1021 OLYMPIC AVE.PDF11111111111111
12428
1021 OLYMPIC AVE
APPLICATION CARD No. ............... ... _ ._.......
for:
The City of Edmonds SIDE SEWER PERMIT EASEMENT No ......................................... .
OUTSIDE ❑ INSIDE ❑ REPAIRS ❑
OWNER ... E.�.`....
COTRACTOR�.. . ........ . G ......... PERMIT No.:. _. .......
STREET
HOUSE No... O `............... . - . �-4•:"'........................:.............. AVENUE LOT No.................................................. ................ BLOCK No..................................
..1 .��
NAMEADD.................................._..............................................._......_......_.._........................................................_...............
JAnaFQR��E
� 3
uj_s�...
Lu
cc
(IF'o d
P
x
Date Approved:
BACKFILL FORKRDER ISSUED ........................................... DEPOSIT, $...............................
SEWER WORK ORDER ISSUED ............................................ DATE
/:...
l