456 ADMIRAL WAY.PDF10017
456 ADMIRAL WAY
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-RECEIPT FOR CERTIFIIWMAIL
SENT TVern Higman, Manager
STREET NO.
MiDonds Yacht club. 460 AdN
P.O., STATE AND ZIP CODE
-prirnn-incl.q- Washington 98020
POSTMARK
OR DATE
1. shows to whom and date deliverea ..........
:ETURN Wit h restricted delivery ------------------- ----
ECII?T 2. Shows to whom, date and where deliverd_da
SERVICES With restricted delivery ............... ... ---
S� R�IT DELRIVERY ---------------------------------------------- - - --------- ---- --
CIAL F_
DEL V E T (extra fee required) ..... ...... .
PS Form NO INSURANCE COVERAGE PROVIDED— (See other side)
Jan. 1976 3800 NOT FOR INTERNATIONAL MAIL * GPO: 1975-0-591-452
STICK POSTAGE STAMPS TO ARTICLE TO COVER POSTAGE (first class or airmail),
CERTIFIED MAIL FEE, AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES. (see front)
1. If you want this receipt postmarked, stick the gummed stub on the left portion of the address
side of the article, leaving the receipt attached, and present the article at a post office service
window or hand it to your rura[ carrier.. (no extra charge)
2. If you do not want this receipt postmarked, stick the gummed stub on the left portion of
the address side of the article, date, detach and retain the receipt, and mail the article.
3. If you want a return receipt, write the certified -mail number and your name and address on
a return receipt card, Form 3811, and attach it to the back of the article by means of the
gummed ends. Endorse front of article RETURN RECEIPT REQUESTED.
.4. If you want delivery restricted to the addressee, or to an'authorized agent of the addressee,
endorse RESTRICTED DELIVERY on the front of the article. Check the appropriate blocks in
Item I of the return receipt card.
5. Save this receipt and present it if you make 'inquiry.
C,
j
ADDRESS:
TAX ACCOUNTIPARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: E] Conditional Waiver [] Study Required Ej Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DA
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER):
1q6Zb7--7:3(-f4,vtpm,A 11&2- () 4-q&,jrji) Igezoy 0( � I?ez- f 17em Dw;p (fire-
- I / , - %� d I -f -_ iKpfl, . / 0, 7
I--( vc,
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE
SHORTPLAT
LOT:
LID #:
BLOCK:
SIDE SEWER AS BUILT DATED: 12A U 9 1 ':�I)w , U - 12-111)ltj 14j//
U -
SIDE SEWER PERMIT(S) #:..qbc-29
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
OTHIiaW
LATEMP\DS'rs\Forms\Street File Checklist.doc
I" I
2-
ADDRESS:
TAX ACCOUNT/PARCEL
BUILDING PERMIT (NEW S
COVENANTS (RECORDED)
CRITICAL AREAS:
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
DETERMINATION: [] Conditional Waiver F Study Required F-1 Waiver
PERMITS (OTHER): 1 q,51 Ob a hyc r--e,,,.r 4 � j (o 7 ,317 _q, ID p c k -016PQJ�Cd,/ � 19&,(,- 007 -71 re'n (e-
tq k5?t:kecf i I I W;
i6M00Q7,-1e�Ld d� 111 p .1
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
SHORTPLAT
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
I
OTHER:
LOT:
LID #:
BLOCK:
J
LATEMP\DSTs\FonTis\Street File Checklist.doc ">�
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED) FOR:
CRITICAL AREAS: DETERMINATION: El Conditional Waiver 0 Study Required E] Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER): 19 q-2 WC1H �-jje 5 x� 2-W-4--415iq!) lqqL -012�2(Mffth) Nq Z
I
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
FOR
WATER METER TAP CARD DATED:
LATEMP\DS'Ps\Forms\Street File Checklist.doc
Ile
RECEIVED 0
7, '91DE
1 1992
CITY OF EDMONDW
PUBLIC WORKS DEPT.
Address of Constructi6n:
�Z, 4-PA41'R_#L
Property Legal Description (Include all easements):
SEWER PERMIT
PERMIT N2- 84-18
STREET FILE
4L I o7l"i
A,
'AJ 07.7
110-01z V,u cr; ge-" 541`44 (k). 132 Ll
Id, lber.; 414a." 541%b��l 9S*0; 41,t4cz V-7 .541"12
54,0 X-CVAI; #(I"'
X.- .5 // `4 �), 13
Owner and7or Contra tor:.
,A414-Aeif 66AJ�r zyos: CAR -ie- Avc. 1(4
StateLicenseNo. Building Permit No.
I rTR E 7AT !ME !NT !PL A:N T]
C3 Single Family
C3 Multi -Family (No. of Units—)
Commercial
0 Public
Invasion into City Right -of -Way: k No 13 Yes
RW Construction Permit No.
Cross other Private Pro�erty:X No 11 Yes
Attach legal description and copy of recorded easement
I certif� thay have read and shall comply with all city requirements
as indic-a-red on the back of the Permit Card.
Date
CALL DIAL -A -DIG (1-800-424-5555) BEFORE ANY EXCAVATION
OFFICE USE ONLY
FOR INSPECTION CAL PUBLIP WORKS DEPT.
7 1 - "G, 12,
Permit Fee: — 7n Issued By
Trunk�Charge: hl� Date Issued:
Assessment Fee: Receipt No.: 9a�_�
Lid No.:
Partial Inspection: Date —Initial —
Comments
Reason Rejected: Date —Initial
I Final Inspection Approved: Datd`.2i n i t i a I A�-
PERMIT MUST BE POSTED ON JOB SITE
White Copy: File Green Coey: Inspector Buff I Copy: Applicant
Revised MID
Side Sewer Drawing
The City of Edmonds
NEW CONSTRUCTION Ej REPAIRS X
EASEMENT NO - ----------------------------
.............
LID NO - -------------- NO - ------------------
MF- CW&NTRACTOR ----------- ------------------------------------------------------------------------ PERMIT NO.
OWNER ------ - �()
45(o Aomk R A, L 'BLOCK NO - ---------------------- ---------
JOB ADDRESS - -------------------------------------------- ................... LEGAL DESCRIPTION: LOT NO - ----------------- .................... ----
0
E
A
z
F_ucL4suR.f_ Fock Ker-Telk
Ap4b C-0.
AeovE GPou&4t)
V'P.05. GATE VALVE-S
wA,Mfkcus
19
u
PWW-0001-1 1/75 (REV.1 1/78)
-----------------------------------------
NAME OF ADDITION
ScuTAeAVT
11BUILOWC-P
W
'7'
_t_R�_S_s LINE
I I
Gr-?Z-ASF- -r-F-*A,P
U
4�'c.o. -To Gct^v&
Go"ASS W'JF-
1 2" 0 1 7_' DEEP
Nk
: :X %STING
all
4'
Approved:
PARI"NL
DATE 1.-.�.2 . .............. By ....... ell?
..............................
CITY OF EDMONDS
XQR INSPECTION N?
PUBLIC WORKS DEPASONT __6452
SIDE SEWER PERMIT �� 775-2525 Ext. 220 Issue Date
PERMIT MUST BE POSTEDON JOB SITE�-ij
777
1. Address of Construction A4 I'v, t"I Ilk
2. Property Legal Description.(include all, easements)
1- 77w, ;,4,1T dul 6t, Jji,'U'a 4-71r., 00C &�227-
3. Single Family Residence Multi -Family No. of units
Commercial 11�
4. Owner and/or Builder — ACT oF
5. Contractor & License No. P&v--T— e, F E-a( 416 Aj
6. Invasion into City Right -of -Way: No L,-� Yes (If Yes Right-of-
way Construction Permit Required - Call Dial Dig (342-5344) before
excavation).
7. Cross other private property: Yes No ,., Easement required -
attach legal description and county easement number.
READ THE FOLLOWT.NG AND SIGN:
a. Property owners must obtain apermit to install side sewers on
their property. A licensed side sewer contractor must be employed to
construct side sewers in the public' right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year.
c. Commercial establishment requires a minimum of a six inch (6")
side sewer line.
d. Side sewers may not be installed closer than thirty inches (30")
to any structure.
e. Side sewer lines must be laid at a minimum grade of�2% (1.150)
and maximum grade of 100% (45 0 ). 0
f. No turn in side s8wer greater than 45 (1/8;bend) is allowed
between cleanout. All 90 turns must be constructed of a 45 (1/8
bend) and Wye with removable cap.
g. No down spouts, footing drains or floor drains can be connected
to side sewer system.
h. Pea gravel is required for bedding when installing sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60" from each plumbing exit line
and at minimum intervals of 100' along sewer 'line run.
j. Trenches within City right-of-way must be restored to original
conditions. Contractors shall be responsible for right-of-way failure
due to poor compaction of fill.
k.. Side sewer must be left uncovered until inspected and approved
by the City.
1. Inspection during normal working hours only. Two (2) working
days notice required.
DATE: 2 -Pkj �,
I certifythatOI have rea
and shall comply With the above
PERMIT FEE:
CONNECTION FEE:
0
FX4 PERMIT MI
DISAPPROVED BY: Date:
By: -Date:
APPROVED By: Date:
T BE POSTED ON JOB SITE *
CITY OF EDMGNDS FOR INSPECTION CAI*,
110 ,
4PUBLIC WORKS DEP#MENT Permit 1k. -
.775-2525 Ext. 220 Issue Date -79
SIDE SEWER PERMIT
PEP -MIT MUST BE POSTED ON JOB .. SITE
MW 'AM
777777
1. Address of Construc
2. Property Legal Description (include all, e,asements)
3. Single Family Residence Multi -Family No.,o f Units
UJ commercial__`� A C H T C-LL)
LU4. Owner and-/o-r--Bu±-1-de%r f, rryk1j". C-0 PO n s Jm 0 vids
VX_S -770 -S - 1
�.5 Contractor & License No. LI
U)6. Invasion into City Right -of -Way: No,v Yes �:A,1f Yes Right-of-
way Construction Permit Required - Call Di:al Dig"q 042-5344) before
excavation).
E-4 7. Cross other private property: Yes No'V-"'Easement required
attach legal description and county easement number.
P.
READ THE FOLLOWT.NG AND SIGN: cxe y o iva 0 0 1,
P4
P4
4 Z PRE-S:SUkE_TG-'r1_- C"
a. Property owners must obtain a permit to install side sewers on
>4 their property. A licensed side sewer contractor must be employed to
construct side sewers in the public' right-of-way.
b. The side sewer contractor assumes full reponsibility for each
installation for one year.
C. Commercial establishment requ mijaimilm ^;E a --h 6
04
:E� side sewer line. �,n
0 d. Side sewers may not be'install-ed c ��jr an PA*f-P!kq e s (30")
U !1k 48 HOURS
to any structure.
e.. Side sewer lines must be laid at a g raSER09% (1. 50)
0 and maximum grade of 100% (450). YOU DIG t 1
E-1 f. No turn in side s8wer greater tha ibencl)i s a110WEd
between cleanout. All 90 turns must )e u t d of .8
bend) and wye with removable cap
g. No down spouts, footing drains zadA drSNON0, H §REcted
to side sewer system. 541XITT UTILITY CiliflUTIF6 � U
r0 h. Pea gravel is required for bedding when inst�lling sewer lines
through other than granular soil.
i. Cleanouts are required at 30"-60". from each plumbing exit line
and at minimum intervals of 1001 along sewer 'line run.
j. Trenches within City right-of-way must be restored to original
0 conditions. Contractors shall be responsib,le---ft�r-right-of-way failure
due to poor compaction of fill.
k. Side sewer must be left uncovered until in's'pected and approved
,7� by the City. , I I
1. Inspection during normal working houris'-only.) Two (2) working
4_1 days notice required.
C-c- 1?- -7
DATE:
1/,df�'.ftify -that I hav"ead
X&n shall' 6omply wi-th the above
1C.F, kD, C- -4)o E I ,
)MMC
PERMIT FEE: 0, DISAPPROVED BY: Date:
BjS�, _Date:
CONNECTION FEE: Nj APPROVED By: pate: I-,->
PEP141T MUST BE POSTED ON JOB SI
Side Sewer Drawing I
The City of Edmonds EASEMENT NO . .......... .................................
NEW CONSTRUCTION E] REPAIRS 0 LID NO - ------------------ ASMT..NO - ------------------
OWNER ----- Y(X ---- ��-V-26 ---- - CONTRACTOR ---- Rv-��-s .. ��-"SO.VN ........................... PERMIT NO.
JOB ADDRESS ... 4.1.0 ----- 0 ......... 0 ... \AI-CL%j
.... :�j -------- LEGAL DESCRIPTION: LOT NO . .......... --------------------- BLOCK NO - ------------------------------------
bum DOCK
0 1,+a-7V%�01/\ I - i
NAME OF ADDITION .............
SS I i I
2!' Pressure tirte-
-Ssuye
Ire
A-esxure-
-%4�4peti at
Llnl-- C4,ppelcAl
LU Ev%CA -
1
0L 1'2/ 19 / -7 cl
+
41
totle- Sewev- Pressure- Liv%e- 2!' Frc s s v r e U vi c-
tonstrvc-le-A oP 2." A-8-S.
Csci\-40) c-e-wte-w6ed Z-bivits.
Bqo--lg Flow Device on exists'nq
Siae- %C-LUer Wat Ce-C-0W%rAe-V%6le-Cj /4*h send -4
cz
NOT E: SEE P EA M I TS 2Z4-) Z2.s
AND 423Sc)
8'k 13enJ
EDMONbS
Y A C H"r
c Lul?
8 tk se"'d
+
c C) V, - a Y--1 I
Surf4ce- Co.
App 7oved: OP
Ex Itti pvc. TT V
719 PWW-0001 -11/75 (REV. 11/78) aw) DATE Z)9C.T!-.VYq .......... By
CITY OFOPMONDS SIDE SEW PERMIT
WATER -SEWER DEPARTMENT
STREET FLE PERMIT
caii 775-2525 for side sew - er Inspections BEFORE covering any portion of the construction.)
Inspection will be providd within 24 hours after requst. NO Sat., Sun., or holiday inspections.
ADDRESS LOCATION OF CONSTRUCTION ............. "'N ........ K A— RA.1 /-� %I , -
.............................. . .......................................................
PROPERTYLEGAL DESCRIPTION ........................................................................................................ I .............................................................................
.................................................. . ...................... . ........................................................................................ . .......................... ...........................................................
................................................................ 014,7NERANDIOR, BUILDER .............. 5.5..t. ... - L I _r .........
. .... ....... � --- ------ -
*MACTOR'S NAME & ADDRESS ............
...... . . . .............................. ...................................................
Permission Is granted ........................................ 1971�4, for repair and/or connection of a side sewer to the city sanitary sewer
*in accordance with City of Edmonds ordinances.
ENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—The owners of the property may obtain a permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before it has been inspected.
NOTE No. 2—All work performed in city right-of-way requires an Invasion of RJght-of-Way PermJt obtain -able from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—.Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade
' sharper than % will be permitted.
NOTE No. 5--Trenches in street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
work which may develop within one year of completion.
NOTE No. 6—It is unlawful to alter or do any other work than is provided f or in the permit, or to do any work on the madn sewer or its appurtenances except to in -
Bert the pipe into the wye.
DISAPPROVED 0 Date --- - --------- e-I
........................ By ............ — Date .............. i ...... :n .......... By ................
APPROVED ..... . ...................
eDate ................ ............................... ........... By .........
Renwks: ...
. ............. . ..... N .... ....................................................
.... . .............................................................. I ..................................................................................................................
............ 'BY ................
...................................
...................................
BOTH e I Cop' s S Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection
I ...... . . .. .. ........... .... .... hereby certify that the side sewer installation constructed under this permit
r
ruc
c t�,
er oieo CZrmi—Pert" __W___6on.
th all governing of the City of Edmonds.
ov,
wrier of Co Ing w
C'Or c aL11
talled n racco
Datedthis ............................ day of ................................................................. 19 .........
Check BEFORE you dig for: Water E], Gas [], Telephone E], Power E], Sewer [], Other 0 V j
APPLICATION
---"w6The City of Edmonds for
cinc CCWCO DCOMIT EASEMENT NO . ........................................
NEW CONSTRUCTION REPAIRS LID NO. /0.7 ..... ...:.ASMT. NO . .................
OWNER................................................................................................ CONTRACTOR ..................... PERMIT NO.�-
JOB ADDRESS .... P�PMI.9.4--L . ...... . 44��"'V .........
------- LEGAL DESCRIPTION: LOT NO . ............................. --------- BLOCK NO - -------------- .................
............................................................ ---------------------------------------------------------------- ....................................
NAMEOF ADDITION -----------------------------------------------------------------------------------------------------------------------
__j
L.L.
ui
w
M. I
lo—
PeKt-AIT '0
4e,, -3,06---e
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= P:le-=;O� M ( 2.Z4,
%at
t
Approved:
DATE ......... j( ...... . .... By
CITY OFdPMONDS SIDE SEWS PERMIT
WATER -SEWER DEPARTMENT
'7' � 7
PERMIT "11:"
STREET FLE 10
CEL11 7,76-1107 for side sewer inspections BEFORE covering any portion of the construction.1
Inspection will be provided within 24 hours after request. NO Sat., Sun., or holiday inspections.)
ADDRESS LOCATION OF CONSTRUCTION ......... 460 ... Arlml.t-A.l ... N;1;11_ ...........
PROPERTY LEGAL DESCRIPTION -------------------------------------------------------------------------------
.................................................................................................................................................................... . ......................................................................................
.................................................. ............. OWNER AND/OR BUILDER ....... EQ4, ONDS YXXT CM
.................. ��D . . ........... !;� .................... . .................... ........................ : .........
nn ,
CONTRACTOR'S NAME & ADDRESS ... S-C-AUP"TP ^nnz-� I �"IMQ H A pond lr�l, � q
0_ ........ z ................. a ..................... r .............. . .............................. a ......................... .............. I ...................
Pern-dsslon Is granted ............. 5 ............................... 19.13, for repair and/or connection of a side sewer to the city sanitary sewer
system in accordance with City of Edmonds ordinances.
ATTENTION IS CALLED TO THE FOLLOWING:
NOTE No. 1—The owners of the property may obtain EL permit to construct sewer inside property line. A licensed Side Sewer Contractor must be employed to construct
side sewer in street area. Do not cover any portion of sewer before it has been inspected.
NOTE No. 2—All work performed -in city right-of-way requires an Invasion of RJght-of-Way Permit obtainable from the City Engineer's office.
NOTE No. 3—Obtain full information regarding Ordinance 11.16.030 and Regulations governing side sewers when you get permit.
NOTE No. 4—Top of side sewer must have at least 30 inches coverage at property line and 12 inches inside property line; minimum grade of 2%. No bends in grade
sharper than 1/8 will be permitted.
NOTE No. 5—Trenches In street must be water settled and surface of street restored to original condition. Contractors shall be responsible for failure due to improper
work which may develop within one year of completion.
t a4n sewer or its appurtenances except to in -
NOTE No. 6--1 is unlawful to alter or do any other work than is provided for in the permit, or to do any work on the m r
sert the pipe into the wye.
DISAPPROVED 0, Date ........... . ................ By ................ Date ..... JB I 1i ,
-Y Date ............................. y ................
---- --- ... *�� "i i I
. ....... ...........................................
APPROVED Dat B .............................................
)9 Y'
Remarks: ... SPIlAr- nv/-rHn;-)11v rnnnPrtyri nn -#291a 11 9�1_
............. ;: ........... -Z; ----------------------------------------------------- ---------- .....................................
Be Signed By Owner of Firm Performing Construction PRIOR To Request For Inspection —
hereby certify that the side sewer installation constructed under this permit
err -i'- r - ming ... C - on - st - r - u - ctio - n
all governing ordinances of the City of Edmonds.
F;;;� r
was inst; re(ionwace "d c,
Dated this ... /--/ --- .......... day
011-1--1 ------------- *11, ................. __
Check BEFORE you dig for: Water F], Gas E], Telephone E], Power E],
E], Other Ei -� V
APPLICATION
for
The City of Edmonds SEDE SEWER PERMIT
NEW CONSTRUCTION El REPAIRS EASEMENT No . ..........................................
OWNER 0 ------- M ....... 0 ----- t9.. ..... M ...... % ............... ........ ....... 9=LWe; CONTRACTOR ......... MUSS
......... ........................................................................................ PERMIT No.
ADDRE SS .....
..... ....
...... ........... LEGAL DESCRIPTION: LOT No . .............................................. BL4DCK No . ............................................
NAMEOF ADDITION ..........................................................................
t--JCYrE=: OSSEm PWRM1115 224 9L 22S
0
anlEbT. 4vdc*x.
ED M Q t A 0456
YN-C-H7 c:::::LUEE:,
%.I &""'SF-WMR t>kl F-- e6t�,UWU
ry
I vg:;� C:XK.
—2:9
've)(MM
ro �ull
00,
By. . ...... ..... .......
I
APPLICATION
for
The City of Edmonds SEDE SEWER PERAHT
NEW CONSTRUCTION [] REPAIRS E] EASEMENT No . ..........................................
112-00300
OWNER .......... E.d.m.onAs ---- Uacht Club .............................................. CONTRACTOR ................................................................................................... PERMIT No . ......................
j .... *--*,* -------------------
ADDRESS ....... 45.6 ... Ad-rd.r.al ... May ........................................................... LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAME OF ADDITION
LLU
1--Jr
UA
LAA
E=
Dye Tested On Sewer 1972
Approved:
DATE................................................ By ......................................................................
The City of Edmonds
OUTSIDE Pt
APPLICATION
CARD No . .. ..........
for
SIDE SEWER PER311T.'
EASEIMENT No.
. .............. .......... .... .. .
INSIDE 0 RHIPAIRS 0
/174 .... .. . ..... .
..... ...... 1. . ...... .. .... 3/
.' / PERMIT No.
ONVNER ....... 07 K CONTRACTOR will
STREET
HOUSE N . . .....
...... . . ............... ..... AVFNUE LOT No . .......... .......... .......... ............... .......... .... ........... ..... .... ....
...... BLOCK No . ..... ...........
NAMEADD ..... ... .. ......... . .......... .......... .............. . ............ ....
, I'a .. . ......................... ......... ........... .... ...... ...
N, -L-
lu
M,
117 .4
APPROVE
C. e. Af
'%<L-�_,
Date Approved:*
BACXFlLL WORK ORDER ISSUED'
.......... ........... ...................... DEPOSIT, .......... 7.� ............
...............................
SEW
. ..... ............. ............ ........ ........
WORK ORDER ISSUED .............................. ........ DATE..
BY .......... ........ ... ........... ..............
Date Approved:
..........
BACKFILL WORK ORDER ISSUED ..... .......... .................... - DEPOSff,, ....... ...... ...... ...... ............... DATF.../.t . ....... .. .. .. 07 . ....... ..... BY. —
SEWER WORK ORDER ED ....... -.— ............. ...... ...