19515 82ND PL W.PDF111111111111
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19515 82ND PL W
ADDRESS: 1A
TAX ACCOUNT/PARCEL NUM13ER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: [] Conditional Waiver E] Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #: /.s 17
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:--7/12-7 I j -7 SIDE SEWER PERMIT(S) #:-!�32-
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSrs\Fomis\Street File Checklist.doc
APPLICATION
for
S11DE SEVVER PERN"
The City of EcImASFRIE
EASEMENT No . ..........................................
NEW CONSTRUCTION REPAIRS 0
%,
IN ��M— --- -------
it. �.*- -
r
Ow`Nm ........................................................................ ..................................... CONTRACTOR ...... ....... ................................................................... PERN" No . .....
gar
BLOCK -No . ......................
ADDRESS ............ i .................. ....... ...... ...... ................ *..."
_A!,EGAI, DESCRIPTION -LOT No..�- ................ ..........
......................
pl— 'vq. NAME OF ADDM I— ......................... ; ........ ........... ;;M.; ...................
...................................................
WJ
-A
U
10
-M=Zl MA
L9
(40smOEP) LA
ApproveM
op
INTO lsmu dpo' �11 0 �
DATE..... ...... .... . .... .......... By ... ............. 0 ...............
.0 . ........
'00110�7:7 '000
PtO
WATER -SEWER, DF-PARTMENT, ;V,',
P T
0 .47
V
4' i� V.'
4
.,(call 714"U81 for, side 06wei liepwooAS i3iiroxtv� oovori4`�ani. portion of . the, oonstriietim')
Inspection will.. be provided within 24 hours after request. NO Sat., Sun., or,holiday.inspaidtions.
195134-� IMF', 82nd 'Pla qe�, West
'.ADDRESS t60A)i16*, 010 6ONSTRIUCTION ............. �-g .......... . ......... !.t .. . ........................ . ...... ...... . ...............
... . .... .......
7.
Lot 16 ftplewoo
9CRWT1O...... ....... ........ ........ ........ ...... .....
: .1 * ' ` ' - ': d
PRbPERTY',LEGAL bE 14
............. ........ .......... ............ .......
wes
-k6rd H
...... OWNER AND/0 Blil Dik' ........ . ....
................... R L ............. I .......
S-i
CONTRACTORS NA . M I E . & ADDRESS .... Russ Joh'visoo ewer &'-Plumbf 16009.:
.. aq
. ....... .................. ; .... I ....................... J ..... . �.6 ... .. ..... ............. ........
73
%May 30.
Permission Is granted.,: ... .. . .......................... . . .. . .... . ...... . 0 ......... for rep9dr and/or connection of a side sewer to tfie. �4t*,S�Motary'sewer,
. )SYS1 In accordance: with: Cit)r of Edmonds ordinances.
Ior-T I
S CAT -I D TO THE
'All FOLLOWING!
NOD�_o. .1—The own'ers of -the propqrty may obtain a permit, t6 con struct' .'sewer Inside property ItnC- A,licenied Side Sewet,,Contrac�or.must,be employed, to construct
PIde, sewer in:. street arew. Do not. cover any:portion of sewer.�be;o,re It, Pas. been Inspected.
Not!X No, 1�—All work perf6q'ix�ed' -of-wo. Way P6rmJt obialriablj'.-jivin th�,Clt
ka city'right av requirea.,an. Invasion of'Rlght.of-I y Enginber's office.
k6TO Nq�, �-!—O�t'aia full Information regarding Ord�lp%n�e.11.14.686' and governing side eiwiri whin'k;u,'jet permit
jtergula !Pna
I :.,NOTE N,� 4—To�..of'st�e�'.se�ver.'�riiugt have at least, 36:towie. co e &t:pro, rty -line aJhd :12 incfiei"I�kde- piojerty, line,,, mfinii4uni' grado' of 2'%. No bendo"In - grade
sharpei'thwi % �-*Ill �,Pe pd��Ik�eo.
h e's' :tb
40TIfl. ' 0 : Ad
No, 4re ln,.s�rtetLM48t be,wsler settled �es qdndltlo�
work whlch� may, 'develop,, wIthIn",one!.!
t%, .
y
o,any, malUL o!jp��r" or'Ate a "rte,dandosrexcept,to In-L.,,.
oth Uor 6 pe�r�`or-lio, an
tjOTE'N&. 0 ;ed
-t the pipe Irito.th In th
ook
wye
E 'By.
DISAPPROV D ,E] Date_,- .... .................................. Byi.4 '116'te ............ �_,By_ ...........
......... .................... ..............
APPROVED
............. ...................
............. ......... .............
........... . ... . ............................. .. ......
Rernar": ..... . .. . .. . ............... .. ... . ....
....... . ... .............. ........... . ...... ...................... .............
................... I ........ ........ ; ............... ....... ...... 1! ............. . . .. . .. . ................ .......... w ...... .................
.............. ......... ...... ) .........
'Rec
it Co ie T' Signed By.Qv�ner,of,'Fft7n,Perio` 'Co'nstruction,PRIOR."T6. ju'6'st' Foe' I�Speqd;xi:'
!t t d un
hereby. ..6ertify thafth�ilde -sew la'
. .. ........ ................ er inatial tidn.�cofis hte e der &I
all accor' th all 96yerning ordiz�"qes
er;bf Piefdrining Coni�ruption)
:0 th on
MitedAhis...'e. ....... .................
tof" ........
C FOR]
heek BE
you dig for: Water []Y, Gas.C], TeM ligna' Other-
ep CV� � �ippwe�,