1251 BIRCH ST.PDF11111111111111
10313
1251 BIRCH ST
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER: 00M ZDb Q 10DO
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DA
EASEMENT(S) RECORDED FOR:
PERMITS
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
SEWER LID FEE $: LID #:
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DA
SIDE SEWER PERMIT(S)
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
BLOCK:
LATEMP\DSTs\Forms\Street File Checklist.doc
The City of Edmonds
Side Sewer Drawing
EASEMENT NO- ............................................
700-09500 NEW CONSTRUCTION ❑ REPAIRS ❑ LID NO ................... ASMT. NO . ..................
OWNER-9.t ... HOLBERT ..................................................................... CONTRACTOR .................................................................................... PERMIT NO. ....................
JOB ADDRESS ----- 125l--3IRCH--S-T - ------------------------------------------------ LEGAL DESCRIPTION: LOT NO. ------------------------ ------------- BLOCK NO. ....................................
..................................................................................................................................................................
NAMEOF ADDITION ........................... .......................... - ...........................................................
DYE TESTED ON SWER
Approved:
PWW-0001 - 11/75 (REV. 11/78) DATE ........................................ ... By ----------------------------------------------------
. . ..........
C I TY or ;'; iJ,dDS
RECEIVED
Leif R.Larson —�� I 'v CI:1;7!-'I, Street Dept. —�— DATI-�P�t! {`'iR; t�_ 6/25/75 -
- -__
R. T
[)I:P.' ICE.1L'.NT IIFAD' S _ JOB ORDER S I `: A "','U. UP / ��// �FAC I L I_I�Y : NUMER 104-75
"�'SCRIPTIO.! SKETCH OF W'O RK, TO EE PERFOQ I[D
Deliver 4 tons of quarry spalls to Mr. Ernie Holbert at 1251 Birch Street,,
Contact him at 776-5668 prior to delivery for location to dump(tentative,
south side of driveway).
NOTE: Quarry spalls = 3" to 1/3 cu.ft.
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DATE ASSIGNED: It
1
STREET FILE
AU-CIIORIZING SIGNATURE
PUBLIC WORKS DIRECTOR:
DATE COMPLETED: 1(�{2 T,-'•IAN'S INITIALS: I FOREMAN'S .NITAIALS: I