107 EDMONDS ST.PDF1111111111111113902
107 EDMONDS ST
ADDRESS: / (�L,�UPWAQX�S Y'KCi1
TAX ACCOUNT/PARCEL NUMBER:��]Zc�DD
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DA'
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
LID
SHORT PLAT FILE: ��//�� nnLOT: BLOCK:
SIDE SEWER AS BUILT DATED: G��(6 �tG
SIDE SEWER PERMITS) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
L:\TEMP\DSTs\Forms\Street File Checklist.doc
APPLICATION
for
The Cityof Edmonds
SIDE SEWER PERMIT
NEW CONSTRUCTION ❑ REPAIRS ❑ EASEMENT No ...........................................
112-05600
OWNER .......... rjrS .... j q j. j a.- McRoberts..... CONTRACTOR PERMIT No.
ADDRESS ....... 107...EdmQn-ds--- St.............................................................
.J
•
•
LEGAL DESCRIPTION: LOT No ............................................... BLOCK No..............
NAMEOF ADDITION........----•-•--------•--------------------••-------......-----.......-----------........................................
Dye Tested On Sewer 1972
Approved:
DATE................................................ By..------....--•-----...............-----•...............----•---...---