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12619 16TH AVE SE 2017-10-04
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12619 16TH AVE SE 2017-10-04
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Last modified
10/4/2017 2:50:12 PM
Creation date
10/4/2017 2:50:11 PM
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Address Document
Street Name
16TH AVE SE
Street Number
12619
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UTILITIES CITY OF EVERETT <br /> PERMIT SERVICES <br /> (9L PERMIT <br /> 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> ;,�jk ISZ (425)257-8810 <br /> PERMIT NUMBER U1606-031 DATE: <br /> JOB ADDRESS 12619 16TH AVE SE LOT 4 LEGAL DESCRIPTION <br /> DESCRIPTION NEW 3/4" COMPLETE WATER SERVICE APN: <br /> OWNER PACIFIC HEIGHTS HMS LLC TENANT <br /> 620 SE EVRT MALL WAY#350 CONTRACTOR <br /> EVERETT WA 98208-4950 <br /> PHONE. <br /> PHONE <br /> WATER SERVICE <br /> SERVICE SIZE SERVICE TYPE FRONTAGE I NQ OF ll�TOSO SERVICE ORDER NO. APPLIC'A9'ION NO <br /> SETTER INSTALLATION DATE Y Ff l- Al+ 7 <br /> METER NO.&-/LA3j'?-r,�49 SIZE '71q <br /> 41 BACKFLOW DEVICE SERIAL NO. <br /> R F.NO. /5-ti)�/)845-�8 <br /> ♦, #2 BACKFLOW DEVICE SERIAL NO. <br /> BRAND ry�lY� t/"t (,� MODFI NO T <br /> METER ISTALLATION DATE /� BY �� / 11111 i1�I11I I II"111811115118 11111 II11I1 <br /> WATER ON k OFF LOCKED OUT BY <br /> �aL A-f 3 y 1541618568 TSG <br /> REMARKS: NEW 3/4"COMPLETE WATER SER ED2Bl l RWF3 <br /> 5/8"x W4" <br /> 69337258 <br /> I IIIIII IIIII ILII II III III I I I II <br /> PERMIT NO. PERMIT TN PE NEW CONNECTION LID NO, <br /> REMARKS: Please Note:The City is responsible for structural defects in the side sewer on the City ROW side per EMC 14.08.260 <br /> INSPECCED BY: I DATE: <br /> FEES <br /> Water Utility Fee $2,514.00 <br /> JUN 13 2016 <br /> CITY OF EVERETT <br /> TOTAL FEES $2,514.00 PerEpir Services <br /> PERMIT NUMBER U1606-031 <br /> UTILITIES COPY <br />
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