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24305 78TH PL W
APPLICATION
for
The City of Edmonds STREE I FILE SIDE SEWER PERMrr
OUTSIDE 0 INSIDE 0 REPAIRS 0
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OWNER ... J.0 ... WV4 ......... lF ...... <S..)�A.E-T S ......................... .................. CON ...... P..6-.A ......... ....... PERMIT No.
.... TRACTOR ...... ... ................................ ...... ...... .. I ........................... ........ (L�9
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HOUSE No . ...... ..... ......... I ........ I . ...... ........... ............
...... . .................................................. AVENUE LOT No . .................... ......................... ...... ..... ............. .... BLOCK No.
CARD No . ........................... ... ..._
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EASEMENT No . ............. ..... ......... ....
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NAME ADD .......... ... S .... ............ ....... ..... ..... ....... ..... ............... .. .....
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APPROVED.
0-K 2 0 02
Date Approvefl:
BACKFILL WORK ORDER ISSUED ............................................ DEPOSIT, $ ......................................................
SEWER WORK ORDER ISSUED ................................................
DATE ... 4 By.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 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 S)hall be Iia-b-l-e for the
information given on this map(s), nor for
any one representation provided based
upon said map(s).