1427 7TH PL S.PDF1427 7TH PL S
�+ APPLICATION
for
The City of Edmonds STREET FILE SIDE SEWER PERMIT
OUTSIDE ❑ INSIDE ❑ REPAIRS ❑
CARDNo. ......................................
EASEMENT No . ......................................
OWNER.............................. G--•-----........t-/r_..'K!----......-----•---..................---------.. CONTRACTOR.--................................................................................................ PERMIT No. ..
STREET
HOUSE No.......... ................. 21 �ih!.....-J.=-�✓>'�'.......S-cJ �;:7.1 ------. AVENUE LOT No..........................w?...--........--...........--............. BLOCK No. ........................
NAME ADD. ...........�c Z=-------- /�!�:........ ....... ..........................
Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ ..................................
SEWER WORK ORDER ISSUED ..........................................
DATE
.............. By...................................................................