24021 79TH PL W.PDF111111111111
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24021 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 -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
empl-oyee-s o-r officers -sh-all be 1..ia-bl-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
CA-RD No . ......................................
The City of Edmonds,
for
SME SEWER PERYaT
IET FILli
EASEMENT No
OUTSIDE INSIDE REPAIRS
. ......................................
4 IoY
OWNER U./ .. -------------- ........................... CONTRACTOR PERMIT XO. .
rznTTQ'W- WT 7,
STREET
767 44 J-K A�& AVENUE LOT o
BT A-lt'W No
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0
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0
. .......... ............... ... ------------- . ...................................................................... . ...............................................
..............................................
NAME ADD . ....... . ........... ....................
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7 <7 Y--� R/
BACKFIM WORK ORDER ISSUED ........... Date ............... DEPOSIT, $ ............................................. Approved:
SEWER WORK ORDER ISSUED — ....................................... ..... B Y .. .....................
qjjj 2f ERM2EDS
pUBI,IC WORKS - EMINEER114G
�teTqC)N.-REPORT
SUSPENSE DATE:
N9 4t62 -
Time: File # r--lYes
Date:' Attachments: CZINO
d�
SUB/JECT: IL
NAME
REQUESTOR: Aj -79
ADDRESS:
PHONE:
REQUEST RECEIVED BY: TELEPHCNE 916
CONTACT IN OFFICE r --- I
OTHER:_
RECEIVED BY:
ACTION: d -�,q 1� . - I �// Zix, /
All concerned Notified
Action Completed/File