432 DALEY ST.PDF11111111111111
10742
432 DALEY ST
ADDRESS: - _7 --_X:;X Llbf L-0-t
TAX ACCOUNTIPARCEL NUMBEIC nt)q5qzbz-��01000
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS4--" DETERMINATION: E] Conditional Waiver [] Study Required Ej Waiver
DISCEETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER): 117-42611167eA U)
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
-SEWER LID FEE $: LID #:
SHOXF PLAT FILE: LOT: t 0 BLOCK: LA
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S)
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHERU
I
LATEMP\DS'Ps\Fomis\Street File Checklist.doc
APPLICATION
for
The City of Edmonds SEDE SEWER PERNaT EASEMENT No . ..........................................
NEW CONSTRUCTION E) REPAIRS 0
114-05100
Ernest Adamson
OWNER.............................................................................................................. CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS ....... �3.? .... ... S
0
0
1�1
0
..................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAME OF ADDITION ...............................................
S'TRFEET
Dye Tested On Sewer 1972
Approved:
DATE................................................ By .........................................................