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4kTY OF EVERETT <br />PTILITIES <br />EVERETT <br />PERMIT SERVICES <br />WASHINGTON <br />PENT <br />i 1 1 <br />3200 CEDAR STREET <br />EVERETT, WA 98201 <br />(425) 257-8810 <br />PERMIT NUMBER U1908-048 <br />DATE <br />8 UL 1 2019 <br />.SOB ADDRESS 4628 31 ST AVE SE <br />EGAL DESCRIPTION <br />DESCRIPTION 3/4" METER ONLY, NEW SEWER CONNECTION, SYSTEM D1 <br />APNr ` 01161100080100 <br />OWNER ' POLYGON WLH LLC <br />TENANT OVERLOOK AT RIVERFRONT <br />11624 SE STH ST <br />BELLEVUE <br />WA 980015 <br />CONTRACTOR POLYGON WLH LLC <br />11624 SE STH ST <br />BELLEVUE WA 98005 <br />PHONE <br />PHONE 4255867700 <br />WATER SERVICE <br />SERVICE SIZE <br />SERVICE TYPE <br />FRONTAGE <br />NO OF UNITS <br />SERVICE ORDER NO <br />APPLICATION NO <br />3/4" <br />SFR <br />0.00 <br />SO-14499'` <br />APP-19485 <br />SETTER INSTALLATION DATE By <br />- <br />' <br />- METERNO:. SIZE <br />41 BACKFLOW DEVICE SERIALNO. <br />R.F. NO. <br />#2 BACKFLOW DEVICE. SERIAL NO.. <br />_ <br />BRAND <br />MODEL NO. <br />METER ISTALLATION.DATE ... BY <br />- <br />WATER ON OFF _ LOCKED OUT BY <br />- TSG <br />3/4" METER ONLY <br />REMARKS <br />SEWER SERVICE <br />PERMIT NO . SP-18126 - <br />PERMIT TYPE. NEW CONNECTION <br />- LID NO. <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: <br />- I <br />DATE <br />FEES <br />SEWER UTILITY FEE <br />$7000 <br />SYSTEM DEVELOPMENT FEE SEWEI <br />$5,121.00 <br />�V <br />SYSTEM DEVELOPMENT FEE WATEF <br />$3,957.00 <br />Oq �O�S <br />CIT O U <br />WATER UTILITY FEE <br />$520.00 <br />CITY OF EVERETT <br />Permit Services <br />TOTAL FEES <br />$9,668.00 <br />PERMIT NUMBER U1908-048 <br />ADDRESS COPY <br />