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UTILITIES <br />CITY OF EVERETT <br />PERMIT SERVICES <br />PE�IT 3200 CEDAR STREET <br />EVERETT, WA 98201 <br />(425) 257-8810 <br />PERMIT NUMBER U1605-008 <br />roa aDDxEss 4624 HARBOR LN <br />DEscx�rTioN SIDE SEWER ALTERATION <br />owNEx BROWN TIMOTHY <br />4624 HARBOR LN <br />EVERETT WA 98203-1512 <br />rHONE 4083415455 <br />I DATE: �,,� � \ � <br />� <br />LEGar, DESC1uPTION DARLINGTON REPi,AT OF LOT X <br />APN: 0041 % 1 OOOOOE)OZ <br />TENANT <br />CONTRACTOR OWNER <br />� I PIIONE I <br />WATER SERVICE <br />SERVICG SIZE SERVICE TYPE FRONTAGE — NO. OF UNITS SERVICE ORDER NO. I APPLICATION NO. <br />Q.�� <br />SETTER INSTALLATION DATE <br />METER NO. <br />R.F. NO. <br />BRAND <br />METER [STALLATION DATE gy <br />WATER ON _ OFF _ LOCKED OUT By <br />REMARKS: <br />PERMIT NO. <br />REMARKS: <br />INSPECTEDBY: <br />I itiBACKFLAW DEV[CE SERIALNO. <br />#2 BACKFIAW DEVICE SERIA[. NO. <br />MODEL NO. <br />TSG <br />SEWER SERVICE <br />4� a P`- �j'�i-7 <br />:x:. � : <br />:'�'- f' �"7 <br />L,-f ,`?�,� <br />SP-16653 PERMTT TYPE �i PAIR LID NO. �, <br />��� <br />Please Note: The City is responsible for structural defects in the side sewer on the City ROW side per EMC 14.0.� � x�:a <br />L«1 C_>a <br />a � �� n._? <br />c-a �} , �-a <br />C�.'� C� <br />Sewer Utiliry Fee <br />TOTAL FEES <br />$30.00 <br />$30.00 <br />DATE: <br />`�'7 J T � <br />r1i �7j"T'7 <br />� �•_'i <br />h^w � W <br />---� . <br />r—� <br />�� �:� <br />[",y Y�7 C.•! <br />-•..•� ,d:;• CCJ <br />�`0 P���'1�� � � ' � ._._- <br />PERMIT NUMBER U1605-008 <br />ADDRESS COPY �� <br />! � � <br />k��� <br />