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UTILITIES CITY OF EVERETT <br /> PERMIT SERVICES <br /> PERMIT 3200 CEDAR STREET <br /> 0/72 T EVERETT,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1812-014 DATE <br /> JOB ADDRESS 4521 31ST AVE SE LEGAL DESCRIPTION <br /> DESCRIPTION 3/4"METER ONLY,NEW SEWER CONNECTION APN: 00574700100102 <br /> OWNER POLYGON WLH LLC TENANT OVERLOOK AT RIVERFRONT <br /> 11624 SE 5TH ST SUITE 100 CONTRACTOR POLYGON WLH LLC <br /> BELLEVUE WA 98005 11624 SE 5TH ST SUITE 100 <br /> BELLEVUE WA 98005 <br /> PHONE 4255867700 <br /> PHONE 4255867700 <br /> I WATER SERVICE I <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO.OF UNITS SERVICE ORDER NO APPLICATION NQ <br /> 3/4" DOM/FI 0.00 SO-14349 APP-19335 <br /> SETTER INSTALLATION DATE ,�/(" �] BY (} <br /> METER NO. 9' J((S.D 77- J-7 I lq SIZE 5/Q #1 BACKFLOW DEVICE SERIAL NO. <br /> R.F.NO. 1, 10-37,(�J� --- 7 'I,/ #2 BACKFLOW DEVICE SERIAL NO. <br /> BRAND ""7-- CAt 7 MODEL NO. <br /> METER ISTALLATION DATE ) Zv_l / BY `_60 <br /> WATER ON )(OFF_ LOCKED OUT BY f 2'1.0 <br /> TSG <br /> 3/4"METER ONLY <br /> REMARKS: <br /> ISEWER SERVICE I <br /> PERMIT NO. SP-17898 PERMIT7YPE NEW CONNECTION 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 /> NEW CONNECTION <br /> INSPECTED BY: I DATE <br /> IFEES I <br /> SEWER UTILITY FEE $70.00 <br /> WATER UTILITY FEE $520.0011 ZZ a,ll el <br /> CI <br /> JAN ® 4 2019 <br /> TY°F EVFRE <br /> Permit Services <br /> TT <br /> TOTAL FEES $590.00 <br /> PERMIT NUMBER U1812-014 <br /> UTILITY BILLING COPY <br />