1042 ALDER ST.PDF11111111111111
10036
1042 ALDER ST
0
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER: ObgZ62_ OID
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): mMlq(hk
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMITS) #:
GEOTECH REPORT DA
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER:
L:\TEMP\DST's\Forms\Street File Checklist.doc
APPLICATION
a
The City of Edmonds for EASEMENT NO. --------------------------------
SIDE SEWER PERMIT
103-04700 NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO- ------------------ -ASMT. NO. -_-_--____________
OWNER --------------- H,--_R.--Goshorn-------------------------------------------------- CONTRACTOR PERMIT NO. --------------------
------------------------------------------------------------------------------------
JOB ADDRESS ---_- ----------- Street---------------------------------------- LEGAL DESCRIPTION: LOT NO. -------------------------------------- BLOCK NO. -------------- -__-_____-__--______-.
NAMEOF ADDITION-----------------------------------------------------------------------------------------------------------
DYE TESTED ON SEWER - February 11, 1976
By Jim Jensen
Approved:
DATE-------------------------------------------- By --------------------------------------------------yiy-y