1237 BIRCH ST.PDF11111111111111
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1237 BIRCH ST
ADDRESS: 17,37 01V � uJ
TAX ACCOUNT/PARCEL NUMBER: (DO 5I 52o0lp 0 l'+OO
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS r/
DISCRETIONARY PERMIT
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
SEWER LID FEE $: LID #:
SHORT PLAT FILE:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMITS)
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DA'
LOT: BLOCK:
L:\TEMP\DSTs\Forms\Street File Checklist.doc
The City of Edmonds Side Sewer Drawing EASEMENT NO .............................................
700-9600 NEW CONSTRUCTION [] REPAIRS ❑ LID NO . .................. ASMT. NO . ..................
OWNER MS ... .H=.. ..... BEELER .................................................... CONTRACTOR ................................................................ ------------------- PERMIT NO. ....................
JOB ADDRESS ----- 12.37..31=--S.T . ................................................ LEGAL DESCRIPTION: LOT NO . ...................................... BLOCK NO. ....................................
............................................................. ........................................................ ......................................
NAMEOF ADDITION ............... .......................................................................................................
DYE TESTED ON SE -ER
Approved:
PWW-0001-11/75 (REV.11/78) DATE ............................................ By .................