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UTILITIES CITY OF EVERETT <br /> #11111-r---A - - . PERMIT SERVICES <br /> ii,„ PERMIT 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> ( 25)257-8810 <br /> ti/4sPERMIT NUMBER U1504-107 DATE: /5 <br /> JOB ADDRESS 9215 5TH DR SE LEGAL DESCRIPTION <br /> DESCRIPTION WATER,SEWER&SYS DEV FEES FOR NEW HOUSE APN 28051800302200 <br /> OWNER SEATTLE PACIFIC HOMES TENANT <br /> 120 SW EVERETT MALL WAY CONTRACTOR SEATTLE PACIFIC HOMES <br /> 120 SW EVERETT MALL WAY <br /> PHONE 4259532800 <br /> PHONE 4259532800 <br /> WATER SERVICE <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO.OF UNITS SERVICE ORDER NO. APPLICATION NO <br /> 3/4 SFR 1.00 SO-13483 APP-18483 <br /> SETTER INSTALLATION DATE BY <br /> METER NO SIZE NI BACKFLOW DEVICE SERIAL NO _ -.-._.. <br /> R.F NO N2 BACKFLOW DEVICE SERIAL NO <br /> BRAND MODEL NO. <br /> METER ISTALLATION DATE___ BY <br /> WATER ON OFF LOCKED OUT BY TSG <br /> REMARKS <br /> I SEWER SERVICE , <br /> PERMIT NO SP-15946 PERMIT TYPE NEW CONNECTION I LID NO I <br /> REMARKS: Please Note:The City is responsible for structural defects in the side sewer on the City ROW side per EMC 14.08.260 <br /> INSPECTED BY 74 �_•�//I I DATE - ( ^ 7r /� <br /> FEES I <br /> Sewer Utility Fee $70.00 <br /> System Development Fees $8,873.00 I 3 c ' lin <br /> Water Utility Fee $480.00 `_� E <br /> il <br /> APR 2 8 2015 J <br /> TOTAL FEES $9,423.00 1 (. t�RL- <br /> 'ern . Noes <br /> ..^ r14STING f15IIe PERMIT NUMBER U1504-107 <br /> � PUBLIC WORKS COPY <br />