21103 70TH AVE W11111111111111
14936
21103 70TH AVE W
STAT! lARM STATE FARM INSURANCE COMPANIES
NOTICE OF CANCELLATION
INSURANCE State Farm General Insurance Company
® PO Box 5000
Dupont, WA 98327-5000
2 POLICY NUMBER RENTAL DWELLING SPECIAL FORM DATE DUE PLEASE PAY THIS AMOUNT e
,o 98-BS-3740-8 DATE CANCELED MAR 03 2001 JAN 12 2001 $234.00
98-BS-3740-8 341 J- 2451-F486 F R Insured:
CITY OF EDMONDS M MELINE SHANNON H
BUILDING DIVISION 1396 WILLIAMS LN
250 5TH AVE N MADISONVILLE TX 77864-4752
EDMONDS WA 98020-3146
IIJnIuI�IInniI�Illnn�Ilnnllrinl�Iln�I�IJInn�I1II
Location: 21103 70TH AVE W
EDMONDS WA
Payer - Insured
SFPP No: l0330113315
Important Message(s)
As of the "Date Prepared" shown below, we have not received the premium required to keep this policy in force. Therefore, this
policy is canceled effective 12:01 a.m. (or NOON if required by state law) on the "Date Canceled" shown above. If the full
premium has been paid and accepted before or on the date of cancellation, you will receive a Notice of Reinstatement, verifying
that your coverage continues under this policy. Otherwise, coverage will end. Please contact your State Farm agent with any
questions.
Agent JIM MINIFIE
Telephone (360) 435-2419
IF YOU HAVE MOVED, PLEASE CONTACT YOUR AGENT. J-2451 -F486
STATllARM
INSURED MELINE, SHANNON H
POLICY NUMBER 98-BS-3740-8 RENTAL DWELL 3
DECEIVED
JAN 2 4 2001
BUILDING DEPT.
Please keep this part for your record.
Prepared: JAN 17 2001 J
F PLEASE RETURN THIS PART WITH YOUR
CHECK MADE PAYABLE TO STATE FARM.
DATE DUE PLEASE PAY THIS AMOUNT
JAN 12 2001 $234.00
21103 70TH AVE W
EDMONDS WA
1509102011
State Farm Insurance Companies
537-162.16 Rev. 08-1999 (o1f3012e)
FOR OFFICE USE ONLY 0370
Prepared: JAN 17 2001 FIRE CANCEL $234.00 0201
N 04 M
500103200023400 798612293740812515>
STATE IARM STATE FARM INSURANCE COMPANIES
NOTICE OF CANCELLATION
INSU0.4N[f State Farm General Insurance Company
® PO Box 5000
Dupont, WA 98327-5000
12 POLICY NUMBER RENTAL DWELLING SPECIAL FORM DATE DUE PLEASE PAY THIS AMOUNT
in
1 11 98-BS-3739-6 DATE CANCELED MAR 03 2001 JAN 12 2001 $234.00
98-BS-3739-6 340 J- 2451-17486 F
CITY OF EDMONDS
BUILDING DIVISION
250 5TH AVE N
EDMONDS WA 98020-3146
II1In1nl1llnn1IJIInnJInn1IJnI1IIn1I1I1IInnJ111
Payer - Insured
SFPP No:
Important Message(s)
0330113315
R Insured:
M MELINE SHANNON H
1396 WILLIAMS LN
MADISONVILLE TX 77864-4752
Location: 21031 70TH AVE W
EDMONDS WA
As of the "Date Prepared" shown below, we have not received the premium required to keep this policy in force. Therefore, this
policy is canceled effective 12:01 a.m. (or NOON if required by state law) on the "Date Canceled" shown above. If the full
premium has been paid and accepted before or on the date of cancellation, you will receive a Notice of Reinstatement, verifying
that your coverage continues under this policy. Otherwise, coverage will end. Please contact your State Farm agent with any
questions.
RECEIVED
JAN 2 4 2001
BUILDING-DEPT.
Agent JIM MINIFIE
Telephone (360) 435-2419 Please keep this part for your record. 1
P Prepared: JAN 17 2001
IF YOU HAVE MOVED, PLEASE CONTACT YOUR AGENT. J-2451-F486 F PLEASE RETURN THIS PART WITH YOUR
CHECK MADE PAYABLE TO STATE FARM
STATE IARM
�NSU0.ANCE
INSURED MELINE, SHANNON H
POLICY NUMBER 98-BS-3739-6 RENTAL DWELL 3
537-162.16 Rev. 08-1999 (olf3012e)
FOR OFFICE USE ONLY 0369
Prepared: JAN 17 2001
N 04 M
DATE DUE PLEASE PAY THIS AMOUNT
JAN 12 2001 $234.00
21031.70TH AVE W
EDMONDS WA
1509102011
State Farm Insurance Companies
FIRE CANCEL 1 $234.00 1 0201
500103200023400 998612293739612515>
APPLICATION
The City of Edmonds SET FILE for
SIDE SEWER PERMIT EASEMENT NO . ............................................
NEW CONSTRUCTION 0 REPAIRS E] LID NO . .................. ASMT. NO- ................
OWNER . -74 CN9"-4 V—:!- --r ----- F;zl C>E�ll t4 -'l CD t4 C PERMIT NO - --------------------
. ............................................. CONTRACTOR ...... ... I ...... . ..................... (0
Sipd
------------------------------------
JOB ADDRESS --- !ZJAO3.- 77(�::)7u-: ------- -
............................................... LEGAL DESCRIPTION: LOT NO- -------------------------------------- BLOCK NO. ------------------------------------
-T
.......................................... .............................. .........................................................................................
NAME OF ADDITION
\9
2Z%t0<.l) -r7O-
b%.4E 21101 �70�u wq E-=
N
21 40SI rlow M VJ
A `V
ekl�
.4 ljl�j I
?b0,660 Llaw a pv-,c.
4/0
< - "cw)
1-610"p
wy"
*fP*
ka I
VnEw
(a, Deep.)
21051 B 70 UN
Appro ed:
DATE7- - ------ By ......................
.
e..? APPLICATION
The City of Edmonds for SIDE SEWER PERMIT EASEMENT NO_ --------------------------------------------
NEW CONSTRUCTION ❑ REPAIRS E] LID NO ................... . ASMT. NO . ..................
OWNER 77
-------------- ----- -------
--------------------------------------------------- CONTRACTOR .7, - . . ...... ------- *Aa��- ........... PERMIT NO. --------------------
JOB ADDRESS -------- LEGAL DESCRIPTION: LOT NO- -------------------------------------- BLOCK NO. ------------------------------------
................. .................................................... .............................................................
0
k4a
0
NAMEOF ADDITION .........................................................
0A1 -e S
tj
—Ur—
" �446
Approved:
M-10-
701
DATE............................................ By ...................
r
- _CITY OF EDMONDS - SIDE SEINER PERMIT
WATER -SEWER DEPARTMENT
PERMIT v
I
- ¢ n Call 775-2525 for side sewer inspections BEFORE covering any portion of the construction)
c - (Inspection will be provided within 24 hours after requst. NO Sat., Sun., or holiday inspections./ J .:
--;nT" L_.UJ Zl 1('3-70T14 �.
--!-r�VEV�I;ztc.,s-•cam _��' ;�u�.�„1 Z_!107
ADDRESS LOCATION OF CONSTRUCTION .....:..::.....'--- t-•-----...... ----..... ' ---- y----•--•-•---. ' .._...... .._..............
kPROPERTY LEGAL DESCRIPTION .................................................. --.................................. --... ............................................. ....._...---------------------------
---- ......
.___....._.. .--..- ...----.-.
. i
c7 ¢ _UiY��
-�-•-...._...� OWNER AND/OR BUILDER----'---�--...>.,.:_:.� �;.. _.1.- ...:......:..._..__.
-CONTRACTOR'S NAME &ADDRESS.-------- r:'.'_-R . ..................... .
- --••-...................................................
Permission is granted ---------------
r._..___.._-:_--_.--._------------ 19�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 in 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. j
l- 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%. 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.
F DISAPPROVED ❑ Date---- ........ ........ •--- •----- IB� Date --------:r/� --- ... By ................ Date ............... .:.-............... By................
•
,..APPROVED Date._._...._-.'. %._ By --- __.
--�•..................._.._.._..............._......-----..._...._..._•................. .......................
• a
¢
Remarks
• l
` � p
---•-•-••---------------•--.--.---.-----•-----•--•-•---------.---_-•--••----•------..-.--..------------•--•-•---------•---.----•--.---••--------•----•------•----.-.-------------.-------_-.--------..---_--..--..---.._--.-------------------..........
— BOTH Permit Copies MUST Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
I..........................................................................................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.........
t r Check BEFORE you dig for: Water ❑, Gas ❑, Telephone ❑, Power ❑, Sewer ❑, Other ❑ J 4 �1
r '
Date November 26, 1974
Memo to: Director of Maintenance & Operation
Public Works
From: City Engineer
Subject: Sewer Connection Charges
Legal Description: See attached
21116 Hwy. 99
21031 70th Ave. W.
21031-A 70th Ave. W.
21031-B it"
21103 "
Commonly known as: 21107 If
of
to Owner: Harvey Robinson
21109 If
" If
Z.F.F. Calculation:
( 230.4 ) Z.F.F. x ( $.7.50 )
(. 0 ) Lateral x ( 0 )
( 7 } Unit x ( $ 25 )
cc: Harvey Robinson
41900. 0*0
Form 6
4/0 vo off," i ;pa�mzCf'
je oo ' �s�7�t
$ 19728.00 Connection Fee
$ 0 - Lateral Charge
5 175.00 Trunk Charge
$ ln_nn Permit
1,913.00 TOTAL
i
:j
rs
November 20, 1974
File No. 4673
LEGAL DESCRIPTION FOR HARVEY ROBINSON
ENTIRE PROPERTY EXCLUDING_PARCEL LEASED TO SHELL OIL COMPANY
That portion of the southeast quarter of the southeast quarter of the
southwest quarter of Secti"n 20, Township 21 North, Range 4 East, W. M.,
in Snohomish County, Washington, described as follows: Commencing at the
southwest corner of said subdivision; thence N 107'12" W, along the wrist:
line of said subdivision, a distance of 184.02 feet; thence N 8801218" E,
a distance of 30.00 feet to an intersection with the east margin of 70th
Avenue West, the True Point of Beginning of this description; thence con-
tinuinq N 88°12'48" E, a distance of 73.70 feet; thence S 13012'48" W,
a distance; of 1 5:00 fvvt. ; thence �, 76"Q 17" C, a d i s t ancc of 120 feet
more or less to an intersection with the wpsL margin of U.S. Hhhway 99;
thence N 25°12100" E, along the west margin o1 the U.S. Highway 99, to
this southeast corner of Lot: 4, Hoyt Acres,according to the plat thereof
recorded in Volume 16 of Plats, on page 26; records of Snohomish County,
Washington; thence N 89°53'00" W, along the south line of said Lot 4, a
distance of 140.65 feet to the southwest: corner of said Lot 4; thence
N 1"47'12" W, along the west line of said Lot 4, a distanco of 6.70 feet;
thence N 89°53'00" W, a distance of 80.00 feet; thence N 1°47'12" W, a
distance of 7.77 feet to an.intersection with the south.line of Lot 3,
said plat of Hoyt -Acres; thence N 89°53'004 W, along the south line of
said Lot 3, a distance of 70.00 feet to the southwest corner of said
Lot 3 on the east margin of 70th Avenue Wcst; thence S 1°47'12" E, along
said east margin, to the True Point of Beginning.
HELL P141(1Di;E:iON A AnseMm,
L-npiner:rs '�• `;ut ✓cyuts rt, I'lww(� rs
321 maw SL MAN
riEn iii.: r;i• !:' rn I