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mai <br /> ILITIES COY OF EVERETT <br /> EVERETT PERMIT SERVICES <br /> WASHINGTON PERMIT <br /> 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U2012-017 DATE <br /> JOB ADDRESS 1922 112TH ST SW LEGAL DESCRIPTION <br /> DESCRIPTION CAP SEWER TO REMOVE EXISTING MOBILE HOME APN. 00537900004402 <br /> OWNER KELTING KELVIN&MING TENANT <br /> 1922 112TH ST SW CONTRACTOR OWNER 11 dyY. <br /> EVERETT WA 98203 <br /> APPROVAL <br /> PHONE 4253613424 JAN 2 6 2022 <br /> PHONE <br /> WATER SERVICE rC V E F <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO.OF UNITS SERVICE ORDER NO. APPLICATION NO <br /> 0.00 <br /> SETTER INSTALLATION DATE BY <br /> METER NO. SIZE__ SI BACKFLOW DEVICE SERIAL NO. <br /> R.F.NO. #2 BACKFLOW DEVICE SERIAL NO. <br /> BRAND MODEL NO. <br /> METER ISTALLATION DATE BY <br /> WATER ON_ OFF LOCKED OUT BY TSG <br /> REMARKS. <br /> SEWER SERVICE <br /> PERMIT NO. SP-18477 PERMIT TYPE CAP OFF 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 /> CAP SEWER <br /> • <br /> INSPECTED BY: DATE <br /> FEES f <br /> aff "'t <br /> SEWER UTILITY FEE $10.00 k <br /> . 12020 <br /> Tv OF pvvr, <br /> TOTAL FEES $10.00 <br /> PERMIT NUMBER U2012-017 <br /> ADDRESS COPY <br />