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UTILITIES CITY OF EVERETT <br />EVERETT PERMIT OPERMIT SERVICES <br />DI <br />WASHINGTON (425)257-8810 <br />Online Inspection Request onllnecermiss.everettwo.aov <br />PERMITNUMBER: U2303-017 <br />ususD ogre: 3/10/2013 <br />UOOADI 2520 MADISON ST <br />LLwLDEscR: <br />DEE(AIenpx Sewer pipe for laundry/kitchen broke and needs replaced <br />API: 2805MM200100 <br />OYVNER Sunrise View Convalescent Center LLC <br />m. <br />SUNRISEVIEW <br />2520 Madison St. <br />'^ALTO^: <br />OWNER <br />evereft WA98203 <br />PHOI (360)391-1575 <br />PHONE <br />WATERSERVICE <br />EMARKS <br />NOTE: A water backflow prevention and/or consultation is required regarding Dross connection control for irrigation services. <br />Correct Tim Markham at (425) 257-8833 or by email at tmarkbam@everettwa gw. <br />TO Hariti CITY WATER CONNECTION CALL 1425( 25189273-4 WEEKS IN ADVMCE.IF METER ONLY INSTALL CALL (@5( 2573&1 <br />SEWER SERVICE <br />If you have a sewer blockage Outside Your home, OR Puget Sound Energy firstUS 1-889-225-5773 ED prevent moss bare danger. <br />ENERGHPIT E SP-19121 PERMirrxe SIDESEWER-REPAIR uo NO. <br />MARKS. PIBW Nu,: The dEris mg nMiebrOl ,ral d,NO, in lM1esitla Nweron MaClrry ROW 4MpMFMC W.0R.260 <br />EE ATTACHED IMAGE FOR LOCATION OF REPAIR (RED CIRCLE) <br />ewer pipe for laundry/kitchen broke and needs replaced- must cut roughly 8 R into our tire lane to access the pipe <br />SURIECTTO FIELD INSPECTION ADDITIONAL PERMITS MAYBE REQUIRED' <br />NotRy the Public Works Inspector (425) 257 891024 hours In advance toschedule an Inspection. <br />It is the applicant's responsibility to insure adequate protection against sewer backflow if the structure is located in the combined sanitary/storm sewer <br />system. <br />FEES <br />SEWER unury FEE <br />$30.00 <br />Porri Cretlit Card Fee <br />$0.69 <br />TOTALFEE <br />00.0 <br />Permits expire If work Is not commenced within 180 days or ceases for more than 180 days. <br />PERMITNO: U2303-017 <br />_APPLICANT _TREASURER _ADDRESS FILE <br />