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UTILITIES CITY OF EVERETT <br /> EVERETT PERMIT SERVICES <br /> WASHINGTON PERMIT <br /> 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1912-006 DATE u c;, IJ F <br /> JOB ADDRESS 2531 E GRAND LEGAL DESCRIPTION <br /> DESCRIPTION SIDE SEWER REPAIR APN: 00516858300100 <br /> OWNER SECOR SUSAN TENANT <br /> 2531 E GRAND AVE CONrRACI OR HOLMSTADS PLUMBING INC <br /> EVERETT WA 98201 PO BOX 5635 <br /> EVERETT WA 98206 <br /> PHONE <br /> PHONE 3602021428 <br /> WATER SERVICE <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO.OF UNITS SERVICE ORDER NO APPLICAI ION 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 ISTALLATION DATE BY _ <br /> r � 1 <br /> WATER ON OFF_ LOCKED OUT BY TSG V'T <br /> t-4 <br /> r <br /> �y --4 <br /> REMARKS: �.d r={14i <br /> ?; ren' <br /> 0:2 <br /> I - <br /> r.:) <br /> ISEWER SERVICE , <br /> n <br /> PERMIT NO. PERMIT TYPE LID NO. 5;rr <br /> SP-18240 REPAIR `t!� <br /> REMARKS: Please Note:The City is responsible for structural defects in the side sewer on the City ROW side per EMC 14.Q§,26V.,.., n? <br /> 0,4 <br /> SIDE SEWER REPAIR <br /> c:) <br /> c=a 0 c' c`.) ' <br /> C-7 C3L•I <br /> —4 c'-.P--D <br /> '-i <br /> INSPECTED BY: DATE <br /> FEES <br /> SEWER UTILITY FEE $30.00 <br /> TOTAL FEES $30.00 <br /> PERMIT NUMBER U1912-006 <br /> ADDRESS COPY <br />