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1042 3RD AVE S.PDF1111111111114930 1042 3RD AVE S BUILDING PERMIT (NEW STRUCTURE) M COVENANTS (RECORDED) FOR: CRITICAL AREAS M DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver CRITICAL AREAS #: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver DISCRETIONARY PERMIT #'S: DRAINAGE PLAN DATED: PARKING AGREEMENTS DATED: EASEMENT(S) RECORD FOR: PERMITS (OTHER — list permit #'s): PLANNING DATA CHECKLIST DATED: SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: LOT: BLOCK: SIDE SEWER AS BUILT DATED: 7 A SIDE SEWER PERMIT(S) M GEOTECH REPORT DATED: STREET USE/ENCROACHMENT PERMIT M FOR: :'WATER METER TAP CARD DATED: OTHER: LATEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc CITY OF EDMONDS !eVBLIC WORKS DEPAR FOR INSPECTION CALL �1� C SLDE SEWER PERMIT 775-2525 Ext. 220 Issue Date * PERMIT MUST BE POSTED ON JOB SITE VIA EDMONDS WAY. 1. Address,. -of Construction 10 41 ''. Ord �rac��1'� TRUNK LINE 2. Property Legal Description (include all, easements) 1 3. Single Family Residence Multi -Family No. of Units Commercial 4. Owner and/or Builder Curt 0 M N6 F R 5. Contractor & License No. 6. Invasion into City Right -of -Way: No Yes (If Yes Right-of- way Construction Permit Required - Call Dial Dig (342-5344) before excavation). 7. Cross other private property: Yes No Easement required - attach legal description and county easement number. READ THE FOL.LOWT,.NG AND SIGN: a. Property owners must obtain a permit to install side sewers oft their property. A licensed side sewer contractor must be employed to construct side sewers in the public right-of-way. b. The side sewer contractor assumes full reponsibility for each installation for one year. C. Commercial establishment requires a minimum of a six inch (6") side sewer line. d. Side sewers may not be installed closer than thirty inches (30") to any structure. e. Side sewer lines must be laid at a minimum grade of 2% (1.15°) and maximum grade of 100% (45°). f. No turn in side sewer greater than 45° (1/8,bend) is0allowed between cleanout. All 90 turns must be constructed of a 45 (1/8 bend) and Wye with removable cap. g. No down spouts, footing drains or floor drains can be connected to side sewer system. h. Pea gravel is required for bedding when installing sewer lines through other than granular soil. i. Cleanouts are required at 30"-60" from each plumbing exit line and at minimum intervals of 100' along sewer line run. j. Trenches within City right-of-way must be restored to original conditions. Contractors shall be responsible for right-of-way failure due to poor compaction of fill. k.. Side sewer must be left uncovered until inspected and approved by the City. 1. Inspection during normal working hours only. Two (2) working days notice required. DATE:MET " FILE I certify that I have read 4 and shall comply With the above PERMIT FEE: %sc DISAPPROVED BY: Date: B Date: P4 CONNECTION FEE : APPROVED By : Date : 7.22-83 ® PERMIT MUST BE POSTED ON JOB SITE * �