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UTILITIES <br />PERMIT <br />PF.RP41T NUMBER U1602-001 <br />�o� .a�i�izr.•.ss � g23 OAKES AVE <br />»�;SCR�Pr��N INSTALL BACKWA'TER VALVE <br />owNcx URABECK SUSANNE L <br />1823 OAKGS AVE <br />� EVGItETT WA 98201 <br />�'���>N� 2536402737 <br />CITY OF EVERETT <br />PERMIT SERVICES <br />3200 CEDAR STREGT � <br />EVERFTT, WA 98201 <br />(425) 257-8810 <br />DATE: 2/ j /ZO � E) <br />�,ECAt. �Escizrp�r�orr EVGRETT DIV K PL.AT pF BLK 36� <br />�E'N: 004379365Q I 100 <br />.1.rrrnN�r <br />coN�'��ncroR AMERICAN SEPTLC & SIDE SWR LLC <br />2606 LARLIN DR <br />EVERETT WA 98203 <br />� I i>iioNr. 4257897296 � <br />WA'I'ER SERVICE <br />SI:RVICE SIT.I' I $EftVICG TY"Pti I PRUNTAG[ I NO.OF UNOt'IUO I �IiIiVICt:URDEN NQ I APPI.ICA'i1pN NO. <br />SETTGR IN59�ALLATION DAl'8 <br />METER NO. <br />IL.F. NO. <br />METCR 159'AL.LATION UA"I'E _,____'___ BY <br />WA'fER ON ___ OFF _, LOCKL'U UUT _^ HY <br />RfiMARKS <br />BY <br />SIZL <br />NI 13ACKFLOW DF.VICE SF:RI:\L NO. <br />k2 dACKFLOW DEVICH SERIAL Np. <br />MOUBL NO. <br />SEWER SF,RVICE <br />TSG <br />"T;� � �:g_'i <br />1y''t """9 �'�-i <br />:a� c; :� <br />F_�. M..... �..,.� -�. � <br />�- { �� <br />!.._.._I Ct� �`.fi Ct"3 •:..J_ ��"} <br />,� i._.. r�-� rs•i � �`� -r. <br />.x::. .r.-_-- �:- �r���- i.`;i: <br />':'x'7 1'' 7 P "7 1'"r7 <br />�:_� '-rt ,..r;} ,;a.-� j_.... <br />�`'�""'�NO SP-16506 ''"`""'TYYF ALTERA'TION I `'°"O .6;�k <br />��� <br />REMARKS: Please Note: The City is responsible tbr structural def'ects in the side sewer on the City ROW side pe��'iC �4.08.2yi!!,. <br />•�iY S r�j c�'a t:j r.: a r�l <br />� '..::� �••') a"'�"x i'�,_:7 +._:r <br />� '4m" v . �a _.Y n <br />.�;,? ��°O5 `7 C:.} �;, � :�� ,-.V"} <br />.�:J "^+" 'w� C.N :.' a ('•.�Y �._ <br />�NtiPECT�D [il'- <br />Sewcr UtilitV I ec <br />TO'I'AL FE[:S <br />11A f�' <br />_ FEES _ <br />$30.00 <br />$30.00 <br />t,�} <br />[:":'1 �o f :rry <br />_--t i''..'.1 _t.:+ <br />—t:rii�— <br />r_.-a <br />�-.+. G•S <br />PERMIT NUMBER U1602-001 <br />roposr��G �r� �� � A��n�z�:Ss �pPY <br />