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APPLICATION for <br /> PA. PUBLIC WORKS PERMIT <br /> ETT PUBLIC WORKS DEPARTMENT <br /> 3200 Cedar Street <br /> Everett, WA 98201 (425) 257-8810 <br /> PUBLIC WORKS PERMIT REQUIRED? )(RC <br /> Date: 6/23/2015 <br /> Bldg Permit #: C1506-018 <br /> Owner: Mailing Address: Phone: <br /> HAACK BROS CONST INC 3922 87TH AVE NE 4253977360 <br /> MARYSVILLE, WA, 98270 <br /> Contact: Contact E-Mail Address: Contact Phone: <br /> [ContactName] [ContactEmail] [ContactPhone] <br /> Description of Work: NEW SINGLE FAMILY DWELLING-MAKAYLA PARK <br /> 1//>,F S n o 7e-S <br /> 1933 - 74 -'2= <br /> Site Address: 2004 4 T S -" & /arc-Service porcA41e OJ <br /> 4'Lr'e zd w - <br /> e 'z pp4f <br /> 9 p / <br /> Legal Description: <br /> -- /1•14.4e6 pe?;c2/ <br /> Comments from Re ewer: g l iwa / w/Shrf /°ZQ f <br /> Q v�.se bv��in _.' e <br /> ..S'2G0G�r at/. Pei-y.77;74 heec/e4 <br /> er�►�f a de�res� futi-1 xp r S'71644) <br /> School h,; ee ID Go ,n>#y) <br /> UTILITY INFORMATION <br /> Meter Only ❑ Complete Service 0 Install per building or per unit? (circle one) <br /> Size of water meter <br /> City of Everett Sewer: yes or no (circle one) <br /> Approved for Issuance by: SyS4eri bev ((JCS,. Date: <br /> EXiss Houcse 51 Aloes lloufe • 2071 -4-t 6373 <br /> $2 4 [3tsar+f: 8373 <br /> /6480 -eo l ett = 7/29 cHec%f - 7 1 z <br /> '1F/ 714 Due <br />