21326 95TH AVE W.PDFiiiiiiiiiiii
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21326 95TH AVE W
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
NEW CONSTRUCTION E] REPAIRS 0 EASEMENT No . ..........................................
111-37500
Orville G. Danfortli CONTRACTOR .................................................................................................. PERMIT No . ......................
OWNER --------------------------------------------------------------------------------------------------------------
ADDRESS ...... ?1-326 ......... 9.5 t.11 ... Ave ------- 1.1 ................................................. LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
....... . .. .... . ....... .
NAMEOF ADDITION .........................................................................................................................................
40
Dye Tested 011 Sevier 1972
Approved:
DATE................................................ By ............................................. ........................
APPL IRTION
for
The City of Edmonds fawnw- SIDE SEWER PERKff
Z&—,O 75-0 0 OUTSIDE INSIDE E3 REPAIRS 0
CARD No . ....... ... I ........ -
EASEMENT No.,Alva—(Z . ....... . ......
OWNER ...... . ........ . ......... 6e .......... I ............................. ..... CONTRACTOR ... klllda-74�.j4 .......... ...... 4� .............................. ... PERMIT No
-r6 STREET
5 ......... AVENUE .......................................................
HOUSE No . ..... 71.0 ............................. ........... . .................. LOT No. ...... BLOCK No . .................
NAMEADD ........ ....... ....... .................................
NJ
?jpiR())f EV
[A
13
/:Z 7-7 --,,
Date Approved:
BACKFUL WORK ORDER ISSUED ........................... ................ DEPOSIT, ..................................... w-
-4,
SEWER WORK ORDER ISSUED ......... : ...................... ............ . DATE.�,-�X- ..........
NOTIC�:
nf--
NO w-a r-r a. - Y ... ID -� the attached
The information shown on
map(s) was compiled for use by the City 01
Edmonds/ its Empl-oyees and Consultants.
Th,.e City of 'Edim.onds does. not . warrant the
accurac,y of anything set for.th on these
rn a p ('s"), A n . y person or entity -requesting a
copy should c:onduct an independent
Oirm-ation shown* c
Inquiry regarding the inf
ffi-�� Map(s), including, but not limited to
-er stub shown. Su(
the lotation of any sew
sewer stubs may or may- not e.xist and ma�,
or may not exist at the location shown
Neitheir the City of Edmoinals, nor its for th
empjo-yee-s O-r offi-ce-rs -sha,H be lJa-1r-j4,e
information given on this map(5), nor for
e-ntation provided based
anyone repres
Upon'said map(s).