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21519 90TH AVE W.PDF
lill iiiiii 1 11 8774 21519 90TH AVE W APPLICATION for The City of Edmonds SME SEWER PERNaT ":z" EASEMENT No . .......................................... NEW CONSTRUCTION E) REPAIRS E] 111-04500 OV*rNER ........... Rand-olp ......... .. . -h ... 5L .... Rove ......................................................... CONTRACTOR ................................. ................................................................ PERMIT No . ...................... ADDRESS ...... ?-15-1.9 ... ?!� --- 90th-Ave.-Il . ............................ .............. LEGAL DESCRIPTION: LOT No . .............................................. BL4DCK No . ............................................ 0 0 NAMEOF ADDITION .......................................... .......................... Dye Tested On Sewer 1972 Approved: DATE................................................ By ..................................................... ................