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615 6TH AVE N
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Assessor Map
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Septic Tank Design Approved
Date
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Sani Sewer Availability
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Shoulder draina��in collection an
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Soil tions and Ground Water Field Checked
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Date
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Reviefed: lvlO-1977
Page 2
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Curb an' Reqd.
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Sidewalk Reqd.
Curb Cut for Driveway Reqd.
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Pre Permit Site Inspection made on
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P4 ENGINEERING
'4 Special Requirements listed in mem to Conumity Development Department,
Building Division
> BY- tj Date
o All item filled in on Building Permit Application
BY f5N Date 17Ct
64"001
P4 Drawings StaiTped and Notations Made
04 BY Date
Approved by Public Works Department
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Revised:.1v 10-1977
APPLICATION
for
The City of Edmonds SEDE SEWER PERNaT
NEW CONSTRUCTION 0 REPAIRS 0 EASEMENT No . ..........................................
114-og800
George Hostland
OWNER.............................................................................................................. CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS...... �15 ... ... Ave ........ N .......................................................
0
0
LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ............................................
NAMEOF ADDITION .........................................................................................................................................
Dye Tested
Approved:
On Sewer 1972
DATE................................................ By ..........