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UTILIT`�ES <br />�'ERIVIIT <br />P�RMITN(1MBER UlbU4-QI4 <br />70BADDRESS 2Y 17 LOMBARb AVE <br />DESCRIP7'lON 1NSTALL BACKWATER VALVE <br />owNER yq��� MIKE & MICHELLE <br />z�.i7 LOMSAr� <br />EVERETT WA 98201 <br />CITY �F EVERETT <br />FERMIT SERVICES <br />32Q0 CEDAR S'I'RGET <br />EVI;RETT, WA 9820f <br />(425} 257-8810 <br />DATE; <br />LccALaEscR; �V�R�TT PLAT OF BLK 439 D-00 - L�T <br />^�'H 00439143900800 <br />Tf:NANT <br />CON'IRACTOk g��rER DETECTIVES <br />215 1 STH 5T <br />SNOHOMISH WA 9829Q <br />LPHOTIE PHONF. + <br />4259234958 i <br />WATER 5L',f2VICC <br />SERVICE <br />REMAAKS; <br />7�t0��'I'AGE 1 \'O.OFUNfYS � SL'HVECS <br />NOTE: A�vatef• backtlow prevention aud/or consultation is required regaz•ding cross connection contro� for in•iga[io� services and <br />services 1" or larger. Calt Tim Ma�•kham at (425) 257-8833. <br />PI�EASE CALL (42S) 257-8862 TWO TO TlIREE W�EKS PRIQR T'O WANTING WAT�R SERVPCE INS7'ALL�I�. <br />SEWER P�RMIT NO. SP� I Fi(��i PERMIT TYPE AL��'ERA��]QN L1D N0, I.�,�—„a <br />REiv1ARKS: ylease \otC: "C'he Cih� is responsible for structural defects in the side sewer on the City R01�'sidc per �R�IC 14.08.260 <br />� <br />� <br />APPUCATION �O. <br />� <br />� 1NSPF.CiED BY; I BATE� 4�� � <br />t�.r tr� <br />�—na�.t��9—�... <br />Notify the Public R'orks Inspcctpr (425) 257-8810 241iours in advance to schedule an inspectian, �� r, ,�, <br />�� <br />4 ? � <br />� m �� �v� t�? L•a <br />It is the appiicant's respopsibility to insure adequate protection againsl sewer backilow if tha strueture is located in the combined sanitaiy/storm�awer <br />system. <br />t. .. �r•, <br />Szwer Utilily Fee <br />30.OQ <br />TOTAL FE�S $30.00 <br />Perntits expire ifwo'rk is not cammenced tvithin 180 days or ceases for more tha» 780 days. <br />PERMIT NUMBER U1G04-Olq <br />Applicant Copy <br />