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in UTILITIESCITY OF EVERETT <br /> EVERETT PERMIT SERVICES <br /> WASHINGTON PERMIT 3200 CEDAR STREET <br /> rr (� p �//�, , ( + EVERETT,WA 98201 <br /> 1��� 1 C>l I n 3i [J LI 1 1 4 Lo .24 (425)257-8810 <br /> PERMIT NUMBER U1904-029 Le. 7 l Q* 1 fl OM DATE: <br /> JOB ADDRESS 4616 31ST AVE SE C , <br /> n z LEGAL DESCRIPTION <br /> DESCRIPTION 3/4"METER ONLY,NEW SEWER CONNECTION APN: <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 <br /> BELLEVUE WA 98005 <br /> PHONE 4255867700 <br /> PHONE 4255867700 <br /> WATER SERVICE ' <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO.OF UNITS SERVICE ORDER NO APPLICATION NQ <br /> 3/4" SFR 0.00 SO-14407 I APP-19393 <br /> SEI ItRINSTALLATION DATE BY �pAy <br /> METER NO. A SIZE .3/V #1 BACKFLOW DEVICE SERIAL NO. <br /> RF.NO. F2 BACKFLOW DEVICE SERIAL NO. <br /> BRAND Q/ MODEL NO. <br /> METER ISTALLA N DATE-Gl"'�/"/rf By ." _ v/ <br /> WATER ON OFF <br /> -7 KED OUT BY TSG <br /> ~t3/4"ME R ONLY ,/�Ti <br /> REMARKS: .. G f <br /> -' 2-,.-1 i: ) 0 i (. I L, I o ' er <br /> 1 SEWER SERVICE <br /> PERMIT No. SP-18000 PERRBTTYPE NEW CONNECTION I L NQ. 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 IIIdas LI 6 <br /> SYSTEM DEVELOPMENT FEE SEWEF $5,121.00 .' ` , <br /> SYSTEM DEVELOPMENT FEE WATEF $3,957.00 <br /> WATER UTILITY FEE $520.00 MAY u,, a=E:s' <br /> ca CITYOF EVERETT <br /> $ 11S <br /> ( ices <br /> TOTAL FEES <br /> $9,668.00 CC @+, <br /> IPERMIT NUMBER U1904-029 I <br /> UTILITY BILLING COPY <br />