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23404 75TH AVE W.PDF111111111111 6018 23404 75TH AVE W APPLICATION CARD'No . ...................................... lor The City of Edmonds 87 AD EET FILE SIDE SEWER FER�%F� EASEMENT No . ...................................... j OUTSIDE INSIDE Gr' REPAIRS /I>/ 09 OWNER --------- ........... .............................................. CONTRACTOR .............. ...... ... PERMIT No. -4z - STREET HOUSENo . ..... I ..... ? ............. ........ ...................... AVENUE LOT 'No . ...................................................................... BLOCK No . ............................................... NAMEADD - ----- ....................................................................................................................................................... 0 Date BACKPILL WORK ORDER ISSUED ................................... DEPOSIT, $ ................ ................... ........ SEWER WORK ORDER ISSUED .......................................... Approved: ------ . ...... By APPROVED 4Y, 2 0 1%3 r; ay C70 V) 00 loo gol� CA-4, -S, ��