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23224 75TH AVE W.PDFlill 11111111 6008 23224 75TH AVE W F, 0 wl APPLICATION for The City of Edmonds 87'""Eff FILE SIEDE SEWER PERNaT OUTSIDE f-I INSIDE 0 REPAIRS F-1 57 OWNER....V. ... ...... . ................. ...... ......... .................................... CONTRACTOR ------ STREET HOUSE No . ..... ............................................ .................... AVENUE LOT 'No. NAME ADD . .......... 3 z' 2 Zj t;; 'c� LL� 7--!5--7-,,'l CARD No . ......................... EASEMENT No . ......................... ------------------------------- ------------------------------------- PERMIT No. ........................................................ BIA>CK No . ............................................... ................................................................................................................................... -0% Date DEPOSIT, $ ............................................. Approved: BACKFILL WORK ORDER ISSUED ......................... * ......... 7 SEWER WORK ORDER ISSUED ....... BY . . . . ........... ................. DATE