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2521 GRAND AVE 2022-04-18
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2521 GRAND AVE 2022-04-18
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Last modified
4/18/2022 11:10:26 AM
Creation date
4/18/2022 11:10:01 AM
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Address Document
Street Name
GRAND AVE
Street Number
2521
Notes
BACKWATER VALVE
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UTILITY PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />�.� �-/ G���� <br />PROJECT ADDRESS <br />L G .S � Y �F ��! <br />Property Owner Mail Address <br />Tenant Name (If �his is (or a commercial business) <br />CT�r-/�� clls ��u.+s�i <br />Conlraclor Mail Address <br />G��/�'h�� �/7�'IS <br />WA Slale Contractor License Numher (required) <br />Work to be donc: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ Side Sewer - New Installalion <br />Cdy <br />�] Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />,���,��o,,,,,,:o,� <br />City <br />Slale2ip <br />State/Zip <br />Phone <br />Phone <br />D y77o � _ <br />Cily of Everell Business License Number (required) <br />FEF <br />� .� @) . �„ <br />�� PFRMITN <br />---_ U � 5b �' � � <br />
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