630 13TH WAY SW.PDFiiiiiiiiii
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630 13TH WAY SW
APPLICATION CARD No . ......................................
for
The City of Edmonds AIL FIVE, SIDE SEWER PERYaT
D - BASEMENT No . ......................................
OUTSI E INSIDE F1 REPAIRS
0
OWNER ....
............................. .. T
. .................................................. CONTRACTOR ............................... .......................................................... ......... PERMIT No.
STREET
HOUSE No. A? .......................
.......................................... ......... .... . .............. .............. AVENUE LOT No . ............. ................................. BLOCK No . ...............................................
NAME ADD. L A N e-2--
................................................ .................................................................................
I I uj A Y
E
14
or
Date
BACKFILL WORK ORDER ISSUED ......... : ......................... DEPOSIT, $ ............................... .............
SEWER WORK ORDER ISSUED ------ ...................................
A.pprov
DATE ...............
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