24119 78TH PL W.PDFlill 11111111
6791
24119 78TH PL W
P,6,qM /T !�9,01,il �O :?),4 Y3
CITY OF EDMONDS SIDE SEWER PERMIT
9 0 -1 9 c� 1, PERMIT
I - 9 115
Address of Construction: at-il" / 1 9 _� 9 P L L�j - 0 riJ S
Property Legal Description (Include all easements): RECF"" U
JA% 3 1 2UUU
qUBUG \NORKS
Owner and/or Contractor: Re") t C) Q,o f c-r 5c- r 0 It c r-S
State License No. 10! 6 To IZ1051 Building Permit No.
/o") (kf�) YlA 7EBIALLIN(3EF�
`V' "G
LIF-F STA-r,ON
7-
esingle Family Invasion into City Right -of -Way: 0 No CYes
0 Multi -Family (No. of Units-) RW Construction Permit No. (650-
13 Commercial
0 Public
Cross other Private Property: eNo 11 Yes
Attach legal description and copy of recorded easement
I certify that I have read and shall comply with all cit� requirements
as indicated on the back of the Permit Card.
61 -x a 06
Date
* CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY-tXCAVATION *
OFFICE USE ONLY
FOR INSPECTION CALL 771-3M, PUBLIC WORKS DEPT.
Permit Fee: Issued Bycm�!�/?�,
Trunk Charge: Date Issued: V-2 gla 0
Assessment Fee: Receipt No.:
Lid No.:
Partial Inspection: Date -Initial -
Comments
Reason Rejected: Date -Initial
Final Inspection Approved: Date2-1-2000 Initia/d_00'
** PERMIT MUST BE POSTED ON JOB SITE **
White Copy: File Green Copy: Inspector Buff Copy: Applicant
Revised 3 90
The City of Edmonds Side Sewer Drawing EASEMENT NO - ------------------------------- ------------
NEW CONSTRUCTION Fl REPAIRS C?-**" LID NO . .................. IASMT. NO... ................
OWNER................................................................................................ CONTRACTOR .... ifA.b --- 49.?�ex� .......... .................................. PERMIT NO.
JOB ADDRESS ... 2-L1.11.5 .. . .... LEGAL DESCRIPTION: LOT NO . ........... ...... .............. BLOCK NO . ....................................
........................................................................................................................................................
NAMEOF ADDITION .......................................................................................................................
7 9 A fl- W-
$we
0
r%
Ak
PWW-0001-1 1/75 (REV.1 1/78)
M
Approved:
DATE........ .......... By�� ......................................
:1
APPLICATION
for
The City of Edmonds S-rREET FiLt SEDE SEWER PERMIT
OUTSIDE P--" INSIDE 0 REPAIRS
OWNER ...
HOUSE No.
CAXtDNo - --------------------------------------
EASEME14T No - ------------------ -------------------
k- 10 /0
'TOR f:5 LO
---------------- ----------------- .... COIITTRAC .............................................. ------ . ....... ...... --------- PERMIT No.
— ---------
....... -------
V -:�Y'<XJ/
-------
�'.-STREET
--�,/AVENUE LOT,
No.
BLOCK No.
I -TAME ADD . .....
......... ... .......
- ------- .....
BACKFILL WORK ORDER ISSUED — --------
SEWER WORK ORDER ISSUED ---- - ----------------
L
WIM
........ DEPOSIT, $ ....................
�3 5-
mm
'FEB
App eo:
-----------
ajo� - ------ ---
By
%I
E
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 loc*ation 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'-o-yee-s o-r officers sh-all be 1..ia-b-.I.e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).
STREET, FILE
The City of Edmonds
An (J. t-1-7 0) C-7 --A
APPLICATION
for
SIDE SEWER PERMff
OUTSIDE M---' INSIDE 0 REPAIRS 0
-OWNEPR .... .. .... .. ............ . ........................................................................ CONTRACTOR ................ ......
STREET
HOUSE No . .......... .......................... ..... ...
...... ........ AVENUE LOT No . ...... 71e.ee ....... C.J ... ..........
NAME ADD "Xe ..... ....... h14:71!
Z'14
-76
)a
4
4
I
CARD No . ............. . .......
EASEMENT No . .................. ... ... .................
............... ................. PERMIT No.
...........
.... BLOCK No. ..... c/1).- ...................
............................................. .........................
APPROVED
4N'n W2
Date Approved:
BACKFILL'WORK ORDER ISSUED ............................................ DEPOSIT, $ ........ ............. ...............................
SEWER WORK ORDER ISSUED ................................................ DATE)�, .... ..... 4 ..... / .. .. ........ BY ........ ..... ..... .......