for more information and schedule an
appointment for inspection of your irrigation system.
Please respond.within 15 days notice of this.letter.
Sincerely,
Linda
McMurphy
Water
Quality Control Specialist
Incorporated August 11,1890 •
Sister Cities International — Hekinan, Japan
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City of Edmonds
' RIGHT. -OF -WAY CONSTRUCTION
PERMIT Permit Number:
STUREET FLE _ Issue Date: —1
A.. Address or Vicinity of Construction: 21124, 76 .Avenue• West
I O B. 'Type of Work (be.specific): Install New Service
890. l90'
C. Contractor: Washington Natural Gas Company Contact: Frank Swan,
Mailing Address: 815 -Mercer Stteet, Phone: 224-2278
Seattle WA 8111
State License #: ' Liability Insurance: Bond: $
D. Building Permit # (if applicable): Side Sewer Permit # (if applicable):
E. ❑ Commercial ❑ Subdivision ❑ City: Project p Utilit PUD, GTE, WNG, CABLE; WATER)
❑ Multi -Family. ❑ Single Family ❑ Other. — _
INSPECTOR: INSPECTOR:
F- Pavement or Cnncreie Cut': }I —IC Yes MNo (1) G. Size of Cut: x 4, Hr Charee $
APPLICANT TO READ AND§IGN p
INDEMNITY: Applicant understands and by his signature to this application, agrees 4�1the City of Edmonds horniless i ijue� * ges, or
claims of any kind or description whatsoever, foreseen or unforeen, that may be made agai.Pthe City of Edmonds, or any of its departments or employ-
ees, including or not limited to the defense of any legal.proceedings incliuling defense costs;`and attorney fees. by reason of granting this permit.
THE CONTRACTOR IS RESPONSIBLE FOR WORKMANSHIP AND MATERIALS FOR A PERIOD OF ONE YEAR FOLLOWING THE FINAL INSPEC77ON
AND ACCEPTANCE OF 771E WORK. ES77MA7ED, RESTORA7TON FEES WILL BE HELD UN77L THE FINAL STREET PATCH IS COMPLETED BY
CITY FORCES, AT WHICH 77ME A DEBIT OR CREDIT WILL BE PROCESSED FOR.ISSUANCE TO THE APPLICANT.
Construction drawing of proposed work required with permit application:
A 24 hour notice is required for inspection; Please call the Engineering Department- 771-3202.
Work is to be inspectedduring_ progress and at completion.
Restoration is to be. in accordance with City Codes.
Street shall be kept clean at all times.
Traffic Control and Public Safety shall be in accordance with City regulations as.required by the City Engineer.
All street cut ditches shall be patched with asphalt or City approved material prior to the end of the working. day;
NO EXCEPTIONS.
I have read the above statements and -understand the permit requirements and the pink copy of the permit will be available
on site at all times for inspection purposes.
Signature: ° " °� Date: April 7, 1992
(Contractor. or Agent)
CALL DIAL-A=DIG PRIOR TO BEGINNING WORK
RECEIPT.
NO WORK SHALL
Engrg. Div. 1991
j
FIELD INSPECTION NOTES (Fund I II - Route copy to Street pept.)
Comments:
Diagram:
CONTRACTOR CALLED FOR INSPECTION ❑ YES ❑ NO
Partial Work Inspection by P. W.:
Work Disapproved By: Date:
FINAL APPROVAL BY: Date:
Eng. Div. July 1'
M
Washington
Natural Gas
A Wb9V7gI3n &-WC-V-N
Addendum to City of Edmonds
Right of Way
Permit Application
Submitted by: Kerry Walsh
Engineering Aide
Washington Natural Gas
H 2A -7 &V palter 995-6914
WNG
ONWati
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815 Mercer St. (P.O. Box 1869), Seattle, WA 98111 (206) 622-6767