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UTILITIES <br />PERMIT <br />PERMIT NUMBER U1606-003 <br />JOB a���aFss 1805 RAINIER AVE #A <br />��scizmnoh SIDE SEWER REPAIR <br />°Wh!`� BROWN BRUCE E <br />PO BOX 1629 <br />OCEAN SHORES WA 98569 <br />CITY OF EVERETT <br />PERMIT SERVICES <br />3200 CEDAR STREET <br />GVERETT, WA 98201 <br />(425) 257-8810 <br />DArE: 06/02/2016 <br />���nL �FscxiPT�orr EVERETT DIV P PLAT OF BLK 361 <br />^PN 00438436100300 <br />fI;NAN'1' <br />coNrKncroK JIM DANDY SEWER & PLUMBING <br />1501 NW 46T}-1 ST <br />SEATTLE WA 98107 <br />I PIIONI: I <br />i'fu�Ni: 2066331 141 <br />WATER SERVICE <br />11�:R\'I('L tii'I.L SER\lCL'fl'PI: FRO\TAGE I \'O. O�' OI OO I SERVICF OlLDER \'O. I APPLICATIO\ \'O. <br />SG77ER I1rSTAI.I.ATION DnTf <br />METER NO. _ . <br />R.F. �O <br />�RA\D <br />�1ETER ISTALLA'I'10� D.4TE <br />WATF:RO�': _ OI�I� _ LOCKEDOUT <br />RE�tAR�I'S� <br />PL:RMI'I' VU <br />REVIARKS: <br />RY <br />SIZ[ <br />BY <br />F3Y <br />NI BACKfLOW DEVICE SERIALNO. <br />#2 13ACKFLO\V UEVICE SERIAL NO. <br />MODEL NO. <br />SEWER SERVICE <br />� . cc� �,� <br />,� ri <br />TSG -- ,-,-; <br />.... _ . i� . . <br />� J_ - <br />I—i �_ <br />..-� .......{ f,r t � .. <br />�e ..� i ".' I'�'1 <br />�:�fh �,� f.:7 <br />i i'h : _, i"'a <br />SP-16673 PHRMITTYPL REPAIR I LDNO <br />Please Note: The City is responsible 1'or structural defects in the side sewer on the City ROVI'side per EMC <br />� <br />dae�No ;� .... <br />m.� " i._ <br />...... ��,� �._ � - <br />�.... ... �"� ��.. <br />'_'� "" <br />'__ � C..:` f �.. . . <br />IIVSPECTED 13Y. I DATE'. ,-` `, <br />FEES <br />Sewer Utility Fee <br />'TO'1'AL FEES <br />$30.00 <br />$30.00 <br />PERMIT NUMBER U1606-003 <br />AUllRGSS COYY <br />