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UTILITIES CITY OF EVERETT <br /> '111P'001PERMIT SERVICES <br /> %,� PERMIT 3200 CEDAR STREET <br /> ZS 33-./ - EVERETT,WA 98201 <br /> / (425)257-8810 <br /> PERMIT NUMBER U1412-112 • DATE: `.— ` t5- <br /> JOB ADDRESS 10517 15TH DR SE LEGAL DESCRIPTION <br /> DESCRIPTION WATER,SEWER,SYS DEV FEES FOR NEW TOWNHOME UN APN: 28051900103200 <br /> OWNER NORTHLAKE COURT LLC TENANT <br /> 17921 BOTHELL EVERETT HWY#100 CONTRACTOR OWNER <br /> BOTHELL WA 98012 <br /> PHONE <br /> PHONE <br /> WATER SERVICE <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO.OF UNITS SERVICE ORDER NO. APPLICATION NO, <br /> 3/4 SFR 1.00 SO-13401 APP-18401 <br /> SE I I ER INSTALLATION DATE `p BY XA <br /> METER NO. /✓-a O 1 7 113/-- % -/V SI BACKFLOW DEVICE SERIAL NO. <br /> R.F.NO. // <br /> #2 BACKFLOW DEVICE SERIAL NO. <br /> BRAND ) "y�.•G MODEL NO. <br /> METER ISTALL N DATE 2~/7q4 BY <br /> WATER ON OFF_ LOCKED OUT BY TSG <br /> REMARKS: <br /> ISEWER SERVICE I <br /> PERMIT NO. SP-15440 PERMIT TYPE NEW CONNECTION I LID NO. I <br /> REMARKS: Please Note:The City is responsible for structural defects in the side sewer on the City ROW side per EMC 14.08.260 <br /> .\'..,,?4t. <br /> INSPECTED I}X::\) I DATE: \ 1 a Li a I`5 <br /> FEES ' <br /> r- Uit - .,,, <br /> Sewer Utility Fee $70.00 <br /> System Development Fees $7,129.00 JAN 2 8 Z 015 <br /> Water Utility Fee $480.00 r <br /> C2 -'Y O1 .. ERE 'I <br /> Pernii :.,:....vices <br /> TOTAL FEES $7,679.00 <br /> PERMIT NUMBER U1412-112 <br /> PUBLIC WORKS COPY <br />