Laserfiche WebLink
i _ _-- -- - - - -- <br /> � WATER/SEWER UTILITY PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 58201 <br /> 425-257-8810 - FAX 425-257-8857 -wvnv everettwa gov <br /> llOS C�° A� £vc�rr �✓A 9�?0� <br /> PROJECT ADDRESS <br /> � �t'f�r c�r�`f l�f. I105 �f✓1.n l�.F �U�Lf�T l,)/� ���A�D ( 4�S- -7�i3 <br /> IProperTy Owner 1,taa i�Cdress Ciry S�atc2�p Fhone <br /> --_' <br /> � Tenant Name(If;nis �s tor a commeraal Gus�ness) <br /> I <br /> � 5,- w,ti��c: y�a� s-U�- �,,,a�, ,U, Sf�rr-�� c�� 9RI03 <br /> Conlractor 1.'a•,IAad�css Cqy Sta�e2�; Phone <br /> I� f� �STPGt, `�7 � LD 030`�95 <br /> I lNA Sta;e Contrac;cr License Number Ireqwretl) Ciry of Eoereti fics�ness L�cense Number (reGwred) <br /> II Work to be done: I <br /> I � Side Sewer Repair �I <br /> � <br /> 'I ❑ Side Sewer Aiteration <br /> ❑ Side Sewer - New Installation <br /> I � Install Backwater Valve �utside the building) I <br /> i <br /> ❑ Cap off Sewer <br /> ❑ Install Water Meter --- <br /> FEE <br /> �_p o� <br /> � /0/�/� PERh1IT: —� <br /> � Srtpiatu � Uate 1 ' <br /> U ��1�- �O� <br /> �.��__.. � . . <br />