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I'ILITIES TY OF EVERETT <br /> iiiii:LA PERMIT SERVICES <br /> 444GY PERMIT 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1901-003 DATE 00 1 JAN ;•r' 91 9 <br /> JOB ADDRESS 925 112TH ST SE LEGAL DESCRIPTION <br /> DESCRIPTION CAP SEWER AS PART OF DEMO APN: 28051900301200 <br /> OWNER HABITAT FOR HUMANITY OF SNOHOMISH( TENANT OWNER <br /> 925 1/2 112TH ST SE CONTRACTOR OWNER <br /> EVERETT WA 98208-5025 <br /> I'I IONL <br /> PHONE <br /> I WATER SERVICE I <br /> SERVICE SIZE SERVICE TYPE FRON'T'AGE NO.OF UNITS SERVICE ORDER NO. APPLICATION NO <br /> 0.00 <br /> SETTER INSTALLATION DATE BY <br /> METER NO. SIZE #1 BACKFLOW DEVICE SERIAL NO. <br /> R.F.NO. _ #2 BACKFLOW DEVICE SERIAL NO. <br /> BRAND MODEL NO. <br /> METER 1STALLATION DATE BY <br /> WATER ON_ OFF LOCKED OUT BY TSG <br /> REMARKS: <br /> I SEWER SERVICE I <br /> PERMIT NO. <br /> SP-17913 PERMIT TYPE CAP OFF L31) �� <br /> REMARKS: Please Note:The City is responsible for structural defects in the side sewer on the City ROWper C 14.0 . 60 <br /> CAP SEWER JAN - 7 2019 <br /> INSPECTED BY: I DATECITY OF EVPermit ERETT <br /> ices <br /> I FEES <br /> SEWER UTILITY FEE $10.00 <br /> fizausio <br /> JAN _ 12019 <br /> TOTAL FEES $10.00 Aerrna 5�, RE7 <br /> • I PERMIT NUMBER U 1901-003 I <br /> ADDRESS COPY <br />