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23807 80TH AVE W
APPLICATION
The City of Edmonds SYREET FLE SEWfEor PE...T
OUTSIDE INSIDE E] REPAIRS E]
A
CARD No. ..
EASEMENT No . ......................................
'10 IDR
OWNER,.,'�—�e:�: . .. ... / .... ----- - ----- ere
............................................. CONTRACTOR ............................ PERMIT No . ...... .....
STREET
HOUSE No . ........ —7.4pi�19 .... z ----------------- — ------- - J� . . ............. ! ............ AVENUE LOT No. ...................................................... ...... BLOCK No . ....................... ...... ................
NAME ADD. .........
0
0
Date
BACKFILL WORK ORDER ISSUED ..... ............................. DEPOSIT, $ ......... ....... ......
SEWER WORK ORDER ISSUED ........................... ..............
51
P RR OV ED!
�Fw 24 1963
Approved:
DATE------------------------------------------------ By .......................... ........................................
NOTICE:
No.warranty of accuracy.
The information'shown on the attached
map(s) was compiled for.use by the City of
E dmonds, its Employees and Consultants.
The City of �Eclmoncls does not warrant the
accuracy of anything set forth on these
map(�_). Any person or entity -requesting a
copy should conduct an independent
regarding the information shown on
fh-e -map(s), including, but not limited to,
the location of any sewer stub shown. Such
sewer stubs may or may, not exist and may
or may not exist at the location shown.
Neither the City of Edmonds nor its
ernp]-oyee-s o-r officerS, sh-a-111 be ha-ble for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).