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21214 96TH AVE W
f f u.O§TREET FILE
The City of
'o , p
LICATION
for
SEDE SEWER PERMff
OUTSIDE 0 INSIDE 13 REPAIRS 0
CARD No . ...........
EASEMENT No . ........... .... --
........ ............... PERMIT No.
OWNER - ....... �a.D'Y�l ............ ............ CONTRACTOR Ilew ...... 47�-
. ....... ..... ..
STREET
HOUSE No . ....... ...... ...... ..................... AVENUE LOT No . ........ ........ BLOCK No . ...... .................
212141, .... . ....... .. .. ... ........ ................... ........ ....... ..
-41 1
WI =� MM
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N,
Ail
APPROVED
1602
c;;A/
t"
44, Maw
Date Approved:
BACKFILL WORK ORDER ISSUED ... ............... .................. ..... DEPOSIT, . .....
SEWER WORK ORDER ISSUED ..... ..........
DATE-1490�.
............
NOTICE,
T.
..Wa r-r a nty ... c) a.-c . C -07
N**0
The.infor matiOn'shown on the attached
Hed for use by the CItY 01
map(s) was com ' pi
Edmonds/ its Empl.oyees and Consultants.
Th,..e City of *Edrn.onds does. not. warrant the
accuraCY(Df anything set for.th on t * hese
M a P (s). A n . y person or entitY requesting a
copy should conduct an -independent
orm'ation shown* c
Inquiry regarding the inf imIted to,
t-Fe -M a P (S) / including, but not J
-er stub shown. Su(
the location of any sew
sewer stubs may or may- not exist and ma\,
or may not exist at the location shown
Neitheir the City of Edmond S nor its
e M P-1.0-ye e-S 0-r off rce,rs -shal.l b e 1--j a-b-1--e f or th
information given on this map(5), nor for
Pr 'ded ba
any One representation ovi sed
upon map(S).