23424 76TH AVE W (2).PDF111111111111
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23424 76TH AVE W
APPLICATION
The City of Edmond(;TRM-- - RLE for EASEMENT NO - --------------------------------------------
SIDE SEWER PERMIT
5U3 — 02100 NEW CONSTRUCTION E] REPAIRS r-1 LID NO . .................. ASMT. NO . ..................
OWNER------- D,1011D ...... B.O.QXZ-� ................................. .................. CONTRACTOR ----------------------------------------------------- ------------------------------ PERMIT NO - --------------------
JOB ADDRESS ------ ---- ---- 7�'�H__A-V ENU-E ---- W-E-ST�t� ......... LEGAL DESCRIPTION: LOT NO - -------------------------------------- BLOCK NO - ------------------------------------
........... .. -- -- -----
9
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NAMEOF ADDITION .......................................................................................................................
DYE TESTED ON SEWER
Approved:
DATE............................................ By ............................................................
11/75
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P1 rUIC P1:171T. GJT�, LIST -2idio Mw-
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LDf NG PEP",IT ff."'T,11' .. .... .
7.
Street Pdj,1it-oE-1-:aN Existin7 160 (0 DID
Access 1-asements, Pais tin REN) Nj A r-
Utility Eascmont E istin
PT-.O!) N
Lot Per Subdivision Plat Assessor I up
127
or Accurac, Is( TE 7-1-ft-ts)
itc PI'm Olcd�cd f
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Hydi-ant s t 1.1,
IN'(1rant "'(1.0 rCr.hre C.��,(:!c !�ize
PIctecto-r CJ�ccl: :cter
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Sa;iitau S(.n-cr Cm.,icction Fuc, Powdrcd
77
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culvor III I MCI S i. z 0
0
n( oil C�ii:c Plan
catcli D"isill Pu(illil
Nall"hole recildrud Indicate )itc
Soil Conditions oujid 1'�'atcr
PO t 0
Ask
S fre c aV i I 1g, Rcquircd
curb ul(l (',,I q, I
sidcwall� Ile Ii. c c!
9-:4.
airb nut forTriveway R.0(1111
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Pi Oht- 01 C ction rcli'lit
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Bond 1), i, dre(I for Public ImprowneInts
street mrc! Sign ileciiired
Other Sig-lini" PCquired
I Ire t SJ to* Insp-ction macic on
BY: Sewer
Water
Street
1nginccrin
spe-cia". Pom'..i.1-crimts listed in vic-im to Building A-prn.-tment
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ill oll
1,14 1 (Ij I,(; Permit Application
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Pravaln,�s St'ripcd andi 1--btaticns '1110C
Rate
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