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1011 CASCADE DR.PDF
11111111111111 10542 1011 CASCADE DR ADDRESS: TAX ACCOUNT/PARCEL NUMBER:Db!�� M O O O 0 2 0 0 BUILDING PERMIT (NEW STRUCTURE COVENANTS (RECORDED) FOR: CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ 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 #: SHORT PLAT FILE: LOT: 2— BLOCK: SIDE SEWER AS BUILT DATED: SIDE SEWER PERMIT(S) #: GEOTECH REPORT DA' STREET USE / ENCROACHMENT PERMIT #: WATER METER TAP CARD DATED: I (l Z OTHER: LATEMP\DSTs\Forms\Street File Checklist.doc 3 n The City of 5"086 67� k--- �7 OWNER ..... HOUSE No . .......... ........... C'PUCATWIR CARD No. . . .... - .................. for SIDE SEWICit PERMIT OUTSIDE 0 INSIDE 0 REPAIRS 0 EASEMENT No. ................... fto ............................... CONTRACTOR . ...... 4) *'JA 4 A ...... 7,wollIA")J�A ................... PERMIT No. STREET 2— ...................................... AVENUE LOT No . ................................... BLOCK No . ................................................. .... . .... NAME ADD.. .................. .............. ............ ........ .......... . 6 .......... e(L . PAID Date Approved: BACKFILL WORK ORDER ISSUED............................................ DEPOSIT, . ...... . ... ..... .... SEWER WORK ORDER ISSUED ................... - ............ ......... WONDS VINfEl V'VPL DATE- .......... Byl, .... $100000 ...........................Disc NO%, �21962 i City of Edmonds ---Water Department TAP CARD Date........... 21/12./6? . .............. No............................... No ...... 76 ........................ Meter Tap Size.............................. Size........................................ Mfgrs. No .................................................... Style............................................. For............................ Glen Dale........................... ............................... ....................................................... .......................................... .................... . ....... . .............. ............ **"* ......... ---- - - ......... LotNo ........................................... Blk. No .................................................... Add. ........................................................................................................................... i. Service Location ............................................................................... ........................................................................................... Meter Location ................................................. .......................... Make Tap Pressure .............................. lbs. Test....................... Send Bills to .................... A. ..................................................... Date of Work .............. .................................................... Guar. Voucher No... i P ... . ....... . . % I .......................................... Foreman ....................... $ ................................... . ..... .................................................................................................................. ................................................................................................................. . ........ ............ ........................................................................................................ ................................................... .. ...................................................... ti ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ....... . ........ ............ - r ILE ..................... -------------- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..................................................... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . OUTGOING Index .......... Reg ....... Route Bk ......... Stencil ...... Card .... INCOMING Index .......... Reg ....... Route Bk .... .... StenciL.....Card .......