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1021 SPRUCE ST
APPLICATION CARD No. ............... ..........
for
0
•
The City of Edmonds SIDE SEWER PERMIT
EASEMENT No. ..............................
OUTSIDE Ia INSIDE ❑ REPAIRS ❑
OWNER .....G%.I 1.t..•/........................... .................................... CONTRACTOR ........ `:.::::::............. ... PERMIT No. ....fir ....
/ j� BLOCK No...........v2.../..............
......_...........
HOUSE No..1...................yl••I••G....�................��.................. AVENUE LOT No...........L.................................. .
NAMEADD.................................................................................................................................................................................
FILE
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Date
BACKFILL WORK ORDER ISSUED ............................................ DEPOSIT, $.,.............................
SEWER WORK ORDER ISSUED ................................................
Approved:
DATE....�.,�3.�....�..�.../.�..../.... BY ... ....11.......J...1..1'.. :... ..............