17819 69TH AVE W.PDF11111111 lill
5297
17819 69TH AVE W
T*,4�q�g
-C
. I g9z
City of Edmond,s
SIDE SEWER PERMIT
PERMIT NO: .95D
PERMIT EXPIRES
P
Address of Constructio* n: 1i *V Ir- A I LID# 6ZI
Property Tax Account Parcel No. lllbl�- 419
:7 4W
Attach copies of all access and utility easements Verified and Approved b
SA?�u
Owner and/' ConZacto . �Orrr Iyx (,i(& S
r-
Contractor License #: ermit
A`Single Family
Invasion into City *Right -of Way: El Yes .,2 o
F-1 Multi -Family (No. of Units ..*RW Construction Permit.#
F] Commercial (No. of Units Cross other **P rivate . Property: El Yes-. ..�N o
Public "Attach. legal description and copy of recorded easement
Own Contract
Owner or contrYctor signature and acknowledgement statement: Da�e
y signing for this permit I certify that I have read the City's public handout entitled
ide S�ewer Specifications, and shall comply with all City, requirements outlined therein..
W.CALL DIAL -A -DIG (1-800-4Z$75555) BEFORE ANY EXCAVATION,
9 FOR INSPECTION -CALL 425-771-0220 extensioni Iff
24 HOUR NOTICE REOUIRED FOR A L. L INSPECTION REOUSTS
t
LLI
>
LLJ
32'
<
_17 C/o
C/o
91
NOTICE- NO WARRANTY OF ACCURACY The Information shown on the
attached map was Compiled for use by the City of Edmonds, it--
cmr"r-yecs
and consultants. The City of Edmonds does not warrant th,�,
anythilig set forth on the map. Any person or entity requc,-:�;:j j Of
a C.-; p y
ShLi'd conduct an Independent Inquiry
regarding the InforiTjLtjc,,, cj
the. miap, including, but not limited to, the location
of enly
S110,"n , Such sewer stubs May Or May not e)dst and may or rr:��, ctc,-jz:j
"
the location shown, Neither the City of Edmonds its
officer8 shafl be liable forthe Information given on thisrlol' r
0 "Ploy=3 cr
r8Presentafion map, nor for any
o,-[j
Provided based upon said map
CITY [IF EDMONDS SIDE SEWER AS -BUILT
ADDRESS
17819 69TH
AYE W
PERMIT
NUMBER 9513
HOMEOWNER xxxxxxxxxx
CONTRACTOR PERRINVILLE SEWER
DATE
07/24/01
DRAWN ISMAEL ABILA
I BY
W 0 0 0
ON -1
09 0
U
U)
. fV) I OM (v6),
,,aAV