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711 15TH ST SW
r..: -.,-: ,� ___ •. APPLICATION
for
The City of Edmonds ti SIDE SEWER PERMIT
EASEMENTNo ...........................................
NEW CONSTRUCTION O REPAIRS
�DZ—�'��GU 401-06400
W. B. Perle
OWNER............................................-•----•-•------............................... CONTRACTOR-•-•---•-------------------........----.....................---................................... PERMIT No..�f
ADDRESS ....... 11......................................................................Street SW.................. LEGAL DESCRIPTION: LOT No. ............ ...... .. ...... BLACK No. ............................................
NAME OF ADDITION ..... .. ..........•�j-%LJ....•-""..............................................
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Dye Tested On Sewer 1972
Approved:
DATE................................................ BY--•-•-...........................................................
APPLICATION
�for
The City of Edmonds : �,,,, ,� I L sIDE SEWER PERMIT
9 A � 60. � OUTSIDE ❑ INSIDE ❑ REPAIRS ❑
CARD No . ......................................
EASEMENT No.
11)
OWNER ............... ............ ............................................ CONTRACTOR ................................................... ................................ ............ -- PERMIT No.
..../sD
STREET
HOUSE No..._........% / .......... f ..11 _!.?.G /u US------ `(�/,�!' ... AVENUE LOT No...................../---`�......................_...----.._........._. BLOCK No. ...............................................
7/l I "��l NAME ADD. •--•---��..1........... 1.11 ------_-. 1 %t.:../.. li!....-•--............................................................
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PfY"MFlf of Ths information shown ci tho
atte-,
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anc c,
nai warrant the a-.
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, location of ar;.
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Date
BACKFILL WORK ORDER ISSUED ..........
DEPOSIT, $ ........................
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Approved:
SEWER WORK ORDER ISSUED .......................................... DATE ................................................ By