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F <br />UTILITY PERMIT APPLICATION <br />CITY OF EVERET i PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 — www.everettwa.org <br />Lckl� :a C>Q <br />PROJECT ADDRESS <br />a 6L oz o7 <br />Property Owner <br />Mail Address City State/Zip Phone <br />1 <br />Tenant Name (If this is for a commercial business) <br />- — (425) - - <br />Contractor Mail Address City <br />A M'E-Ks I K L <br />WA Stale Contractor License Number (required) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ Side Sewer— New Installation <br />9 Install Backwater Valve outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />State/Zip <br />Phone <br />City of Everett Busine. s License Number (required) <br />FEE <br />3000 <br />015 PERMIT# <br />ul501-0% <br />1EV,sW „nano,. <br />