24028 79TH PL W.PDFIIIIIIIIIIII
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24028 79TH PL W
APPLICATION
CARD No - --------------------------------------
for
The City of Edmonds
'�9H)E SEWER FERMT
EASEMENT No
OUTSIDE--E� F- INSIDE E] REPAIRS E]
. ......................................
OWNER............ ...............................
...... .......................
... .......... --------- ......
CONTRACTOR,,./.'le.-l-,— ...........
STREET
.... PERMIT NO.
HOUSENo. ......................
..........
AVENUE LOT N - - ------------------------- --------------------------------------------
BLOCK No . ......................................
NAMEADD . .............................................................................................................
...............................................
Date Approved:
BACKFILL WORK ORDER ISSUED ................................... DEPOSIT, $ .............................................
SEWERWORK ORDER ISSUED ------------------------------------------ DATE ................................................ By ..........
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
emp-l-oyee-s or office-rs -sh-a-111 be Hla-b-le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).