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UTILITIES CITY OF EVERETT <br /> 4 <br /> T PERMIT SERVICES <br /> PEAT 3200 CEDAR STREET <br /> • EVERETT,WA 98201 <br /> (425)257-8810" ' <br /> PCRMJTmNUMB1,R J1603-019 . DATE 03/11/2016 <br /> JOB ADDRESS 1525",LOM$ARD AVE LEGAL DESCRIPTIDN REMINGTONS 1ST ADD BLK 317 [ <br /> DESCRIPTION BACKWATER VALVE APN: 00553631700900 <br /> OWNER BAKER KAREN A TENANT <br /> 2508 HELENA LANE CONTRACTOR MOEN PLUMBING <br /> EVERETT WA 98208 <br /> 17515 41ST ST SE <br /> SNOT-IOMISH WA 98290 <br /> PHONE <br /> PHONE 4257608360 <br /> I'.. WATER SERVICE I <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO OF UNITS SERVICE ORTIERNO APPLICATION:NO <br /> 0.00 <br /> SE LI ER INSTALLATION DATE ._ BY <br /> METER NO. SIZE - -:H1 BACKFLOW DEVICE SERIAL NO.. <br /> R F.NO. - -.02 BACKFLOW DEViCE SERIAL NO. - <br /> BRAND .-. - MODEL NO_.; <br /> METER'ISTALLATION DATE� . BY <br /> WATER.ON_____;OFF_ LOCKEDOUT <br /> a7 - <br /> -YT'7 <br /> TSG b c) <br /> REMARKS' <br /> I SEWER SERVICE <br /> cS " <br /> PERMIT NO. SP-16563 PERMITTYPE ALTERATION LIDNO. _ iR.; <br /> �i <br /> REMARKS: Please Note:The City is responsible for structural defects in the side sewer on the City RQW side per.EMC 14.08 .260. <br /> in Il <br /> INSPECTED BY; _ DATE;�� }-N.r� = <br /> FEES <br /> Sewer Utility Fee $30.00 1, <br /> rt0p <br /> TOTAL FEES $30.00 - <br /> PERMIT NUMBER U1603-019. <br /> ADDRESS COPY <br />