Laserfiche WebLink
N <br />N <br />� <br />� <br />� <br />BACKINATER VALVE REQUEST FORM <br />Name Todd Pollack <br />Address 806 331'd ST <br />Contac� Phone #: (425)252-9005 <br />e-mail address tinriient@hot.mail.com <br />YES NO <br />Experienced basement flooding? Q✓ ❑ <br />How many times? 6-10 <br />Return this form to: <br />Backwater Valve Request <br />City of Everett Public Works <br />3200 Cedar Street <br />Everett WA 98201 <br />or <br />email to: evemttpw@everethva.9ov <br />