Laserfiche WebLink
� <br />WATER/SEWER UTILITY PERMIT APPLICATION <br />CITY OF EVERETT P'�RMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — vnw+.everettwa gov <br />�i ��l � ��� LeD ✓LQ R� ��. <br />I PROJECT ADDRESS <br />IPropertyOv;r�er t"adl�d�res; <br />I ✓ <br />�� Tena�t Nam� (If ihis is for a comm=rcial bi�siress) <br />I��' � <br />� _ „ , .� � � <br />� ContYactor rdad Atldiess Gry <br />' �v�n��15S 8�I I�l- _ <br />� `NA State Contraaor License Number (requued) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ Side Sewer — New Installation <br />�' Install Backwaler Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />Giy <br />/o-- j�- l <br />SIa:clLip <br />Phone <br />C�z.$) <br />Gu� z7:�G, 2�Y-9qS9 <br />Slate�Zip Phone <br />0535`�f3 <br />C�ty o! Everetl Busmess License Number (requ:red; <br />FEE <br />��o � <br />PERMITk <br />� 1510-�2� <br />