633 ELM PL.PDFIIIIIIIIIIIIII
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633 ELM PL
ADDRESS: b---LM pll-a6A6-1
TAX ACCOUNT/PARCEL #: 667�? 4�)Z+OMO 147
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS #: DETERMINATION: El Conditional Waiver E] Study Required 0 Waiver
CRITICAL AREAS #: DETERMINATION: El Conditional Waiver El Study Required 0 Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORD FOR:
PERMITS (OTHER - list permit #'s):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID -74
SHORT PLAT FILE:
LOT: TBLOCK-
SIDE SEWER AS BUILT DATED: (0/,,71
SIDE SEWER PERMIT(S) #: -7:5
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT
FOR:
WATER METER TAP CARD DATED:
OTHER:
L:\TEMP\DST's\Forms\Jana's Street File Checklist 5-14-08.doc
CITY of EDMOODS SE*ER PERMIT
For Inspection Call 771-3202 STREET FC0 PERMIT NO.,RT3TFCECEIVED
M7Address of Construction: rn lcl_�_�
PUBLIC WORKS
Property Legal Description (Include all easements): Tt C-k cr) -
Owner and/or'Builder:
Contractor & License No
Single Family Residence J_
YIA EDMONDS WAY
t_�4�_ - (1H �- F_ , I TRUNK LINE
Multi -Family
(No.
of
Units
Commercial
(No.
of
fixture Units
Invasion into City Right -of -Way: No -<,- Yes (If Yes, Right -of -Way
Construction Permit required. Call One -Call -Center (1-800-424-5555) before any
excavation.)
Cross other Private Property: No If< Yes — (If Yes, -easement required,
attach legal description and county easement number.)
PLEASE �EA,�THE PTEMS LISTED ON THE BACK
I dd-ftify6t�kft Wave read and shall comply Date
with the items"Tisted on the back.
Permit Fee:
Issued By:
Trunk Charge:
Date Issued:
Assessment Fee:
Receipt No.:
Partial Inspection:
Comments Date Initial
F,inal Inspection Approved:
Date I n
i tW_
00
Rejected:
Reason
—Ta—te 7—nitial
PERMIT
MUST BE POSTED ON JOB
SITE
Wh.ite Copy - File
Green Copy - Inspector
Buff Copy - Applicant
The City of Edmonds Side Sewer Drawing
EASEMENT NO - --------------- - ......................
NEW CONSTRUCTION la REPAIRS R LID NO. -7 - ----- - ASMT. NO - -------------
OWNER .... ------ 90-tAV-S,_ ----------- ----------- CONTRACTOR ... Lux z ... S ..... . B.fA-c.K.%A-OF
.... PERM
ff.VlAE'DMONDS WA
_P I
JOB ADDRESS ------ (0-3-3, -------- E1,1-A ------ PLASs ........ LEGAL DESCRIPTION: LOT NO . ..... V5 -------------------------- BLOCK NO - ------- cTRUr4K--.L4NE--.
........................................ -----------
.... Nr— ----- O�Fr
------ pl-.SIN4� ........... .................
NAME OF ADDITION ..........
0
(P
,rn
Approved:
DATE ... G.12,17-85 --------- By
. ...................
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