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CITY of ED.MONDS SIDE SEWER PERMIT
For Inspection Call 771-3202������ FILE
PERMIT N0.�20
Ly"WOOD LIN9
Address of Construction: 16630 - -7,et-1 h �?L.. YJ
Property Legal Description (Include all easements):
Owner and/or Builder: !)AcX.o C ®^, ,4 , C�
Contractor & License No: VA (�
Single Family Residence
Multi -Family
Commercial
(No. of Units )
(No. of fixture Units )
Invasion into City Right -of -Way: No I, Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No Yes (If Yes, easement required,
attach legal description and county easement number.)
PLEASE READ THE ITEMS LISTED ON THE BACK
I certify that I"have read and shall comply Date
with the items listedon the back.
Permit Fee: %50,00
Trunk Charge: m2.5-,00
Assessment Fee:
Partial Inspection:
Issued By:
Date Issued:
Receipt No.:
0
Comments
Final Inspection Approved: �/-2-
Date Ini al
Rejected:
Reason
** PERMIT MUST BE POSTED ON JOB SITE **
Date Initial
INSP. 8y J1c-M
KkWi►1 SMSTH
Date Initial
Wh.ite Copy - File Green Copy - Inspector
Buff Copy - Applicant
The City of Edmonds
EASEMENT NO- ----------------------------------------
MCAD. cow" -
NEW CONSTRUCTION E] REPAIRS ❑ LID NO. 2-1-0 ------- - ASMT. NO. --_ ----------------
OWNER F C \tj-ca �t E -g ------------------------------- ----- CONTRACTOR .,-DJ:WC C. _N
------- ------------ PERMIT NO. 722
B ADDRESS 16G3-0. ,, -------- ----------P-------L- W ..... ------------ LEGAL DESCRIPTION: LOT NO- ------------------------------------- BLOCK NO. 000 ------- D-no-0
------------------------- ................ 11 ----------------------------- A-k--L ---- ma
NAME OF ADDITION ------------------
---------------------------- -------------
PWW-0001-11/75;(REV.11/78)
Side Sewer Drawing
VCR
C.C.
1319 0
1.5,W.
4"C.O.
4SPOSM9
3V
36.
6.
44;c o 46 7.7'
Approved:
DATE&&74—!.�+IJAI-- By
1 t4sp. lats