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UTILITIES <br />PERMIT <br />PERMIT NiJMBEIi U1602-037 <br />JOt3 ADDRF.SS 2 � 20 OAICES AVE <br />DESCRIP"1'lON INSTALL BACKWATER VALVE <br />owNtri ,1ANSEN DOUG <br />2120 OAIC�S AVE <br />EVER�TT WA 98201-2343 <br />CITY OF EVERETT <br />PERMIT SERVICES <br />DAT <br />LEGAL DL'-SCR: <br />'iSNANT <br />32Ot} CF,17AR STRI:F.:"I` <br />L-'VH:1ZE1'1', Wn 9A201 <br />(42�}257-&8}0 <br />F: 2/ i 6/2016 <br />EVERE�'T PLAT Of= BL4C 437 <br />A�N: p0439I43702100 <br />- LO`f <br />CONTRAC7'OR AMERTCAN SBPTIC & SCDE SWR LLC <br />2606 LARL.[N Dlt <br />EVERETT WA 98203 <br />IPHONE qZ55121350 f PH�� 4257897296 j <br />WATEI2 SERVICE <br />IItONfAGE I NO.OPlMITS <br />fiF3Ml 7RKS: <br />DROGR N0. I APPI.ICAI'iON NO, <br />NO'Ck: A water bacl:flow preventic�n and/or cons�ltatian is required reg�rding cross cnnnection contrc�l For irrigation setv'rces anci <br />services 1" or larger. Cali Tim Markham at (425) 257-8833. <br />PLEASL', CALL (425) 257-8862 TW(? "I'0 `i'1-1l2E'F. WE�KS PR1C1R TO 1�VANI�ING WAT�R SE RViCE IiVSTALI.FD. <br />SEWER PERMITNQ. SP-k653�S PERtvTITTYPE I i.IDNO. -"; <br />RF.MARKS: Pfcusc Notc:'riie City is responsible 4'or structurel defects in the side sewer an the Ciry ROW side per CMC 1�.08.2G0 <br />INSPECTED BY: <br />Da,'rE: -;3.e.. <br />� � ' c.i ;'-' .�'� <br />NoYify the Public Works Inspecior ( 5) 257-8810 24 h�urs in advance to schedule an inspectian. ��,�} :`� `?.+p, <br />lt is th� appficant's responsibility to insure adequaCe protectipn lgainst sewer backflow if the slntcturc is located in the com6ined sanitary/storri����:er- � <br />. �=•F <br />syslem. ''"` �""'' <br />FEES <br />Se�ver Utility Fee 3�•�fl <br />TOTAL F�F.S $30.00 <br />Permils expire iFwoi9c is not commeneed withiii 180 days or ceases 1'or more than 18O days, <br />Y�RIVIIT NUMBER U16D2-037 <br />Applicant Copy <br />