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EVERETT <br />WASHINGTON <br />&ILITIES <br />PERMIT <br />OTY OF EVERETT <br />PERMIT SERVICES <br />3200 CEDAR STREET <br />EVERETT, WA 98201 <br />(425) 257-8810 <br />PERMIT NUMBER U1910-006 <br />DATE <br />20 <br />JOB ADDRESS 4709 31 ST AVE SE <br />LEGAL DESCRIPTION LOT OF THE PLAT OF THE TOWNS <br />DESCRIPTION 3/4" METER ONLY, NEW SEWER CONNECTION, SYSTEM DI <br />APN: 29053200102300 <br />OWNER POLYGON WLH LLC <br />TENANT OVERLOOK AT RIVERFRONT <br />11624 SE 5TH ST SUITE 100 - <br />CONTRACTOR POLYGON WLH LLC <br />BELLEVUE WA 98005 <br />11624 SE STH ST <br />BELLEVUE WA 98005 <br />PHONE 4255867700 <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-14524 <br />I APP-19510 <br />SETTER INSTALLATION DATE <br />BY <br />METER NO. <br />SIZE <br />#1 BACKFLOW DEVICE SERIAL NO. <br />R.F. NO. - <br />- <br />#2 BACKFLOW DEVICE SERIAL NO. <br />BRAND <br />- <br />MODEL NO. <br />METER ISTALLATION DATE <br />BY <br />WATER ON_ OFF_ LOCKED OUT <br />BY <br />T'SG <br />3/4" METER ONLY <br />REMARKS <br />SEWER SERVICE <br />PERMrrNo. SP-18162 PFPNBTTYPE NEW CONNECTION 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 />DATE <br />FEES <br />SEWER UTILITY FEE <br />$70.00 <br />SYSTEM DEVELOPMENT FEE SEWEF <br />$5,121.00 <br />SYSTEM DEVELOPMENT FEE WATEF <br />$3,957.00 <br />R�: t� 13 2019 <br />WATER UTILITY FEE <br />$520,00 <br />TOTAL FEES <br />$9,668.00 <br />CITY Chi~" EVERETT <br />p = Servic,3s <br />PERMIT NUMBER U1910-006 <br />ADDRESS COPY <br />