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21308 84TH AVE W
STREET
ILE
PI FBJ.T DEPT. MMCI, LIST
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Strcet ri,(,ht-of-1;,7aNr Kxistinv
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Access Easements 17.xistinp,__ rT I
Utilitv Easement E--istin
AIA
4)LO LIE
Lot Pcr Subdivision Plat Assessor 7'3T)
Site P1.m (1ccl:cd for Accuracy,
U)
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Ilvdlnint �Zilc 11
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Saniitnry !�cwcr Availa,-'..
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Z(,
Date
-7
Pc
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Smitary SCI-ey C ction Fee Pcquired—
P�wicw
T)j t:d,
--Requi.ml—
Size
cntcil r"11411 i"Cluirca
Eol—le,
Nan"101C requircd
,-,oil Condit-*
Ground I'Jater Field (10-CLOd
ci.cate oil !7itc Plan
' C,
als
Tndicatc, oil Site
Date
Street ll;iviii(, 11cquircd
( 0-irl) -i,- ittcr Rcmdrcd
Y r -L-r
sidrci.mlh Peouirc i
"I I C,
Curb (.Yit for T)rive,..,a), R.
cmillire �--
Construction Pcillal. (III
P'*
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"I' s ct
ri, Ol
Bond 'Required for Pul Im7proveipnents
-1 e
L
Street J.gn Required
J,
icr Sinning, Pcquirect
Pre
Penait Site Inspcction made
on
c
13y:
Sewer
W,LtCr
Street
rigincerinp_
-.,tcd in
sne.c.J."ll 11.0quirc-mclits lis
men m to Bli-ilding F�--pnrti-..icnt
By
Date.
A -1. 1.
-filled in on Building
Pormit, Application
Bv
D'Itc
and "Otations
By—
—Date
C-
Approved
by P:Lil)lic 1',orhs Dcpartincnt
APPLICATION
The City of Edmonds ST REET FILE�- for
SIDE SEWER PER3HT EASEMENT No . ..........................................
NEW CONSTRUCTION C] REPAIRS [j
324-03900
OWNER ........... kl.....Des.orsier .................................................................
ADDRESS ....... ?1.3.08 ... 84 t.h ... A.ven.ue ... 11 ................................................
.. ..... ..... . .. .. ....... ..... ...
0
0
CONTRACTOR.................................................................................................. PERMIT No . ......................
LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAME OF ADDITION ........................................................................
Dye Tested On Sewer 1972
Approved:
DATE................................................ By ......................................................................
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