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UTILITIES <br />PERMIT <br />PERMIT NUiVIBER U1608-021 <br />�o� a��rz�ss 2601 LOMBARD AVE <br />U�S�Rir�rioN INSTALL BACKWATER VALVE <br />owNE:R SCHROEDER GREGORY S <br />16520 NE 45TH ST <br />CITY OF EVE�tETT <br />PER1b�IIT SERVICES <br />3200 CEDAR STREI�T <br />EVERETT, WA 98201 <br />(425) 257-8810 <br />I DATE: <br />LEGAL DESCRIPTION <br />1'ENANT <br />EVERETT PLAT OF BI,K 608 D-00 - <br />APN: 00439160800100 <br />coNiRncTox AA PLUMBING LLC <br />SEATTLE WA 98155 g61 1 VISTARAMA AVE <br />EVERETT WA 98208 <br />i�Fiorvi: <br />�'ii°Nr 4254850123 <br />WATER SERVICE <br />SERVI('[ $IZE I SERVICE TYPC FRONTAGE NO. OF UNIT$ SERVICF ONDER NO. APPLICATION?�'O. <br />I Q.�� <br />I <br />I I <br />SE'I"t'GRINSTALLATIOM1 DATE <br />�tETER M1O <br />R.F. !�O <br />BRAND_ _ <br />YtETER lSTALLATION DATE <br />WATER ON pFl� LOCItif:D pUT <br />RF.MARKS: <br />PLItMII' +l(7. <br />REMARkS: <br />iusPerren ev� <br />BY <br />BY <br />#I BACKFLOW DEV]CE SERIALIv�O. <br />A2 BACKFLOW DEVICE SERIAL NO. <br />MODEL NO. <br />SEWER SERVICE <br />TSG <br />SP-16798 ''ER'"'r'YP` ALTERATION I `'°"° <br />Plcase Note: The City is responsible for structural defects in the side sewer on the City ROW side per E�IC 14.08.260 <br />SEWGR UTII.,ITY f�EE <br />"I'O'IAL FEES <br />$30.00 <br />$30.00 <br />DATL: <br />j p <br />i �,`..� r�.`� ��J � W' _ <br />�� ' � <br />� <br />° � �'�� � � 2u�'�� � <br />; ; l, <br />, '��!� �-,, �' �' �;� �; �, �, ,f -` . <br />PERMIT NUMBER U1608-021 � <br />ADDRESS COPY <br />