23830 78TH AVE W.PDFlill 11111111
6709
23830 78TH AVE W
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
OUTSIDE INSIDE E] REPAIRS
CARDNo . ......................................
EASEMENT No . ......................................
OWNER...... ....... �k .................................. ............... ...................... CONTRACTOR ...................................................................... .................. .......... PERMIT No.
STREET
,-I
/ -1 _Y
HOUSENo....,__ _l/ ........................................................... ....... ................ AVENUE LOT No . .............................................. ....................... BLOCK No . ....................................
NAME AM)
ELP
Date Approved:
K ORDER ISSUED ................................... DEPOSIT, $ ................... ............... ......... C
BACKFILL WOR �2 ........ 13Y . . .... .......
�' ------ - . /L.J)i
SEWER WORK ORDER ISSUED ......... ............................ A -- \ /� ..................
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 forth on these
map(s). Any person or entity requesting 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 liable for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).