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1023 CAROL WAY.PDF11111111111111 10502 1023 CAROL WAY • 0 ADDRESS: TAX ACCOUNT/PARCEL NUMBER:bU 1) o O o o BUILDING PERMIT (NEW STRUCTURE): I- l U Z.=n 2 4 5 E 1 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 DA SCALED PLOT PLAN DATED: SEWER LID FEE $: LID #: SHORT PLAT FILE: G, LOT: C�) BLOCK: SIDE SEWER AS BUILT DATED: 1y-7/ ✓'�0 Z SIDE SEWER PERMIT(S) #: O GEOTECH REPORT DATED: STREET USE / ENCROACHMENT PERMIT #: FOR: WATER METER TAP CARD DATED: I�IIOZ LATEMP\DSTs\Fomis\.Street File Checklist.doc dr ✓rr, .. - I .� _ l I r �! !.+''"�C"1 X`l 1. M 1 r • .' tJ New lr� A431 APPUC `l,p�iG ��i` Appl. No. p p ti i C Gla d.. ' Building Department Permit limit, one,-. . �. C�T.t.OF. EDMONDS , { .. the following workin ai , cordance. vJ# the actors , F i APFLICArON is hereby made for a permit to conauuct K a submitted herewith for•approval d ecifieations. Two sets are submi t� .. panytng Ram an sp P ff•Stg v rI o yai,i Y i a new alter_......................................................... _ .----. Work a�tir� repair ./ ' Parking - .............. j .._ Fire zones:... cup Use ne...........- Const. type .... - � � zone... S wa ' Blk................ � 3.Lot................. Address:. I Fr r 7 p Area.....1......... o ..,-a Sep ti= tank .. .: . , Lot frontage ............................. ' f� k....... r. side.............stele .....!..... ......... I - := front.....�� ,rear. . Bldg. — . nn n ti �dd 1..:�..Q' T tel. No ress ...1.Q...6 (i.. r' ...........................Tel. ' f (.. ,. Builder....---.-•-••--• ............................•--•• AddNo :.. Address ............. ............................ No...... ' Tel: t Plans by......... ' } ....................................... t 4 fN Remarks.............. ................... ................... .. .i 1 f ................... ......... ................__.. r, t. The'above is a correct statement, and I agree to comPly'with all applicable Codes and State laws .cegiilattng ti i .y r Y jwork r a ..:. .. • Aaaress a�:a..io..�:R..f_. Date_ Signed Owner/Agent...ir'L.L....-U'}.k•-fir ,� }} ct e d; bjto the above conditions and to compliance wi dtMR aPp-rowesuth the I pE•for the above work is hereby and Building Department notations.thereon. proved plans and spocifications, g v ' /Jy }•f. r Permit fee ..... �?. Reed-by...`j e .... Dat ;t 5 I Building.Department, By .......................................... •---•-••-• .., `�;� i This 'Permit does ncc cover. plumbing, sewer, or electrical installations, nor does it permit any, work NOTE •— p done. in ,the Right . o f .Way areas. D+iveways and : walktcays must be planned to mcd the off iaal grades Of streets r, k r R� t t , 3 1rY r71 f : i and alleys, arid.plans fcr future sidewalk'developmrnc..;' , 1< • h1 The City of Edmomb �3y /0 — 0 64g;00 1 -7 APPL ATION for SIDE SEWER PERISIT OUTSIDE 0 INSIDE REPAIRS r-3 CARD No. ........ ................ EASEMENT No. ........................................ C OWNER........................................................................... CONTRACTOR .......................... PERMIT o. . STREET oj ;4- C-40e-09- HOUSE No.............. AVENUE LOT No.....) .......... �;) ....... AV .. ..... BLOCK No . ............. - ......................... ....... ........... r -- -BI&ME ADD—......— ...... ----------- ........... ... .......... ................ ...... ... ... .. .... ......... m Date Approved: BACKFILL WORK ORDER ISSUED ............................................ DEPOSIT, $ ................ ................... .......... -- ... 'r 'SEVER WORK ORDER ISSUED ........................... ................... - ..... Ia.- ................................................. IVIAY till ............................District 1 ity of Edmonds ---Water Department TAP CARD �o MAY5 1962 ` Date :�.................... 4 No......... .......... ............. No........................ Meter Tap Size.............................. Size....�....:.................... , ..... y..................Mf rs. No.............................. F�.�, ................. ........................................................................................................................................... ..... LotNo ........................................... B1k. No ...................... Add................................. .... Service Location .......,1..� .... ..... ..... ............................................................................................................... .............. M--ter Location................................................................................................ .......................................................................................................................................... MakeTap........................................................................................... F........................................................................................................... .......................... �. Pressure..............................lbs. Test .................................... % SendBills to ....................,.........................:...........7.............................. Date of Work .. :.,ll�......... .... �......................................... .................................................. ................................................... Foreman Guar. Voucher No ........................................... $ ... ...... Remarks: ......................................................................................... ........................ ................................................................................. ............. . ............. R FILE .......................................................................................................................................... ......................................................................................................................................... ............................................................................................................................ ........................................................................................................................................... ........................................................................................................................................... ................................................................................................................................... OUTGOING Index .......... Reg ....... Route Bk......... Stencil ...... Card ........ INCOMING Index .......... Reg ....... Route Bk......... Stencil ...... Card ........