Laserfiche WebLink
WATER/SEWER UTILITY PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STRFET, EVERETT, WA 98201 <br />425-257-8810 - FAX 425-257-8857 —�wvw everetN+a.gov <br />�1 C1 vv� I �JO(� � 1 <br />PROJECT ADDRESS <br />� � l� (.cJ��o �� �u� -�� p <br />Property Owner t: a�il.ddress ory <br />Tenam Name p( tn�s �s for a comm>raal 6csmess) <br />ContiaCtCi Q `.1a:1 Addiess <br />CIq �'! i�i� � I�t' 1 i Nl S <br />Wn State Con;racrorZicense tvumhrr (reqwred) <br />Work to be donc: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />Gty <br />❑ Side Sewer — New Installalion <br />% <br />�nstail Backwater Valve outside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />� <br />nrn5rn !!'r:•,pu <br />SlaielLp Phanc <br />Stale/Zip Pnor.e <br />047-7c�3 <br />Ciy of Everetl Business Ucense Number (reQuired) <br />FEE <br />30 °a <br />PE R(•1 fTr <br />U ����-d`f � <br />