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1048 9TH AVE S
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TAX ACCOUNT/PARCEL #:O6(p/CJZ�690/00
BUILDING PERMIT (NEW STRUCTURE) #:
COVENANTS (RECORDED) FOR:
CRITICAL AREAS #: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
CRITICAL AREAS #: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ 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: SS�IC�
SEWER LID FEE $:
LID #:
SHORT PLAT FILE:
LOT:
BLOCK:
SIDE SEWER AS BUILT DATED: ( ��—
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DATED:
STREET USE/ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
OTHER:
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APPLICATION
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SIDE SEWER PERMIT
The Citof Edmonds
EASEMENT No.
108-01400 NEW CONSTRUCTION ❑ REPAIRS 0 .. ............. ..........................
OWNER......... M....C-....S.ater ........................................................................ CONTRACTOR .................................................................................................. PERMIT No . ......................
APDRESS ..... 104a.-m-9th --- Avenue ... S. - ------------------------------------------------ LEGAL DESCRIPTION: LOT No . .............................................. BLOCK No . ...................... .....................
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NAME OF ADDITION
DYE TESTED ON SEWER
JULY, 1972
Approved:
DATE................................................ By ................................................................... _
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TOP OF I WYE W/ 4" C. -
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ROW # -8" UNDER SLAB
ENG20070279
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DATE INSPECTEDi INSPECTED BY, DATE DRAWN, DRAWN BY,
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