1005 2ND AVE S.PDFiiiiiiiiiiii
4826
1005 2ND AVE S
'loge
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
OUTSIDE 0 INSIDE 0 REPAIRS D
CARDNo . ..........................................
EASEMENT No . ............................................
Id
OWNER ...... ......
. ........................................... CONTRACTOR
HOUSE No. STREET
7� t
'I & AVENUE LOT No. .441 ... _Zt4Ak ....... BLOCK No . ....... .....................
.... ....................... ...... . . . .. ........ 4111 ... . ............................
...................
NAME ADD ............
......... ............................... ...............................................
Date
BACKFILL WORK ORDER ISSUED ...........................
I SEWER WORK ORDER ISSUED ...............................
V
xb V
4V"?jt0NjF_D
10 42
Approved:
DEPOSIT, $ ...................................................... 2— All
DATE. ................................ BY .....
...... ... ................... I ............................