Laserfiche WebLink
i-.- -- - - - -- - 1 <br />I <br />UTILITY PERMIT APPLICATION ' <br />CITY OF EVERETT PERMIT SERVICES � <br />3200 CEDAR STREET, EVERETT, WA 98207 <br />425-257-8810 - FAX 425-257-8857 - www.everettwa org j <br />�/� � G'/G-/7 /% I <br />PROJECT ADJRESS � <br />z�6 � <br />� <br />�uiren f��l�s'aeplF/ /ZG?S Sl��, ��G.S Scu�1/e ti/��d%��i �iy-G`i�/� <br />Property Owner � tad Address Cny State2p Phone � <br />Tenant Name (If Ihis is for a commercial busir;ess) <br />�ai�. /un�: �(�_ S�_L7�'�'vc .+�� r-�i;��'�%ie �,Ir°' /`�fL�/ 3�7-�SG� <br />conirector �M11aiACdress C;y Sta�e2�p Phone I <br />APciGLPGS�Ci�G7 <br />6VA�Stat2 CoNraclor L�cense Number (reqcired) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer �Iteration <br />❑ Side Sewer - New Installatior. <br />� Install Bacxwater Valve (outsicie (hc building) <br />❑ Cap off Sewer <br />❑ ;nstail Water Meter <br />P[tcSED rvi940�i <br />Ca�e et�� ��ess :_�cense Number (requreo) I <br />� <br />rtt <br />30 � od <br />.� PERMITn �5 D I-(( 3 <br />U� <br />