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23530 75TH AVE W.PDF
111111111111 6031 23530 75TH AVE W APPLICATION STREET FILE for The City of Edmonds SIDE SEWER PERMIT OUTSIDE 0 INSIDE 0 REPAIRS 0 oe 7 1 /ol �O'WNE HOVSE'No. AN, eo;� CARD No . .............. .- . -- 1. EASEMENT No . ........................... - - - P:Z— ............................ COXTRACTOR;--�-,,#*2:�'. �-- ....... . PERMIT Nj,'�� STREET......... . .................. ........... 7 ...... ... BLOCK No. ................... .......... AVENUE LOT No ....... . ........... ...... NAMEADD ... .. . .......... .............................................................. '7� tv, . CL 70 6 q 57, Ml- d- Til Gic�, ct ce-c;�0 r; VD, C: L",' t;, cl, Mwj a -ad (r.zy cr i illr- ".� - - i'� n t t, czfs shaii L, li=: - fC! th., li.'lf this nc' f & a Approve 1: BACKFILL WORK ORDER ISSUED ........................................ ... DEPOSIT, $ ...................................................... SEWER WORK ORDER ISSUED ...... ......................................... DATE. ......... BY . ......... ..... - . ......... 1� . ....................... .01 0 0 The Cify of Edmonds APPLICATION for SIDDE SEWER PERMT OUTSIDE 0 INSIDE 0 REPAIRS E] CARD No . .......... EASEMENT No . ...................................... OWNER ......... /t� / 7 Y p'C'51:10 ... ..... .............................. ....................................................... ................. .............................................. ......... CONTRACTOR ...... . ........ PERMIT No. HOUSENo . ....... .. ------------------------------------------------ ............................ STREET AVENUE LOT No . ...................................................................... BLOCK No . ............................................... NAMEADD . ..................................................................................................................... Date BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ ................. SEWER WORK ORDER ISSUED ........................................... rj U.,e by thc. Ci,,/ J wa's C r�-,r�kad toi Of L.-'; D"2 tity Of kdn'Onds d(x,-','n.ci t— tr'th 0'' L-.' man Any perr.oa c, ej%�- c0nd: '!cl cii independent Inn[Orvfaaardino t�:� r.;-j, in iho cf F-. su": c'Llt!!'g, but ni' amited to, -�, --s',d`)3M-AYorMay-iw —ioandru.yorm City Of io ds ncr h afficars sha be liabie for"the Informabo, cl 1—J,'�;3eW .1 - this m'4" lab ner for L-,,j Gr7. Approved: DATE ... BY....................................................................