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UTILITIE S <br />PERMIT � <br />,__ <br />PERMIT NUMBER U1504-043 <br />�oB A�nRLss 2324 63RD ST SE <br />��scaiP��ioN SIDE SEWER REPAIR <br />�wN�ii STEEN MARGARET <br />2324 63RD ST SE <br />EVERETT WA 98203 <br />� <br />� <br />CITY OF EVERETT <br />PERMIT SERVICES <br />3200 CEDAR STRE�T <br />EVERETT, WA 98201 <br />(425) 257-8810 <br />� DAT� 4/8/2015 <br />LEGAL DESCR1P170N <br />^�'N 00544801301200 <br />rLNANT <br />coNl�ancTOR DAVIS CONSTRUCT[ON INC <br />18 W MARILYN AVE <br />EVERETT WA 98204 <br />Pl ION G I <br />PiION� 42550]9556 � <br />WATER SERVICE <br />SERVICE SI'LE I SLItVICE "I'YPE I FROM'AGE I NO. OP OI 00 I SCItVICG ORUGR NO. I APPLICA'PION NO <br />SE'ITER INSTALLATION DA'TE <br />ME'1'ER NO. <br />R.R NO. <br />ML'I'L•R ISTALLATION UATE BY <br />\VA'fGR ON OFF LOCKN OUT BY <br />IiL:M�IiKS-. <br />ov <br />NI BACKFLOW UEVICE SERIALNO. <br />I N2 BACKFLOW DEVICE SERIAL NO._ <br />MODR NO. <br />SEWER SERVICG <br />TSG <br />PL•IiMI'1' NO. SP—I SO00 PCIiMIT'1'YPH I LIU NO. <br />RGMARKS: Please Note: The City is responsible for structura) defects in thc side sewer on the City ROW side per GMC 14.08.2G0 <br />IINSPL'Cf[DBY: ����J � ra� .%J� C' I DATE�. ��_' � ^, �� <br />(/� G -� 7 <br />FEES <br />Sewer Utiliry Fee <br />"1'O'CAL FGES <br />$30.00 <br />$30.00 <br />I V � � � <br />: <br />aPR o 8 20�5 <br />,�, �, ,�R' :. � <br />'CCIt_.. /,LC�::, <br />PERMIT NUMBER U1504-043 <br />PUI3LIC WORKS COPY <br />� <br />