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1 ... „�;;� _L 9l CITY OF EVERETT <br /> 1= �=— T S <br /> EVERETT d - 75g J 5 PERMIT SERVICES <br /> WA S H I N G T O N PERMIT � 3200 CEDAR STREET <br /> ��a6 a <br /> EVERETT,WA 98201 <br /> `1a,/ /5-6/ , /ld /4� � (425)257-8810 <br /> PERMIT NUMBER U2106-007 DATE 11/9/2021 <br /> JOB ADDRESS 9731 31ST AVE SE LEGAL DESCRIPTION <br /> DESCRIPTION LOT- -NEW COMPLETE 3/4"WATER SVC AND SWR AND S• APN: 28051700404700 <br /> OWNER ROSHOLT TODD J&JENNIFER D TENANT <br /> 15408 35TH DR SE CONTRACTOR <br /> OWNER <br /> BOTHELL WA 98012 <br /> PHONE <br /> PHONE <br /> WATER SERVICE , <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO.OF UNITS SERVICE ORDER NO. APPLICATION NQ <br /> 3/4" SFR 0.00 SO-14698 APP-19677 <br /> _SE I 1ER INSTALLATION DATE 1 —2'1 BY413,-,Q354,3,2. <br /> Ii Q� i ` <br /> METER NO. Ii S5�i 5 Li SEIZE -43 � ' •-� wl #1 BACKFLOW DEVICE SERIAL NO. <br /> R.F.NO. *2 BACKFLOW DEVICE SERIAL NO. <br /> BRAND f� A_4 V - MODEL NO. <br /> METER ISTALLAT1ON DA 1 7-- 3 7-1 <br /> BY \ `5.'3'1 A,"7- L. <br /> ' <br /> WATER ON_ OFF LOCKED OUT BY TSG <br /> LOT 3-NEW COMPLETE 3/4"WATER SVC AND SWR AND SYS DEV FEES--25%'SURCHARGE FOR OUTSIDE CITY LIMITS <br /> REMARKS: <br /> .' -ice <br /> PERMIT NO. SP-1 8705 PERMIT Tn� ?I'4\'''441 . <br /> Z h a r• <br /> REMARKS: Please Note:The City is responsible for structur n Z of • - 4,,i <br /> a.o <br /> 0 V 2 <br /> INSPECTED BY: <br /> Z I m 21 o <br /> g <br /> I 1 \mommummilmini Z c] -0 L ,= S y 0 o N <br /> Ti <br /> L <br /> v 4 v Q e 1 c c <br /> Z ��. ; J o o <br /> SEWER UTILITY FEE $70.( . . ; ;.m .E <br /> y O E. , ` > C <br /> SYS DEV SEWER OUTSIDE CITY SUR $1,355.; - O. 5 •� ` 5 o <br /> SYS DEV WATER OUTSIDE CITY SUR $1,047. c <br /> —= _ d _� m a N - ,tiSYSTEM DEVELOPMENT FEE SEWEF $5,422• `� o o o oSYSTEM DEVELOPMENT FEE WATEF $4,190 • f . �° g A <br /> WATER UTILITY FEE $3,260j _ .E. gi 3 -s $ <br /> TOTAL FEES $15,345.00 - - uHermit• v., i� . .I _. <br /> Services I <br /> PERMIT NUMBER U2106-007 <br /> d LITIES COPY <br />