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TILITIES [TY OF EVERETT <br /> PERMIT SERVICES <br /> •lia. PERMIT 3200 CEDAR STREET <br /> EVERETT, WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1901-027 DATE 14 JAN 2OT1i <br /> JOB ADDRESS 4605 31ST AVE SE LEGAL DESCRIPTION <br /> DESCRIPTION 3/4"METER ONLY,NEW SEWER CONNECTION APN: <br /> 00574700100102 <br /> OWNER POLYGON WLH LLC TENANT OVERLOOK AT RIVERFRONT <br /> 11624 SE 5TH ST SUITE 100 <br /> BELLEVUE WA 98005 CONTRACTOR POLYGON WLH LLC <br /> 11624 SE 5TH ST <br /> BELLEVUE WA 98005 <br /> PI IONE 4255867700 <br /> PHONE 4255867700 <br /> IWATER SERVICE I <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO.OF UNITS SERVICE ORDER NO APPLICATION NO <br /> 3/4" SFR 0.00 SO-14364 I APP-19348 <br /> SI.TEER INSTALLATION DATE BY <br /> METER NO. SIZE _ NI BACKFLOW DEVICE SERIAL NO. <br /> — <br /> R.F.No. <br /> N2 BACKFLOW DEVICE SERIAL NO. <br /> BRAND <br /> MODEL NO. <br /> METER ISTALLATION DATE BY <br /> WATER ON OFF LOCKED OUT BY <br /> TSG <br /> 3/4"METER ONLY <br /> REMARKS: <br /> ISEWER SERVICE I <br /> PERMIT NO. SP-17931 PERMIT TYPE <br /> NEW CONNECTION I LID NO. <br /> 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 SEWER CONNECTION <br /> INSPECTED BY: I DATE <br /> FEES 1 <br /> SEWER UTILITY FEE <br /> $70.00 mal <br /> Ann <br /> SYSTEM DEVELOPMENT FEE SEWEF $5,121.00 <br /> SYSTEM DEVELOPMENT FEE WATEF $3,957.00 JA P'i 2 9 2019 <br /> WATER UTILITY FEE $520.00 <br /> CITY OF <br /> PermV <br /> it KETT <br /> evices <br /> TOTAL FEES $9,668.00 <br /> IPERMIT NUMBER U1901-027 I <br /> ADDRESS COPY <br />