23017 76TH AVE W.PDFIIIIIIIIIIII
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23017 76TH AVE W
APPLICATION CA-RD No . ..................... ................
The City of Edmonds STREU IFILE for
SIDE SEWER T
OUTSIDE El INSIDEP;7' REPAIRS EASEMENT No . ......................................
OWNER ............ ................ CONTRACTOR ................ ... Af.4�2.d17.1.6 .... ............................... PERMIT NZ*
............ .. ...............................
117 STREET
— ---- --- .......... It
HOUSE No . ........ Z40-1-7 ...... -7 ................................ AVENUE LOT No . ............. ........................................................ BLOCK No . ...............................................
NAMEADD . .................................................................................................................................................
4-
9
L -A
1.0
7-k
NOTICE:
No warranty of accuracy. e by the City of Edmonds, its Employees and
The information shown on the attached map(s) was compiled for us (s). Any person
Consultants. The City of Edmonds does not warrant the accuracy of anything set forth on these map
garding the information shown on the
or entity requesting a copy should conduct an independent inquiry re
map(s), including, but not limited to, the location of any sewer stub shown. Such sewer stubs may or may not exist
n shown. Neither the City of Edmonds nor its employees or officers shall be
and may or may not exist at the locatio ion provided based upon said map(s).
liable for the information given on this map(s), nor for any one representat
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
SEWER WORK ORDER ISSUED ........................................... DATE . ...............
Ir
BY.... ... .. & ... ..... .. ....................