22428 72ND PL W.PDFlill 11111111
5725
22428 72ND PL W
STREET FILE
The City of Edmonds
APPLICATION
for
SIODE SEWER PERMff
OUTSIDE 0 INSIDE 0 REPAIRS 0
OWNER
............................................ CONTRACTOR 4�44�We.
STREET
HOUSE No. ... ... ............ AVENUE LOT No . .....................
.W
NA:MD .......... -.1 .............. ..................
t_
w
Date
BACKFILL WORK ORDER ISSUED ............... ........... DEPOSIT, ...............
SEWER WORK ORDER ISSUED ................. ........................... _
CARD No.
M��
Approved:
DATE .......... BY .............
4 ............ ........... ................