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UTILITIES <br />PERMIT <br />PERMIT NUMBER U1602-002 <br />JOB AvnRFss 1702 RAINIER AVE <br />n�,scxtPT�oN INSTAI.L BACKWATER VALVE <br />owNr:�z BUGGE STEPHEN M <br />1702 RAINIF.R AVE <br />EVERETT WA 98201-2427 <br />�'F���Ni= 2063723051 <br />CITY OF EVERETT <br />PERMIT SERVICES <br />3200 CEDAR STREET <br />EVERETT, WA 98201 <br />(425) 257-8810 <br />DATE: Z%��ZOP6 <br />i.scAL nFscr�rPTioN EVERETT DIV U PLAT OF BI.K 35_ <br />AYN: 00438835303100 <br />�t:NnNr <br />cot��rRac��oir qMERICAN SEPTIC& SIDE SWR LLC <br />2606 LARLIN DR <br />EVEKETT WA 98203 <br />I � i>i�oNi: 4257897296 � <br />WATER SERVICE <br />SERViCE SIZF I SERVICE'fYPE I FRONTAGE I NO. OF UO OO I $ERVICF.ORDER NQ. I APNI.ICA'I'ION NO. <br />SF7"fERINSTALLATION DATE <br />METCR NO. <br />R.F. NO. <br />ME'PER ISTALLATION DATE BY <br />W ATEit ON ___ OF� __.._ LOCKLD qU"I' ___ BY <br />REMANKS. <br />ql $ACKF40W DEVICE SERIAL NO. <br />#2 BACKFLOW DEVICE SERIAL NO._ <br />MO�EL NO. <br />SEWER SERVI('E <br />•.T;f 1 <br />..z. <br />:�. <br />.�.SG r�a n'i <br />_____ —_.— :•,.7 n^�' [�':+ <br />�....,� �.._..� (.""� M—i wdw <br />.--j n <br />i;;��_.-¢ .� � ::.r.._ :. �a :�-;_ F-�-� <br />r�-- r,.� ��;-� v�'� _�:� <br />:�:. �e�:- :�:.� ��:- �.�� <br />._.�,� C..r.1 r..�.� �—�.� <br />i^:7 ..a�r .sr� ,:.r'} i:..... <br />PERMI'f NO. PF:RMfI"fYPf � LIU NO <br />SP-16507 ALTEKA"T10N ��'r <br />REMARKS: Please Note: '1'he City is responsible for structural defects in the side sewer m� thc City I20W side pa�W"FM(�.1,4.08.��q <br />+�-H m •�er�. �-,..., .��:� .;�-.. �:.rF <br />•...L� 4_�•.{ '..� f,,_nl �v.:} ,,,p} <br />� Y m^ 4 3 t"' �} � � �.., .7 . y. <br />�� yua� n '] v .ti.� <br />r�..":Y �� 4�"i r,:....� ��y r��� u T} ::.3 Mn ..S <br />� .r.a w� G.:.:a� �:.�>d Cwa 1"•..:1 r,..�a <br />4""7 ':M} 1-T7 <br />-•—a r..� _�:- <br />INSPGC'I'ED BY� . . � � � I DATE: . . . r"�'� . <br />�..-... C_>3 <br />. FEES _ <br />Sewer Utility Fee <br />"fO'I'AL FEES <br />$30.00 <br />$30.00 <br />YF.RMIT NUMBER U1602-002 <br />�'� �C�STII�� � �.�'�� �"' <br />__._ AnE�rzHs� c��>�Y <br />