23821 80TH AVE W.PDF111111111111
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23821 80TH AVE W
NOTICE:
No warranty of accuracy.
The information'shown on the attached
map(s) was compiled for use by the City of
Edmonds, its Employees and Consultants.
The City of �Eclmonds 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
_tKe -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
emp-l-oyee-s or offiCer's-i shaill be Hable for the
information given on this map(s), nor for
any one re,presentation provided based
upon said map(s).
APPLICATION
CARD No . ......................... ............
The City of Edmonds
czj-FIE-Elp
for
FILE SME SEWER PERNUT
EASEMENT No . ................. ....................
OUTSIDE El INSIDE f-I REPAIRS El
OWNER ................................. . ...............
....... ...
... .. ..................................
CONTRACTOR .............. ............... ....... ........ -------------
...... ......... PERMIT N6'
J7
STREET
HOUSENo . ....... Y::� ..............................................................................................
I..............................
...... AVENUE LOT 'No . ..... ....................
BLOCK No . ...........................................
NAMEADD . ........................................ ........ ................................................. ..................
Date Approved:
BACKPILL WORK ORDER ISSUED ...................... ........ ... DEPOSIT, $ .............................................
SEWER WORK ORDER ISSUED .......................................... DATE < .... ....
----- BY ............
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