22828 75TH AVE W.PDF11111111 lill
5987
22828 75TH AVE W
APPLICATION CARD No . ......... . .... .. . ........ ... .
for
31' EET FILE SEDE SEWER PERMIT
a i R
The City of Edmonds OUTSIDE INSIDE 0 REPAIRS 0 EASEMENT No . ........... ... ...... ... ... ..........
I :2g2-0'2zZ,,)o L / /--) f 6-V
OWNE...... ......................................................... 0.
R ...... ............. 0 ................................................... ................ CONTRACTOR .. ....... /VP.,< .... PERMIT N G
HOUSE No . .......... STREET OCK No....
...................................................... ik .............. ; ......................................... AVENUE LOT No . ........... I ........................................................... . .. BL ... ................ ... ....
NAME ADD .... ....... ........ 74_.� .... A41.A� . .....
... ............... . ..... ....... .... . ..........
4t*
-7
c-
P al
E I
= ja a 6 w — -
Date
BACKFILL WORK ORDER ISSUED ............................................ DEPOSIT, $
SEWER WORK ORDER ISSUED ................................................
APPROVED'
,I IQAR
r
Approved:
...................... 7::�
DATE....... ..................... ........ 1-1 ....... BYA ... . . 1:;� ..... �- ................