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UTILITIES CITY OF EVERETT <br /> PERMIT SERVICES <br /> E Err PERMIT <br /> 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1406-027 DATE: <br /> JOB ADDRESS 1909 19TH ST LEGAL DESCRIPTION <br /> DESCRIPTION BACKWATER VALVE APN: 004379365 02 <br /> OWNER HALL MICHELLE TENANT <br /> 1909 19TH ST CONTRACTOR COMBINED CO RUCTION INC <br /> EVERETT WA 98201 4403 RUSSEL D <br /> TEO WA 98275 <br /> PHONE <br /> PHONE 610 34 <br /> n: <br /> WATER SERVICE <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO. S I SERVICE ORDER NO. I APPLICATION NO. <br /> . 0 <br /> SETTER INSTALLATION DATE BY <br /> METER NO. SIZE C DEVICE SERIAL NO <br /> BRAND DEL NO. <br /> METER ISTALI.ATION DATE BY <br /> WATER ON OFF LOCKED OUT BY •fs(`j 1zm <br /> REMARKS: _ <br /> a <br /> l" r�—mi'�II0i <br /> r- c7 <br /> m m r i 'rri7D 7c:' <br /> 1' <br /> SEWER SERVICE <br /> PERMIT NO. SP-1S 166 PERMITTYPE REPAIR I "F�° i=-` <br /> _.. <br /> d" <br /> REMARKS: Please Note: e City is re nsib for structural defects in the side sewer on the City RQ,},YmMe per_FMC.14.08.;0 <br /> ...7 IBJ <br /> ',5,�eva��, '��,]a �] E�.• Imo-'• <br /> J 4—43 LTl <br /> INSPECTED BY: DATE: ---'•F^'• <br /> AV <br /> FEES <br /> Sewer Utility Fee $30.00 <br /> TOTAL FEES $30.00 <br /> PERMIT NUMBER U1406-027 <br /> ADDRESS COPY <br />