1291 6TH PL S.PDFlill iiiiiiii
5477
1291 6TH PL S
�t- FILE APPLICATION CARD No .......................................
�� for
The City of Edmonds SmE SEWER PERMIT
OUTSIDE ❑ INSIDE ❑ REPAIRS ❑ EASEMENT No.
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OWNER _TcamkX.0--I..----- 1✓. _U.g-��zQ. .� N .... v CONTRACTOR _ I��i+E....l./,f � Lt�? �/ IVT PERMIT o -
STREET
HOUSE No. _...�....._.. C�--....................... (%Tl AVENUE LOT No. ......�-- BLOCK No. .....
NAME ADD. 7 •---- �-
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Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $.............................................
SEWER WORK ORDER ISSUED DATE �-3 BY _--- .-- ---- .......................