23823 79TH PL W.PDF11111111111111
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23823 79TH PL 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'Edmonds does not warrant the
accuracy of anything set for ' th on these
map(s). Any person or entity-reque sting a
copy should conduct an independent
inquiry regarding the information shown on
the 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
employees or officers shall be liabl-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
E
The City of Edmon
,�2� Lt
tV�EET Fls r-
APPLICATION
for
SEDE SEWER PERNaT
OUTSIDE E] INSIDE E] REPAIRS
OWNER......... 0.�-ls—r ....... X ..............................................
HOUSE No - ------ 22. - � J-, � �. - - --2 - J .. . .......... ....................
CARDNo . ......................................
EiX8EMENT No . ......................................
-4- to /
CONTRACTOR ............. &41
.'.jr; .. . .................................... PERMIT No.
STREET
AVENUELOT -No . ............... ------------------------------------------- ]BLOCK No . ...............................................
NAME ADD. --- ------------------- P�/ i 12 c ......... )�/
'P
't --------------------------
Date
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ ...... ......................................
SEWER WORK ORDER ISSUED .............. ......... .................
tlaj�
N % cj IA4
Approved:
DATE . ..... By ......
.... ............
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