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G"✓ E ETT <br />UTILITI E S <br />CITY OF EVERFTT <br />PERMIT SERVICES <br />PERMIT 3200 CEDAR S"TREE"I' <br />EVERET'"1', WA 98201 <br />(425) 257-R810 <br />PERMiT NUMBER lJl512-026 �^��F ' �� 1' �'�j <br />�oii npi�itr,ss 2406 EVF,RET'I' AVE LECAt. r�1.sc�tiNTioN F.VF,RETT DIV I PI,AT Oi' BI,K 633 <br />D}:.sc�zu�rioN INSTALL E3ACKWATF,R VALVE & RF.NAIR SIDF, SEWER AE'N 00437863300300 <br />owNt:R Ml1ELLER JOF; & KIRSTEN rr:NnNr <br />1906 I I I TH DR SE cc,N r�inc• rc>tt �, <br />LAKE STEVENS WA 98258-7954 nn 1 I lJMI31NG I,LC <br />861 1 VIS'I'�RAMn /�V1; <br />F;VI;RI?"f'I' Wn 9820R <br />PliONI? <br />�����>N�� ��Sas;oi��.� <br />wn�rr:ii sr,iivicr. <br />sEsrsvu c size sr.'avicE rvvi; FHON rncr: Nc� or uNi�x I siacvu r-oiauei+ Nu I nrri.0 n ri��N No <br />I �.�� <br />I I _ <br />SEI�'F.'Ii INSTAI.LATION DATE <br />METER <br />R.F'. NO. <br />Mt:I'!iN ISTALLATION DKPE <br />Wq'1'1"iRON_ _ OFF___,_,_ LOCKFDOUT_ <br />kr.Mne�:s: <br />PI�;ItMI"I' NQ <br />RF,IIIARKS: <br />WSPGCTED BY: <br />BY <br />BY <br />(3Y <br />a16ACKFfAW DEVICti SERlALNO. <br />N2 HACKFLOW DBVIC� SERIAI. NO. <br />MODEL NO. <br />��'.���'.�Z ��'.�ZV����'. <br />�rsc <br />T'1 �n¢ _l� <br />iTl � 1"'�"7 <br />_— 17,� �� ) <br />�._.• "51` a�n <br />i--i <br />y -«.� n <br />}. ,i r._ ��'_{ .-r <br />: •r. �': �i <br />.��_7 �."�; <br />i; �9 ; �'+ 1--• <br />C7 PI�:RA91�f I\'I'I�. ) `) ^ 1.111'J�1 ,y,� <br />�,71�'�6456 �\�:1� !\��� '�"� <br />la— <br />Nleasc Note: '1'he Cit�• is responsiblc for structurxl detccts ia tl�e side sen�cr un the Cih� R01'�' sidc per RMC 1d.081p�; <br />ir. Q x�=+ <br />��� �_� <br />v� �� o_= <br />.>> 4M r r_a <br />Sewer Ulility I'ee <br />'I'07'AL FF F.S <br />$30.00 <br />$30.00 <br />FEES <br />D.YI'G <br />�� <br />• II. <br />r Y <br />1�"i 4'�'S .j�'� <br />—.�{ �,}. L,nf <br />'LT7 <br />�_... ; T7 <br />PF:NMI'I' NUMBH;R 1J1512-026 <br />n�miti�;�s �'� �i��� <br />