21412 95TH PL W.PDFiiiiiiiiiiii
9310
21412 95TH PL W
m
APPLICATION
for
The City of Edmonds SEDE SEWER PERYaT
NEW CONSTRUCTION 0 REPAIRS 0 EASEMENT No . ..........................................
110-03000
OvVNER ........... John ... Latteagaver ........................... ............................
ADDRESS ....... �1-412 - 95th Pl. 11.
...........................................................................................
-0
El
CONTRACTOR.................................................................................................. PERMIT No . ......................
LEGAL DESCRIPTION: LOT No . ....................
NAME OF ADDITION ................................................
......... ---- BLOCK No . ............................................
Dye Tested On Sewer 1972
Approved:
DATE................................................ By ......................................
APPLICATION
for
SEDE SEWER PERMIT
The City of EdmondSTR"—t:l FILE NEW CONSTRUCTION REPAIRS EASEMENT No . ..........................................
OWNER ......................................................................................... PERMIT No.
..........
.............................. CONTRACTOR .........
ADDRESS ........ ....... ......... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
'7,<vv Aevci- Jazr
V7,
NL—j
0
NAMEOF ADDITION .........................................................................................................................................
(::::�) Ing -
Approved: TtF-71
DATE..S ...... ...... C.. By ..................... ................................................
�-�17
NOTICE:
---wa r-ra'�
No o r - a. c. c-u- r--aco-y
The -inform ation'shown on the attached
map(s) was com ' piled for use by the City 01
Edmonds/ its Empl-oyees and Consultants.
Th,.e City of Edrn.onds does. not, warrant the
accuracy of anything set for.th on t. ' hese
M a P (S). A n . y person or entity -requesting a
copy should conduct an -independent
inquiry regarding the infOrm'ation shown,c
tF�e -map(S)l including, but not i'rn'ted to/
the lotation of any sewer stub shown. Su(
-not exist and ma�,
-sewer stubs may or may
t at the location shown.
or may not exis
Neit-heir the City of Edmo'nd-z nor its for -,h
empjo-yee-s O*r officers -sh-a-1-1 be
information given on th�s map(5)) nor for
,9ny one representation provided based
upon said. map(s),