24024 79TH PL W.PDF111111111111
6886
24024 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 ofEdmonds 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
empl-oyee-s o-r officers -shall be 1..ia.b.-le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
a
0
APPLICATION
for
The City of Edmonds EIT FILC SIDE SEWER PER T
OUTSIDE E] 1] 7 REPAIRS E]
CARDNo . ......................................
EASEMENT No. .— .............. ...................
L-
0 W N E R ......
V 1 �
................................................... CONTRACTOR ----------------- 14a.-zlz�.l ................................... PERMIT No.
STREET
HOUSE No . ......... ............ .. ... ............ ..... ........ ... .. .... ................ ........... 1— .......... AVENUE LOT No . ......... "C71- BLOCK No . .......... I ....................................
------------------------------ 4 .....................
. Z;k'
NAME ADD . ............. . ...... .....
............................... ....... .................................... ----------------
Date
BACKFILL WORK ORDER ISSUED ....................
..... DEPOSIT, $ .............................................
SEWER WORK ORDER ISSUED ....................................... —
APPROVED
�AP IS 1962
Approved:
DATE
...... By
.................