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ca,dwm tl 86 -005 <br />PIT m 04'$11 <br />THE <br />1;.) NE NT /ACCESS/ S 1 OCVALK <br />GE awa .iZATIa /„RIP1 NO/SIGNING <br />IN PIAILIC RIGHT- OF• WAY <br />1 VIRE LIVISWI! <br />IRRIGATION <br />moms lamp muggy APPL I Es Pon PEIS11 sal am To instal 1 <br />and Public Works letter dated January 9, 1986. Prior to sign- off /use of this emergency intert <br />a written approval to use this intertie shall be provided from the Water Superintendent for <br />the City of Seattle or his designee, per the requirements of the Seattle Water Department's <br />Purveyor's Agreements with Water District No. 125 and the City of Tukwila. Use of this <br />intertie shall be in accordance with the requirements of the City of Tukwila Public Works <br />fl! APIrL 1 QAItf F9.1W W 1rY II I'IT q Ia Dave G ra g e <br />COMPLETION OF WORK AT LEAST 24 HOURS IN ADVANCE. <br />SITE ADDRESS S 131 P1 44 Av S NAME of PROJECT Emercencv Intertie <br />NAME of aurae Water District #125 (co -user City of Tukwila) PHONE 242 -4750 <br />ZIP 98168 <br />ADDRESS <br />CONTRACTOR <br />ADDRESS <br />FEES <br />PERMITS WHICH HAVE LAPSED <br />REISSUANCE OF THE PERMi <br />APPLICANTS SIGNATURE <br />PO Box 68147, Seattle, WA <br />Water District #125 <br />Same as above <br />Way <br />PHI r FHA. lsNFOR ENO1NEEh, c1TV <br />FIELD INSPECTION DATE r. 7- 66 <br />PERMIT NOT SIGNED -OFF BECAUSE <br />CITY OF TLA(W I LA <br />1200 SOUTHCINTIR SAND. <br />TNV I LA, WA 19111 <br />PLAN CHECK FEE 10.00 (000/345.830) <br />INSPECTION FEE 15.00 <br />TOTAL <br />Water District #125 ACCEPTS THIS PERMIT AND AGREES TO ABIDE BY ALL <br />APPLICABLE SECTIONS OF THE CITY OF TUKWILA MUNICIPAL CODE. WE AGREE THAT THE CITY OF TUKWILfi <br />SHALL BE HELD HARMLESS FROM CR ANY CLAIMS ARISING AS A RESULT OF THIS PROJECT. <br />THE PERMIT EXPIRATION DATE SHALL REQUIRE A REAPPLICATION <br />THE C1 LA AT AN ADDITIONAL FEE (433-1849). <br />TI TLE <br />OF TUKW I LA <br />El <br />lESEWER WA <br />MISC. <br />ISSUE DATE <br />c a• I RAT ION GATE <br />eo wc atom 1 <br />MA 1 N OITDS 1 ON <br />STORM <br />WATER MAIN EXTENSION <br />Emeraeniv ntertio <br />emergency <br />RECEIVED BY N/A <br />RECEIPT <br />CITY INSPECTOR <br />intertie per approved plan <br />(433 -1860 OF COMMENCEMENT An <br />PHONE <br />ZIP <br />CC: APPLICANT <br />INSPECTOR <br />CITY SHOPS <br />BUILDING OFFICIAL <br />FINANCE DEPT. (IF APPLICABLE) <br />FIRE DEPT. (1F APPLICABLE) <br />1 HEREBY CERTIFY THAT THE PERMIT HOLDER WHOSE NAME AND ADDRESS APPEARS ON <br />FACTILY MET THE STANDARDS AND CONDITIONS FOR THE PROJECT APPROVED HERE <br />INITIALS DATE <br />1 -21 -86 <br />7 -21 -86 <br />1S RECORD HAS SAT1 <br />AM <br />