24103 77TH PL W.PDFIIIIIIIIIIII
6598
24103 77TH 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 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 liab-le for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
APPLICATION
for
The City a SIDE SEWER PERXff
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�,7W#T OUTSIDE 0 INSIDE 0 REPAIRS 0
OWNER...... ................ ........................... ..... CONTRACTOR .... . .............. . . .......................... .........
—2 31�/O Z STREET
HOUSE No . ...... ...... ;r.�p AVENUE LOT No . ..............................................................
NAMEADD ......... ...... ......... ............................... ....
Daie
BACKFU,L WORK ORDER ISSUED ......................
SEWER WORK ORDER ISSUED ..... .......................
APPROVED
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Approved:
........ DEPOSff, $ ......... ............ - ................... -- .......
DATE.7.7�/ ..................... BY// .....................
CITY OF EDMONDS
PMLIC WORKS — EMINEERING
ACTION REPORT
N9 2479 -
.2
SUSPENSE DATE:
Date: Time: -V'Ale) C? File #
Attachments: =Yes
SUBJECT: o Ze- V),P./r =NO
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REQUESTOR: NM4E: 4 AY �T
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ADDRESS:
PHONE: 6�- Z -7 3
REQUEST RECEIVED BY: TELEPHONE
CONTACT IN OFFICE
OTHER:
RECEIVED BY:
PNITF Tn-
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MEMMEMMIM
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�el 6104 t/l/y\ All Concerned Notified
Action Completed/File
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