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� <br />� <br />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 U1604-039 <br />.ros nDD�ss 2605 RAWIER AVE <br />�Escx�rrioN INSTALL BACKWATER VALVE <br />owNEx RICHARDS-MALIKOWSKI NANCY ANNE <br />PO BOX 1247 <br />LAKE STEVENS WA 98258 <br />PHONE 4255305015 <br />� DA�: � �.� � � <br />LscnLDEscx�PTioN EVERETT DIV I PLAT OF BLK 605 <br />APN: 00437860500200 <br />TENANT <br />coNTTzncTox AMERICAN SEPTIC & SIDE SWR LLC <br />2606 LARLIN DR <br />EVERETT WA 98203 <br />I � pxoNE 4257897296 � <br />WATER SERVICE <br />SERVICF. SiZE <br />SET"fER INSTALLATION DA'I"E <br />METER NO. <br />R.F. NO. <br />SERVICE TYPE I FRONTAGE <br />METER ISTALLATION DA'IE BY <br />WATBRON OFF LOCKEDOUT BY <br />REMARKS: <br />NO.OF UMTS <br />�.�� <br />#16ACKFLOW DEVICE SERIALNO. <br />if2 BACKFLOW DEVICE SERIAL NO._ <br />MODEL NO. <br />SEWER SERVICE <br />TSG <br />SERVICE ORDER NO. I APPL[CATION NO. <br />—S^7 'r^� <br />�..t:1 � �::.�.,i <br />�7„/ C�'3 <br />r r- t-� l....w. � �" .�1 <br />....� . <br />4�---1 G:J � C..� � l.i'.'� �!' <br />r..... r�-� r-�-i r�•� � "',^ <br />•r .r.::-- t:� y� �� e.-'" <br />:�"] f'�'7 I'T'7 Y'T� I"T'i <br />��;} ::r� ,:�i,i ,:a::p �i_t p�.J. <br />p�"""T"o. SP-16644 PEIiM(TTYPL ALTEl\t1TION I LI�i10. <br />r•a <br />REMARKS: Please Note: The City is responsible for structural defects in the side sewer on the City R� �e��e�,�N,�,�;�,�:�,2jb�t ,�, <br />� k',J u L.�d [�:� rr A C> r....•! C:_> Y.; <br />.""� �'a'„� �""f � w y � .� �r �`y <br />._a� � C-.7 C_"j C..1 „e"'7� �•} C_„'r <br />�•�w --J C::a C?'1 �.� '•J... r,,.J <br />INSPECTED BY: <br />Sewer Utility Fee <br />TOTAL FEES <br />$30.00 <br />$30.00 <br />FEES <br />DATE: <br />.C�'�`'..~- <br />4`) = v <br />� `7 C. y7 G-.] <br />,�a �... _c>. <br />.�r�. <br />7 <br />� ..5::- <br />PERMIT NUMBER U1604-039 <br />TO POSTlNG �� � � � <br />ADDRESS COPY <br />