7628 230TH ST SWiiiiii lill lill
16097
7628 230TH ST SW
TAX ACCOUNT/PARCEL NUMBER:
BUILDING PERMIT (NEW STRUCTURE):
COVENANTS (RECORDED)
CRITICAL AREAS:
DISCRETIONARY PERMIT
DRAINAGE PLAN DX
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PLANNING DATA CHECKLIST DA
SCALED PLOT PLAN DATED: b
SEWER LID FEE
DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
SHORT PLAT FILE: LOT:
SIDE SEWER AS BUILT DATED:
SIDE SEWER PERMIT(S) #:
SOILS REPORT DATED:
STREET USE / ENCROACHMENT PERMIT
WATER METER TAP CARD DATED:
OTHER
LID #:
BLOCK:
LATEMP\DSTs\Forms\.Sbw File Checidistdoc
APPLICATION
CITY OF-LZ3D �f�%� t < �� for CARD NO.
SIDE SEWER PERMIT EASEMENT
`,
W WORK ❑ REPAIRS ❑ EASEMENT NO J
d (/�J d / c/. C/l/C/
OWNER ._��� �� ;� - ".�.. ,� •,�•/l � . CONTRACTOR PERMIT NO ,
HOUSE Y STREET p - LOT +— BLOCK NAME OF
NO, L1 OR AVE, NO. ! NO, SUB DIVISION
SIDE SEWER PLAT
DESIGN DWG, ❑ AS BUILT ❑ Q�1
is
r
�J C
•
•
Pipe Installation Inspected and
approved for backfill
Final Connection to House
Service Inspected & Approved
As -Built Sewer Plat
Certified Correct:
: Date
: Date
f
- Y 14 1963
p r
Deposit
f_ APPLICATION APPROVED:
By Rec'd $ Date By
By SPECIAL CONDITIONS:
Date By
NOTICE:
No warranty of accuracy.
The information shown on the attached map(s)
was compiled for use by the City of Edmonds,
its Employees and Consultants. The City of
Edmonds does not warrant the accuracy of
anything set forth on these map(s). Any person
or entity requesting a copy should conduct an
independent inquiry regarding the information
shown on the map(s), including, but not limited
to, the location of any sewer stub shown. Such
sewer stubs may or may not exist and may or
may not exist at the location shown. Neither
the City of Edmonds nor its employees or
officers shall be liable for the information given
on map(s), nor for any one representation
provided based upon said map(s).