631 5TH AVE S.PDFIIIIIIIIIIII
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631 5TH AVE S
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
NEW CONSTRUCTION 0 REPAIRS 0 EASEMENT No . ..........................................
104-04700
OWNER ............ ne -
..... . .................................................................. CONTRACTOR .................................................................................................. PERMIT No . ......................
ADDRESS ........ 631 - 5th Ayepvq�.
........................... . . ................................................ LEGAL DESCRIPTION: LOT No . .............................................. BIA>CK No . ............................................
r
j
0
NAMEOF ADDITION .........................................................................................................................................
DYE TESTED Oil SEWER
JULY, 1972
Approved:
DATE................................................ By ......................................................................