1030 CAROL WAY.PDF11111111111111
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1030 CAROL WAY
M M
ADDRESS:
TAX ACCC
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DA'
DETERMINATION: []Conditional Waiver ❑ Study Required ,❑ Waiver
SEWER LID FEE $: LID #:
SHORT PLAT FILE: r , LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #: I / Z
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED: Ui' Z5 / (D Z
LATEMP\DSTs\Fonns\Street File Checklist.doc
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_771. A7,
-APPLICAT & BUILDINt' -PERMIT -Appl No. 7--rr -
Builcr nq Deourtment.
'
crjY -dO EDMONDS
permit to construct the owing,wor. :in ac6or� with
APPLICAVON is
hereby made for a
panying plans and specifications. Two sets are submitted herewith for approval:14
Off. t
newter............. ........................................ .
Work anon re,pair .. . ..... . .... .
Use type...... .......................... zone.... -._Fire zone..: ....
Occupancy..... ............... Const.
Blk: ..... .......... .
Ad ress
V'z
M"t . . .
............... j��_ ?
............ Septic tank.
A, 27 r.
Lot,frontage ......................................
r side ... ....... 7/(-
........
Bldg.. setbacks — fron......................
Tel: 'No.
Addres&..A.�-
er---
................
builder..... ................................. . Address:.......... ... . ... . ..... .
e Tel., 0— ..............
Tel No
.............. ..
............. Address....... .. .. ............
Plans by._.: .......
. ..............
....................... ..
Remarks............................................. ................. ........... ......... . .....
. ............ .................... ........... ...
"y
............. .... .......
............................. .
.....................
. .................... . ...................... ......... .
.............. ..............
with all applicable Codes acid{ State -lawi regulating-,tm - - 40
Th� above is . a correct statement, and I agree to comply
work--
. .................
........ Date
Addr.../ 4,
Signed Owner/A
.... ... . .. ..
PERM for the above work is hereby approved, subject to the above conditionsand t6 compliancy,
proved plans and specifications, and Building Department notations thereon.
SL
.......... Recd. by ........ . .... . ...........
ff
IF
Valuation ............ Permit fee -
............... .
...
Building Department, By ............................................. Date ......
This Permit does not cover Plumbing, Sewer or Electrical installations.
J.
1
JUN ENTI)
..............District
City of Edmonds ---Water Department
TAP CARD
DatAl jQN 2,-1982
No.----- .. No .............. I ............................
Meter ...... Tap
Size ....... 6/1
...Size-----................. ................. ..
t .......... **
Mfgrs. No ....................................... Style..-..........-:..-------...----............
For................... /1.5-C) ........ .. ...... .. ..... . ..4.w
................................. .. ... ...... ....... e ........ 7
... ...... ...... . ..............
............................. .... ...........
LotNo ........................................... Blk. No..-.......................::........................
Add. ............................................................. .......... : ....................................................
Service Location .............................................................................................
................................................................................................................. . .......................
MeterLocation ................................................................................................
.........................................................................................................................................
MakeTap ...............................................................................................................
.......................................................................................................................... . .............. Pressure .............................. lbs. Test........_.-.............-........... %
...............................................................Send Bills to
..........................................................................................................................................
J, 01
Date of Work ..-JUU..' .................A
...........................
...... ....... ....... * .......... ......................... Foreman
Guar. Voucher No ........................................... $ ..........................................
Remarks: ..................................................................................................................
.......................................................................................................................... . .............
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......................................................... TREE T .... FILE-
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OUTGOING Index .......... Reg ....... Route Bk ......... Stencil ...... Card ..... . .
INCOMING Index .......... Reg ....... Route Bk ......... Stencil ...... Card ........