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1048 EDMONDS ST
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TAX ACCOUNTIPARCEL NUMBER: Mq5 Z041U15�DV
BUILDING PERMIT (NEW STRUCTURE): j q 5
COVENANTS (RECORDED)
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DA
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER): ffil "l l Ctet.W
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
SEWER LID FEE $: LID #: / f
SHORT PLAT FILE: LOT: �J BLOCK: `i' I
SIDE SEWER AS BUILT DATED:�{e
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
OTHER:
LATEMP\DSTs\Forms\Street File Checklist.doc
of Edmonds Side Sewer Drawing
The City EASEMENT NO- - --------------------------------------
218-01900 NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO ................... ASMT. NO..-.---..-.--..---.
OWNER ..... W..-.C:...BR Fl� W ............................................................ CONTRACTOR
-----•-----••--------•-•-••-------•------•--•-------------------------------------- PERMIT NO. ..------------------
JOB ADDRESS ..... 1048--EDMON-DS--ST---------------------------------------------- LEGAL DESCRIPTION: LOT NO. ...................................... BLOCK NO. ....................................
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•
.•----------•------•-------------•--•----••--•--•----------------•---•--••.-•----........--------•----.......-----------------.--------------....------------..... .
NAMEOF ADDITION.---•--------•----•------•-•-----------•-------••---•------•-------•----•------------------------•-------------•-.--
DYE TEST ON SEf ]ER
Approved:
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PWW-0001-11/75 (REV.11/78) DATE ------------------------------------------- BY------------------------------------------------------------
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT EASEMENT No ...........................................
NEW CONSTRUCTION O REPAIRS
118-01900
OWNER........... ......C......B.reM3n................................................................ CONTRACTOR................................................................................................-- PERMIT No.......................
ADDRESS ....... 1048..EamOr!.ds...St . ........................................................ LEGAL DESCRIPTION: LOT No............................................... BLOCK No.............................................
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t
b
W.
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NAMEOF ADDITION..............•..........................................................................................................................
Dye Tested On Sewer 1972
Approved:
DATE................................................ By......................................................................