1055 BELL ST (2).PDF1055 BELL ST
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TAX ACCOUNT/PARCEL NUMBER: LH OZ 1p 0
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DA'
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED
PERMITS (OTHER):
PLANNING DATA CHECKLIST DATED:
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DA'
SIDE SEWER PERMITS) #:
GEOTECH REPORT DATED:
STREET USE / ENCROACHMENT PERMIT #:
WATER METER TAP CARD DATED:
OTHER:
LATEMMI)ST'sTorms\Street File Checklist.doc
APPLICATION
for
The City of Edmonds SIDE SEWER PERMIT
EASEMENT No . ..........................................
NEW CONSTRUCTION ❑ REPAIRS ❑
118-01700
OWNER..-.-....-Uilli-am.-T.ruesdel-I------------------------------------------------------ CONTRACTOR....--..........................----.........................................-----•............... PERMIT No.......................
ADDRESS ......1955.. B-el]...$t- ----------------------------------------------------------------- LEGAL DESCRIPTION: LOT No............................................... BLOCK No.................. ............................................
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NAMEOF ADDITION..-•----•--•.............................................................................•--.............................................
L° fi
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Dye Tested On Sewer 1972
Approved:
DATE................................................ By.....................---..............................................