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n <br />UTILITIES <br />PERMIT <br />PERMIT NUMBER U 1602-003 <br />IOR anoxEss 2001 RAINIER AVE <br />�EscxiPT�orr INSTALL BACKWATER VALVE <br />owNh:i� MONTOPOL[ CYNTHIA L <br />2001 RAINIER AVE <br />EVLRr:T'I' WA 98201-2432 <br />>>��i��N�: 4252593592 <br />CITY OF EVERETT <br />PERMIT SERVICES <br />3200 Cb'DAR S'1'REET <br />EV�RET'T, WA 98201 <br />(425) 257-8810 <br />R�T�= 2/1/2016 <br />�Ec�L �LscRiP�rioN CAPITOL HILL ADD BLK 417 D-00 <br />APN: 00401541700100 <br />rI:NAN�r <br />coN'rttnc�rc�iz AMERTCAN SEPTIC & SIDE SWR LLC <br />2606 [.ARLIN DK <br />F,VERI;�i'T WA 9&203 <br />� � i'iu>Ni` 4257897296 � <br />WA'CER SERVICF, <br />SERVICE SI7.1? I SERVICE'PYPG I I'RON"fAGti I NU� UF `IOt OO I SFRVICF OltDtilt NU. I APPI.ICATION NO. <br />SEI"1'ER INSTALLA'PION DATE <br />ME'�ER NO- <br />R.F. NO._ _ <br />METER IS7'ALLATION DA'fE_ BY , <br />NATER ON _ OFF _ LOCKeD OOT __ BY <br />REMARKS: <br />BY <br />#IBACKFLOW UEVICE SERIALNO. <br />N2 BACKFLOW DEVICE 58RIAL N0. <br />MODEL NO. <br />�x s�;av►cr, <br />- <br />;x'^, <br />TSG --- � �4� r� �' <br />F..�. H..� M-` w—t ��5,,.. <br />�� ��� . �.,.{ �. <br />t. ,� t' -�( Ir�SJ'1 �2: C°t"t '�& C'y,7 '-V <br />:.I'> :L=':.' � :6:::.. i.'. �� <br />_,�.'� f'�"f f"r7 �-��; �� <br />t_:C, ];C'� M:r;;: ... �.,...�. <br />: r.! <br />PHRbII"I'�I'YPI: LIDNO. ,��;;L 1-=� <br />�'�`"",�� "" SP-16508 ALTERA"C'ION k,•,• �T., <br />=�a:� <br />RF.MARKS: Please Nute: 7'he City is responsible for structnral defects in the side scwer on the City RO��- side pe�'„�7MC d4.08.2Gl1. '=�' <br />-tT:F �� 27i�t {;1••. .1Yi? �; T.., q� �;F ..-. <br />�...�:i C.*d t..r f y C:> L•J <br />_:� r,Va P�,:I G7 1'� 7 c_:.� <br />_.r u e^:.a . <br />':�Y �:..�T �:.: T r';Y y�7 <br />� . � � �wm� �:..... i.,.q t_... 1'�..7 r.-,�, t..� � > <br />:..:. ... a �. w <br />�..'T r �Y C..t,! <br />.....Jx P'."} ..f�• <br />INSPECTED BY: I pA'PE: r,_•'� � <br />... Y,..•.i <br />FEES _ _ _ _ <br />Sewer Utility Fee <br />'I'OTAL FGES <br />$30.00 <br />$30.00 <br />� �' �� � NERMIT NUMBER U1602-003 <br />TOPOSTI'NG ���p���:�, ���>��Y <br />