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UTILITIES <br />PERMIT <br />CITY OF EVERETT <br />PERMIT SERVICES <br />3200 CEDAR STREET <br />EVF.RETI',WA 99201 <br />(425) 257-8810 <br />PERNIIT NUMBER U1504.040 <br />DATE- 4/8/2015 <br />IOn ADDRESS 1921 MCDOUGALL AVE <br />LEON. DESCR' <br />DESCRIPTION INSTALL BACKWATER VALVE <br />APN00438438501100 <br />owneR HOLLENEECK GEORGE F JR <br />Tm Ntr' <br />CONTRACTOR AMERICAN SEPTIC & SIDE S WR LLC <br />1921 MCDOUGALL AV VE <br />EVERETT WA 98201 <br />2606 LARL(N DR <br />EVERETT WA 98203 <br />PHONE <br />PHONE 4257897296 <br />W.YI'FR SCRVICIf <br />SCRYICASrt( SF:\4ETYDE EROWACE IIf URrp SlRvite GROG XD RMl�GT1eM:D <br />R[MARKS. <br />NOTE: A water back0ow, prevention and/or consultation is requited regarding cross connection control for in igation scn•ices and <br />services V or larger. Call Tim Markbarn at (425) 257.8833. <br />PLEASE CALL (425) 257-8862 TWO '1'0'1 IIREE WEEKS PRIOR'TO WANTING WATER SERVICE INSTALLED. <br />SEWER PERMIT NO SP-15886 PERMIT TYPE LID NO. G Cc ' <br />It:hIARKS Plcuse Note:1'he City Is responsible fro,stnNturL atic reels in the side setter on the City ROW side per Ea1C 14.080.26�- <br />INSPEMU11YI DAiL'. .71 Wk-W 0S 1,�i <br />Notify the Public Winks Inspc6t(Ir (425) 257.8810 24 hours in advance to schedule an inspection. <br />—i <br />It is the upplicunt's responsibility to insure adequate protection against sewer backflow if the structure is located in the combined sanitcrr)•Istorim a ter <br />_. <br />system. <br />Sewer Utility FCC <br />30,00 <br />TOTAL FEES $30.00 <br />Perrrrits expire if work is tint conorcaced within 180 days or ceases for more than 180 days. <br />PERMITNUMBER L11504.04C <br />A,L..I con <br />H <br />