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2121 MCDOUGALL AVE 2022-05-03
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2121 MCDOUGALL AVE 2022-05-03
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Last modified
5/3/2022 8:21:08 AM
Creation date
5/3/2022 8:20:24 AM
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Address Document
Street Name
MCDOUGALL AVE
Street Number
2121
Notes
BACKWATER VALVE
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I <br />UTILITY PERMIT APPLICATION <br />CITE' OF EVERETT PERMITSERVICE <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857—www.eve rettwa.org <br />Z1zL 6 <br />PROJECT ADDRESS <br />Property <br />Mail Address <br />Tenant Name (If this is for a commercial business) <br />Contractor <br />Address <br />/�PGG G P4 163 Z-T <br />VJA State Contractor License Number (required) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ Side Sewer — New Installation <br />City <br />Dry State/Zip <br />Install Backwater Valve (outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />stele/Zip <br />Phone <br />Phone <br />oS3//s-r <br />City of Everett Business License Number (required) <br />FEE -- — ---� <br />PERMIT# <br />U 150��155 <br />REWSEO II/1?Rei: <br />
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