1051 GLEN ST.PDFiiiiiiiiiiiiii
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1051 GLEN ST
1
APPLICATION CARD No .2 ......................................
for
The City of Edmonds SIDE SEWER PEA_ YE[T
EASEMENT No . ......................................
OUTSIDE E] INSIDE n REPAIRS ❑
OWNER A ...... -------- ..... . .............................. CONTRACTOR .. ..... . .. ............................ PERMIT No
STREET
HOUSENo . ..... ................. ....... AVENUE LOT No. ...................................................................... BLOCK No. ...............................................
NAMEADD . .............................................................................................................................................................
J� V/1
j jr
1 .
or
Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ ...................... ...............
SEWER WORK ORDER ISSUED ....... .................................. DATE .............. By ..... .. . ... .......... .......... 7-11� - ----------------------------