18624 76TH AVE W11111111111111
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18624 76TH AVE W
R'E C 1 y
C I T Y, c f E D M UP N SIDE SEWER. P E R M I T
For'Inspection Call 77�oWREET FILE PERMIT,NO.
LYNNWOOD LIN
Address of Construction: C")
Property Legal Description (Include all easements): 0 1'J (L-e
Owner and/or Builder: Co Ig V-^ A'V'J '-,J S 7--
Contractor & License No: 0 L C
Single Family Residenc.e
Mul ti-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 Yes (If Yes, easement required,
attach legal description and county easemen t number.) N L-C-2
PLEASE READ THE ITEMS LISTED ON THE BACK
I certify that I have read and shall comply -Date
with the items listed on the back.
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P�rmit Fee:
Trunk Charge -
Assessment Fee:
Issued By:
Date Issued -
Receipt No.:
Partial Inspection: .Comment ffa —te Initial
s
Final Inspection Approved:
'Cn i f i a
*D alt�i Fol
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Rejected:
C)
Reason Date Initial
PERMIT MUST BE POSTED ON JOB SITE
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White Copy File Green Copy - Inspector Buff Copy Applicant
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The City of Edmonds
Side Sewer Drawing
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EASEMENT NO . ............................................ ;
NEW CONSTRUCTION REPAIRS E] LID NO . .................. ASMT. NO . ..................
R�C
OWNER ... CON-ST ...... T.PAC ........ CONTRACTOR A.AR.0-VAAK .................................................. PERMIT No. 74-74
DDRESS A
JOB A 9,6.2-4 ............. '7G ... ... ..... w.... ........... LEGALPESCRIPTION: LOT NO. 2 ................................. BLOCK NO . ....................................
.............................................. ..................................................................... ILYNNYMOD-LINE . ........
NAMEOF ADDITION .......................................................................................................................
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DATE i By . . . ........ . ... ....... ... . ......