Laserfiche WebLink
r _ <br />�I WATER/SEWE�C UTILITY PERMIT APPLICATION <br />�, CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR oTREET. EVERETT, WA 98201 <br />I, 425-257-8810 - FAX 425-257-8857 - vn•nv.everellwa gov <br />zw7 I8 � ��-. <br />PROJECT ADDRESS <br />r <br />' S � �2 is � <br />Property Ov:ner L1a�l Adnress <br />II r� <br />ITenant Name (l� Inis is for a commercial business) <br />� ,�a�2� c� <br />', 5 S�de eu�a2 2� <br />i Conl c�cr IAaii Ad^ress Gty <br />I � <br />. �Nl�� ( `) ) �� l C `.l� <br />W� Sta;e Contractar Licen;e Number (reawred) <br />Work to be done: <br />❑ Side Sewer Repair <br />❑ Side Sewer Alteration <br />❑ Side Sewer- New Ins?allation <br />Install Backwater Valve (outside Ihe building) <br />❑ Cap off Sewer <br />O Install Water Meter <br />r=�:�s•o :;nsnm: <br />ri�y <br />l �� � <br />�_7i�Q-7_�1y� �i <br />S:ate/Z�p Pnone I <br />(�{ZS ) � <br />����"�c��C� , 2��1—�`I S � ��, <br />9atc'Z�p Phonc � <br />(�S � S�/� � <br />City of Everett Busmess �icense Number (required) 'I <br />/-�z.-lS <br />PERMITr <br />U����'���I <br />