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21819 93RD PL W.PDF111111111111 9086 21819 93RD PL W APPLICATION CARD No. for The Chy of Edmon& SWE SEWER PERXlT EASEMENT No . .............. ...... . ...... OUTSIDE 0 INSIDE E3 REPAIRS 0 OWNER ........... ... 17-51; ............ HOUSE No. .................... .001 Date BACKFU.L WORX ORDER ISSUED ....... -- ...... - ............ SEWER WORK ORDER ISSUED - ........................... -- .... ory ..- ....... CONTRACTOR ........ Ifz'; - ......... .......... .......... .. .... STREET AVENUE LOT No . ...... ....... 7 . .............. ..... ... ... BLOCK No. NAMEADD -- ................................................................ ... ... ................ ......... ... APProved: DEPOSIT, $ .................. ................................ DATE.... V PERMIT No. PA NOTICE: War-rant-Y ... 0 T -a- Uk­ U- -1 Y. N*o--- The -inform ation'shown on the attached lied for use by the City Of map(s) was com ' p Edmonds, its Empl.oyees and Consultants. Th,.,e City ofEdrn.onds does - n (Dt ' warrant the these accuracy of anything set for,th on map(s). An . y person or entity -requesting a copy should conduct an independent inform . ation shown- o inquiry regarding the tRe -rn a p (s) . including, but not limited to the location of any sew-er stub shown. Suc sewer stubs may or may not e.xist and may or may not exist at the location shown, Neitheir the City of Edmond4s, nor its .1 be for thE empl-o-yee-s 0-r off rce-rs sh.a.1 information given on this map(5), nor for any one representation provided based upon said map(s'.