Laserfiche WebLink
WATER/SEWER UTILITY PERMIT APPLICATION <br />' CITY OF EVERETT PERMIT SERVICES <br />' 3200 CEDAR STREET, EV[R[TT, WA 98201 <br />425•257-8870 - FAX 425-257-8857 - www evereltwa gov <br />' rzr �l!' y �-v� <br />PROJECT ADDRESS <br />� _ , . .� . . _ n !/ - - <br />Property Uwner <br />MaJ AdOress <br />Cdy <br />��� <br />✓✓�-/ '_ `LC�i/ <br />State2ip ��none <br />�� Tenant Name�(II th�s is for a Commercial bus��ress) <br />�-tM�'(2-(�.C'"n' 2�,o(v Gfel2.-(�N (�2. �K25) <br />sc�l.,'_G,�Q S� d� Ser,�e,z. " J�.r'1e'iT� u.�� ,�82� 3 �f 4- 5� 9 S9 <br />, Con'�actor Ma0 AaOress C y S:alr,2:, Phr;��c <br />� �vvt���ss �l K� 0�.35�"' <br />, VJA Sta;e Ccn;ractor License Number (requ�retl) Ciy c' Evere't Bus�.�ess Litense Number (required) <br />Work to be done: <br />�, Q�Side Sewer Repair <br />� ❑ Side Sewer Alteration <br />I <br />j ❑ Side 5ewer - New Instaliation <br />�' Install Backwater Valve oulside the building) <br />❑ Cap off Sewer <br />❑ Install Water Meter <br />� <br />-�y-�s <br />N <br />FE[ --- -- - '', <br />�3�,°� � <br />PERMITi� <br />u[50�-D� <br />