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. f <br /> UTILITIES CITY OF EVERETT <br /> PERMIT SERVICES <br /> Err PERMIT <br /> 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1602-049 DATE: <br /> JOB ADDRESS 2201 MCDOUGALL AVE LEGAL DESCRIPTION CAPITOL HILL ADD BLK 473 D-02 <br /> DESCRIPTION INSTALL BACKWATER VALVE AI'N 00401547300102 <br /> OWNER WAGNER VICTOR TENANT <br /> 2201 MCDOUGALL CONTRACTOR AMERICAN SEPTIC& SIDE SWR LLC <br /> EVERETT WA 98201 2606 LARLIN DR <br /> EVERETT WA 98203 <br /> PHONF. <br /> PHONE 4257897296 <br /> 1 WATER SERVICE <br /> SERVICE SIZE I SERVICE TYPE I FRONTAGE I NO.OFN 00 I SERVICE_ORDER NO I APPLICATION NO <br /> SE'ITER INSTALLATION DATE BY <br /> METER NO _SIZE 11 BACKFLOW DEVICE SERIAL NO. <br /> R.F NO.= = I u'-BACKFLOW DEVICE SERIAL NO. <br /> BRAND MODEL NO. <br /> METER ISTALLATION DATE BY <br /> WATERON OFF_ LOCKEDOUT BY TSG i'T7 I <br /> REMARKS ; <br /> G3 Fj�sl <br /> cs r I—• <br /> r•..7 <br /> SEWER SERVICE =' Fri'' <br /> 1 <br /> PERMIT"° SP-16544 PERMIT TYPE ALTERATION LID No. <br /> REMARKS: Please Note:The City is responsible for structural defects in the side sewer on the City ROW side per EMC 14.08.26 F,9 <br /> J <br /> —1f•J C• <br /> INSPEC"I'EU BY. I DA'I'f: <br /> FEES <br /> Sewer Utility Fec $30.00 <br /> TOTAL FEES $30.00 <br /> PERMIT NUMBER 01602-049 <br /> ADDRESS COPY <br />