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CITY OF EVERETT <br />UTILITIES <br />PERMIT <br />PERMIT SERVICES <br />1200 CEDAR STREET <br />EVERETT, WA 98201 <br />(425) 257-8810 <br />I'F:IUIII N1.\I <br />BEN J1511.017 <br />DATE. 11/10/2015 <br />!06 ADDRE" <br />2709 22ND ST <br />LEGAL DESCRIPTION MINNESO TA ADD BLK 4,17 D-01 - <br />DI-SCRIP-1 ION <br />INSTALL BACKWATER VALVE <br />MIN 005164447013CI <br />QWNLR <br />SOWA KEVIN <br />TENANT <br />2709 22ND $T <br />CONTRACTOR AMERICAN SEPTIC & SIDE SW R LLC <br />EVERETT WA 98201-2526 <br />2606 LARLIN DR <br />EVERETT WA 98203 <br />PHONE <br />4257897296 <br />\\\TER SER\'ICE <br />SERVICE 5171 <br />I SERVICE nK <br />IYGATn4f. <br />I <br />I NO Or UNIT,, <br />0.00 <br />I SERVICE ORDCR NO <br />I <br />A11LICL110N N0 <br />st, i A psinuATION DATE <br />eY <br />n!Mlk NO <br />SIZE <br />RI CACNrLOW DEVICE SERIAL NO <br />R, NO <br />I RACRrLOW DEVICE SERIAL NO <br />I <br />GRAND <br />MMOLL NO <br />kiMRISTAI,"TIONOATE <br />OY <br />wnrERDN_ OST_ LOCNEDODS- <br />9Y- <br />-- TSG - <br />-� <br />77 <br />M, <br />Mr\URAs <br />rT, <br />m <br />SE\\ER SER\ICE m -r <br />erRAm Nu $P-16420 RLRRIIn ME ALTERATION <br />LID ND —; <br />I+Iense Note:--1'he City is respim iWe (ur %iruct Dr:d tic ter I, IN the ..tic so,er un the City ROW side per F,I\RnJ.I m&.41 <br />REMARKS: C- <br />:T E <br />ram--^- <br />I., I1 <br />G,QC+GG <br />oho No �•_+� <br />-1 �=�-al�•Ji <br />u+irLn[o nv I <br />PATE 1-• Cam, <br />PEES <br />Sewer Utility Fee S 0) <br />TU 1't1, I LEJ S30.00 <br />I I'ER111I"I-NUMBER U1511-017 I <br />ADDRESSCOPY <br />