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UTILITIES CITY OF EVERETT <br /> :" PERMIT SERVICES <br /> E� <br /> PERMIT 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1601-008 DATE: 01/12/2016 <br /> JOB ADDRESS 4959 ELM ST LEGAL DESCRIPTION VIEW RIDGE ADD DIV 3 BLK 000 I <br /> DESCRIPTION SIDE SEWER REPAIR APN: 00606300002200 <br /> OWNER WILSON,JOSHUA R&AIMEE E TENANT <br /> 4959 ELM ST CONTRACTOR BEST PLUMBING GROUP <br /> EVERETT WA 98203 4129 STONE WY N <br /> SEATTLE WA 98103 <br /> PHONE <br /> PHONE 2066331700 <br /> IWATER SERVICE I <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO OF UNITSI <br /> 0SERVICE ORDER NO APPLICATION NO <br /> .00 <br /> SETTER INSTALLATION DATE BY ____ <br /> METER NO. SIZE MI BACKFLOW DEVICE SERIAL NO._ <br /> R F NO P2 BACKFLOW DEVICE SERIAL NO _— <br /> BRAND MODEL NO. <br /> METER ISTALLATION SATE BY <br /> — — �, <br /> WATER ON OFF LOCKED OUT BY TSG 7:111 ami <br /> t--- 5c i <br /> I---I <br /> REMARKS. 1.7.)i=-1 <br /> S Cn <br /> m m • <br /> J" <br /> C, <br /> _'" <br /> SEWER SERVICE o:) �fn i <br /> � ` I <br /> J <br /> rl-' <br /> PLRMIT NO. <br /> Cin-16481 PERMIT TYPE REPAIR I LID NO 1:-.7'{ � <br /> S 1640 <br /> la:\IARKS: Please Note:The City is responsible fur structural defects in the side sewer on the City ROW side per EMC 14.08.2e ~`- <br /> m <br /> i_•4 L•4 <br /> G C -> <br /> Ai <br /> INSPECTED BY DATE. 1,l <br /> I mil <br /> I FEES <br /> Sewer Utility Fee $30.00 <br /> TOTAL FEES S30.011 <br /> PER\1Il NUMBER U1601-008 <br /> ADDRESS COPY <br />