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1126 GRAND AVE 2022-04-15
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1126 GRAND AVE 2022-04-15
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Last modified
4/15/2022 3:09:27 PM
Creation date
4/15/2022 3:08:55 PM
Metadata
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Template:
Address Document
Street Name
GRAND AVE
Street Number
1126
Notes
BACKWATER VALVE
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— -- — ---- <br /> ________ _ _--- <br /> ------I <br /> ����.��� ��::�c�i�� ����.���1� ��� <br /> CITY OF EVEREI i PF_RMIT �ERVICE� <br /> 3200 CEDAR STP,L=ET, EVERETT, 4VA 98201 <br /> 425-257-&810 - FAX 425-2b7-8857 — �v�w�.everethva.org <br /> � I � i r (�l i'Q.l{'1� �rl l� -- <br /> PROJECT ADDRESS <br /> �p -�I�a—� �av� S��,�� <br /> IPrCpCdyPNner �l,adAddrass City SWI�p Phonc <br /> I I <br /> ITenant tdame(If this is for a commerci�l business) <br /> ��wP�.- F,�� � v�c�1�c- _ ��. ��� � s ��,��o�,� c�� 9 Sv ti� <br /> I (:onTaClOf R1ailAtldr Crty �SlateJZl -- <br /> P ZULo - 3PqU-7y � cG <br /> s��,;-� f F �. � , � .-�s a �( � �5y <br /> 'NA State ConUaCor License Number(mquired) Gty of Everr.tt Businesc Ucense Numher(required) <br /> Work to bc done: <br /> ❑ Side Sewer Repair <br /> ❑ Side Sewer Alteration <br /> O Side Sev�er— New Installation <br /> � Install Backwater Valve outside the bufiding) <br /> ❑ Cap off Sewer <br /> i <br /> � i <br /> ' ❑ Instail Waler Meter �' <br /> FEE <br /> . � <br /> /�''� 31 ��•' L.� <br /> I Z I I ` PERMIT� l I <br /> �jnaiurc D�tc . I <br /> ni t::,CD nna.vr. ��L� � ' ' � �_ � �J <br /> ___"-- " " _ '___ _'_—� __-�J <br />
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