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. CITY OF EVERETT <br /> ' UTILITIES <br /> EVER EST T ' PERMIk ' SERVICES <br /> r WASHINGTON � <br /> PEI.1 3200 CEDAR STREET <br /> EVE TT,WA 98201 <br /> (425)2`57 8810 <br /> PERMITNUMBER U 19]0 069.: DATE 9 <br /> =JOB ADDRESS 12, E BEECH ST LEGAL D scl�TIor; <br /> DESCRIPTION' SIDE SEWER REPAIR APx 00371400003700 <br /> ;OWNER . PUTSCHDAVIDK&&LOSVAR PUTSCH'NANC TENANT <br /> r 125 E�BEECH ST ': � <br /> EVERETT 9 CONTRACTOR ; , IN DEPTH EXCAVATIO N LLC` - <br /> WA -8203 <br /> • 5129E <br /> VERG.REEN WAY STE B PMB„287 <br /> PHONE . <br /> EVERBTT 'WA 98203' '' <br /> rxo� .. 4253671521 ' <br /> -f.-..'; WATER SERVICE <br /> .• SERVICE SIZE SERVICE TYPE- FRONTAGE NO OFUNITS :.. <br /> SERVICE O],tDERNO-: <br /> � APPLICATION NO <br /> .0.00 <br /> "SETTER INSTALLATION DATE - .BY } <br /> METER NO _ SIZE - #1 BACKFLOW DEVICE:SERX.LNO - <br /> - - #2 BACKFLOW DEVICE$EI;IALNO - <br /> BRAND ';',-..'i_-, - - _ <br /> - - MODEL NOS - - - <br /> METERYSTALLATIONDATE <br /> WATERON_OFF_._LOCKEDOIJT Ey T _ ..I. -. <br /> TSG °•��• u°""�rn <br /> SEWER SERVICE r+-I o I <br /> PERMITNO. -'SP-18215 <br /> --. :. PERMIT TYPE REPAIR . _LIDNo <br /> REATARKS: Please Note The G(y is responsible for structur 1ill' I <br /> a defects n the side sewer on City side per.EMC 14 08.26 ' `m <br /> SIDE SEWER REPAIR b3Ei <br /> res <br /> INSPECTED BY:•��”' _ - <br /> - - I DAiTE i-N'•� - <br /> I - y..^ FEES <br /> SEWER UTILITY FEE $30 00 <br /> TOTAL FEES:„ <br /> $30.00 <br /> PERMIT NUMBER U1910.069 <br /> ADDRESS COPY <br />