1022 B AVE.PDF11111111111111
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1022 B AVE
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TAX ACCOUNT/PARCEL
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 FOR:,
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $: LID #:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED: Vut, g- T V 1/ "
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT#:
FOR:.
WATER METER TAP CARD DATED:
OTHER:
LOT: BLOCK:
L:\TEMP\DSTs\Fonns\Street File Checklist.doc
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APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
NEW CONSTRUCTION E] REPAIRS 0 EASEMENT No ...........................................
107-05300
OWNER ......... Elsie ----- BartleS-on.......................................................... CONTRACTOR ................ =................................................................................. PERMIT No. ........... ...........
ADDRESS---- 1.022...$---Street------------------------------------------------------------------
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to
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LEGAL DESCRIPTION: LOT.No............................................... BLOCK No............ ................................
NAMEOF ADDITION.............................................................................
DYE TESTED ON SEWER
JULY, 1972
Approved:
DATE................................................ By-----.................----.........------...........................--