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1031 BROOKMERE DR.PDF1111111111IIII lill10450 1031 BROOKMERE DR ADDRESS: TAX ACCOUNT/PARCEL NUMBER: V V--5 q-1 U oo b 0 o � O O BUILDING PERMIT (NEW STRUCTURE): lg(Q O tjjfl l SFg� COVENANTS (RECORDED) CRITICAL AREAS t/ DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORDED PERMITS PLANNING DATA CHECKLIST DA' SCALED PLOT PLAN DATED: SEWER LID FEE $: bZ LID #: 9 SHORT PLAT FILE: LOT: ( BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: q,5m GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: WATER METER TAP CARD DATED: L:\TEMP\DS7"sTorms\Street File Checklist.doc 1 .. 1k�l l J f 1('E I M 1 X I -n tit e, . ;- PERMIT NO:.�2 City,of Edmonds �;,Iq-.6%. SIDE SEWER PERMIT PERMIT EXPIRES Address of Construction: l ©3 i Qpie !!--MLA be. aol"4 Jt0g LID # Property Tax Account Parcel No. ��� / l0 00 / 00 Attach copies of all access and utility easements Verified and Approved by Owner and/or Contractor: 0L4,Q,tr i ot.W Contractor License #; BL fl 06 RL 00 1 PIM 0 wilding Permit #: q5-x)U. Single Family ❑ Multi -Family (No. of Units ❑ Commercial (No. of Units ) ❑ Public Invasion into ..City *Right -of Way-O Yes ] No . *RW Construction Permit # Cross other **Private Property: [IYes RNo **Attach legal description and copy of recorded easement + ew Owner/Contractor t �' 9 0 3 Owner or contractor si ature an cknowledgement statement: Date By signing for this permit I certify that I have read the City's public handout. entitled Side Sewer Specifications, and shall comply with all City requirements outlined therein. 9 'CALL DIAL -A -DIG (1-8.00-42' 5555) BEFORE ANY EXCAVATION 2 R FOR INSPECTION CALL 425-771-0220 extensionIJAZI-2 . 24 HOUR NOTICE gEOUTRED FOR ALL INSPECTION REQUESTS Partial Inspection: Date` Initial: Partial Inspection: - Date: Initial: FINAL INSPECTION APPROVED: Date: ' Initial: ,ZsAs-built to Street File: [� t� PERMIT MUST BE POSTED,ON JOB SITE '6- White Copy: File Green Copy: Inspector .1341Copy: Applicant L;temp;bldg;for ms;sspermitj Ig4/00 • CITY OF EDMONDS I:,; -LOT APPROVAL STREET' 'ETFILE J. NAME l rt.Al01 e-,�� _ - ADDRESS o ADDRESS OF PROPOSED BUILDING^�of / ,�r oc e /��� 0,1 . 11031 LEGAL. :DESCRIPTION:.. LOT _.-BLOCK__; ADDITION I.SA- TYPE OF USE -9s. d/e-.c �}- NO. OF BEDROOMS._ SIZE OF LOT /a O SOURCE OF, DRINKING WATER:, Public Supply Private Well r, • r. ;. '_ •a. SURFACE DRAINAGE r r 1. Is disposal 'field site well drained? 2: Any water course (stream, drainage ditch, etc.) through' -site ?��/ ,-�� b- TOPOGRAPHY . . 1. • Any heavy slopes infield area?. /✓�-- 2. Will present topsoil. in field area be removed or graded before field tiles are .installed'? 3. Will arty fill .material •be used. in the -=disposal; field' site? ':s If *yes,• how much c. "_'SOI-L'CONDITIONS 1. Has a hole at least. 4 feet" deep ':tieeri'_dug in the disposal field area .to .deter- mine'.the 'type of soil present?,-- . e Sc _` 2. After- hale is diig -record the soil conditions at, the following ,depths. Record as sand, gravel'. clay; -packed sand; -loam, etc'. ) 12 inches 30 inches' 'Pa.S`,^ lS,.irichea=tea --ir d. 77, 2 : 36' inches o+ °► 24 inches 7 . - ... •� _.1j' 48 inches � 3. Any ground water ,encountered before• -reaching a depth of 4• feet? a ` If so at .what depth? d,.. -WATER TEST A simple water test will, show how,:well this,.soil "will drain or percolate water. . To perform this' -test:: _.__ _.... 1: Dig hole at least .36 inches deep, _:Use a shovel or•post hole digger— size'of' hole makes 'no difference —only depth. 2. Fill hole with -water. Now let all water run out of hole. This soaks the ground and will give•a more'466urate reading. 3. Again pour water in hole to a height of 12.inches from the bottom. Let water run out until there is-jus-t 6..inches from bottom left-in„hole. 4. Note how many, minutes, it takes•.fo'r this last` 6 inches to seep away. Record this time below. Number of minutes for la§t­6 ' iiff s: to_ -.see p away it 5.,: •Divide this time by 6,:to .obtain the rate per'"inc . q 6. 'Date water test was performed I hereby certify the above information to be correct and_ the above .tests were performed by me as prescribed. Signed Address go y„Q NOTE: A septic tank permit is..i.ssued..on the basis"of the above in ormation. If there are any changes or alterations in the'above stated soil conditions it may result in.the installation being rejected.at.the.time of inspection. 0 CASPER ST �� of Ep* CITY OF EDMONDS SIDE SEWER AS —BUILT o ftl- dADDRESS, SCALEvA 1031 BR❑❑KMERE DR NTS H❑ME❑WNERi ' C❑NTRACT❑Ri ED HAMLIN DRAIN DOCTOR DATES I DRAWN . PERMIT 1/2/04 , BYi I, ABILA I NO. 9802 I APPLICATION L BU- ILDING PERMIT i APPI. No.....�!d. CRY -OF EDMONDS Building Department Permit Limitone yMr 1 permit to construct the following work, is acco-dance with the axom• ; APPLICATION i- hereby made fora ponying plans and cP«ifit ors. Two sets are submitted herewith for apzrowl i t Off -St. new niter <e-......................Pazkirg ..-...._... Work aJdn iepair -•---..................................... - _ � i Occupancy .--•- .. Const. type .............................. Use zone_.........-/.�1 Fire one................... L............ Blk........................ Add ......... ...............•-e Address..... � Septic ' i... : I t% Area . / •,. , tG? �... �. Lot frontage.. / r2�• • D �...... . J......... - :ear. ............... Bldg. sec -backs — front.a0..�;' ef�. �Tel. Aio...._.._._:._._....__ TeL ButldczLG�' t - ` �'�L _- -- ...__ f� / i............... Addres,. f' 4 5 Plans i - .........................................._..... ............... ................................ .......................... ............... :................. j t and to comply with all applicable Cedes and State laws regi:lating this ' ..te above is correct statement,t work. f L17,�v ......�—:..r..—� �... ... Signed-0vnarA �• 4. PERMIT for the above work is hereby apprtrred, subject to the above condition.-, and to compliance with the aF 1 (t �. proved plans and specifications, and Building Department notations thereon. r �} Recd. ......... _ Valuation Permit ree......ft{- ................ 1 . / I { �.............. Date...�... ......... a. Department, By ....... ............. ............... r �j i 7, BtrriJmg P •---- � / - _ •''` _� i� ,., ` �... 1 1. This Permit does not covet Plt"b"g, Sewer or Electrical installations. p :•� i f i ,t i ID 0 ) 1 '%; C-e_ � � tips l,4 "nib City Of Edmonds PERMIT NO: 9802 :' PERMIT EXPIRES .n�. , gy� SIDE SEWER PERMIT V,,! 5 F�A1P1 Address of Construction: 0 6 / 3evo Ee_C D k, aM64JOS LID ! # Property Tax Account Parcel No. 003 —7 b 00900 Attach copies of all access and utility easements_ Owner and/or Contractor: 13C46ff ROC _,� Contractor License #: BL406lC lyb 3 q �vv cZ Single Family ❑ Multi -Family (No. of Units ❑ Commercial (No. of Units ) ❑ Public Verified and Approved by_ n3,4 0R-direr "uilding Permit #: Invasion into City *Right -of Way :g Yes F] No *RW Construction Permit # Cross other **Private Property: ❑ Yes allo **Attach legal description and copy of recorded easement. f2--/ j ©3 Owner or contractor signature an&Acknowledgement statement: Date By signing for this permit I certify that I have read the City's public handout entitled Side Sewer Specifications, and shall comply with all City requirements outlined therein. 9 CALL DIAL -A -DIG (1-800-42�-5555) BEFORE ANY EXCAVATION 2 9 FOR INSPECTION CALL 425-771-0220 extension 13-162 24 HOUR NOTICE REQUIRED FOR ALL INSPECTION REQUESTS FOR OFFICE USE ONLY •: Permit Foe $_ Repair Fee $_' Issued By: A",,111 Z�z Tmn Date Issued: �/A /V_4� Assessment Fee $ City Permit Surcharge Fee Receipt No: Total Fees Paid $ Y5 NOTE: IF JOB SITE IS NOT READY FOR INSPECTION WHEN INSPECTOR ARRIVES A $45 RE -INSPECTION FEE WILL BE CHARGED. Job Site Ready YES NO Date: Initial: Partial Inspection: Date: Initial: Partial Inspection: Date: Initial: FINAL INSPECTION APPROVED: Date: Initial: As -built to Street File: ❑ t� PERMIT MUST BE POSTED ON JOB SITE t� White Copy: File Green Copy: Inspector Buff Copy: Applicant L;temp;bl dgforms;sspertn itj Ig4/00 tt '' Page 1 of 1 40 Umbaugh, Theresa /ao/ �e From: Jim Ray [draindr@earthlink.net] Sent: Friday, December 19, 2003 11:56 AM To: umbaugh Subject: FW: Emergency Side Sewer Repair ----- Original Message ----- From: Jim Ray_ To: pentiedp(a.dfw.wa.gov Cc: umbaugh(a-)-c1.edmonds.wa.us Sent: 12/19/2003 11:41:37 AM Subject: Emergency Side Sewer Repair Date: 12-19-03 To: Eric Tentico From: Blade Runner Inc. DBA Drain Doctor Re: Emergency Side Sewer Repair We are doing an emergency side sewer replacement at the residence of Mr Peter Blakie; 1031 Brookmere Dr. Edmonds, WA 98020. We are going to pull HDPE fusible pipe from the cast iron stub pipe from the house to the -main line wye stub, this will go under Sheel Creek with a buffer zone of 20 feet from either side of the creek. cc: Teresa Umbaugh (side sewer inspector) umbaugh@ci.edmonds.wa.us --- Jim Ray --- draindr@earthlink.net --- Earthl-ink: The #1 provider of the Real Internet. --- Jim Ray --- draindraa.earthlink.net --- EarthLink: The # 1 provider of the Real Internet. 1 /16/2004 AMMATION a, The City of Edmonds for SON SEWER PERMITPERMITEASEMENT NO . ............................................ NEW CONSTRUCTION El REPAIRS ❑ LID NO ................... . ASMT. NO. ------------------ OWNER ............. ---------------- CONTRACTOR ------------------------------------------ PERMIT NO - --------- ---------------------------- ------------- PEP." JOB ADDRESS kzl ... . ....... &Ve— LEGAL DESCRIPTION: LOT NO------------------------------ ......... BLOCK NO- ------------------------------------ 0 ui NAME OF ADDITION ....... Ton le, IqAt Approved: DATE-------------------------------------------- By ---------------- PAIT NO 1960 ............................District' __� � City Of Edmonds ---Water Department TAP CARD ......... . .......... MeterNo.......... ....... ............ Tap No.................._..................... I Size .............................. I Size ...................................... Mfgrs. No ..... Style For ........... . . ......... ...... .. ... ................ .................................................................................................................. ....................... .................................................................................. ... . ....... . ................ . .................. . LotNo ........................................... Blk. No....--.--..........................._.............. Add. .................................................................... . Service Location ........... 42,5 .. ...................................................................................... . ....... . ................ . .................. Meter Location ................................................................................................................. ....................... MakeTap ........................................................... . ................ . ...................... . ........ ...................................................................................... . ................ . ....... . . . . .......... Pressure .............................. lbs. Test .................................... % Send Bills to ---------------------------------- -- Date of Wja* ....... ...................... -.jr ..... /" * j,. -e� W. ... . . .......................... Foreman Guar. Voucher No ........................................... $ Remarks: ......... . ............................................................. ------ OUTGOING Index .......... Reg ....... Route Bk ......... Stencil. ..... Card._ — INCOMING Index .......... Reg ....... Route Bk ......... StenciL ..... Card.._.. Material `iargeable to Installation Meters NO. zE DESCRIPTION Meter ---•-- RATE AMOUNT c) MeterBox .............................. .............. ..-•--• L 5 ............... - ......... Meter Plate '............................ . .._...-...... ........... Check Valve ........-----•--•--....... .............. _........... .......... ........... ........: Pipe, Galv. Screw .................. .............. .._......... .......... ............. .......... Nipples .................................... .............. ....................... . .......... Bushings ................................. --•--•............ ... Plain Ells ................................ -- ................... St. Ells --------------------•-------•--- --- -----------•-• ------------ -------•-- .---..................... Tees .--•--........... -•-•-•-••..._......................... _(!,flhc(/!.Z'�....G'�n `✓ .. f ` .............. ... -----------•_----"• -------- Material Chargeable to Taps Connected NO. SIZE, DESCRIPTION RATE AMOUNT .... Pipe, Black Screw -----•-----••••--- •...-••...... ............. ......... .............. .......... Pipe, Galv. Screw .................. ............... ••-••----•••. ......... ........... .......... Lead Connections .................. .............. ........... _ ......... .... ..... . ••' f. Curb Cocks ...•-•--...-----•---• ..................... Corp. Cocks ........................... .............. ..............�. ...... 4- f .. ........................ Unions .................................... ............... ............. ,.,• . ......... Saddles --•-------- .......... Nipples----------------------------••-•-- Bushings r �' I✓ ........................ Plain Ells ----------.............. •. -........ .......... ....... I............ Street Ells ....................... .. �1 . ................. _ ._.... ......... I........... ---------- ----••---- Tees ........... .......... :................... Curb Boxes -------------------••--- S. O. Extensions ....... ------••-•-- •---......... ............... .............. .. ........... .. ......... . ............. ....... Gates ...................................... ................ ............ ------------- .......... Plugs ............... -----•--------_---_--- ---------- .. ....... :.... .......... --------- •--- .......... Couplings -------------------------------- ---------- --- ............. .............. --••--•-•-- --- •--- • - - - - -- •--- -• - - -- .......... •-••-•---- ••-•...... ---....... Gate Boxes ---•- ...................... ----•...........••..............•-------•--•-•-----• ---•••-•--•...-•••----••----••-•-•--- - - - -••-- -• - - -• ....................•--...............--•---•-•-------..... ... --.-•• ..... --••-••--•-•-• --•••-•••...... --•-•...........----.••••• ............. ---..........-•••••.... .....:................ ....•..... ..... .... .............. ............ .......... .... .......... ........................................................... ......................................_.............. Hours Time —Day Men . _��� --••--•••••. �.� . ._ :.�{ .: -•••.............._... ...... _ .. _._ __ ... . ...._ ................ / . Hours Time —Monthly. ............... ........ ..._...... ......................... .............. .......... Hours Time —Auto ............ ... Superintendence-_---------------_ Total.............._.._ ..... ----•--.-••-- _.......... 0.. :..��' =:...,,�.. _--•-- . l✓ "�•. �