Laserfiche WebLink
WATER/SEWER UTILITY PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT, WA 98201 <br /> 425-257-8810 - FAX 425-257-8857-www.everettwa.gov <br /> '�-/u Pve- <br /> PROJECT ADDRESS <br /> 01 Icz, 0 e \' <br /> Property Owner Mail A dress City State/Zip Phone <br /> Tenant Name(If this is for a commercial business) <br /> ContractorMail Address City State/Zip Phone <br /> 4 011 <br /> vej- <br /> VVA State Contractor License Number(required) City of Everett Business License Number(required) <br /> Work to be done: <br /> ❑ Side Sewer Repair <br /> ❑ Side Sewer Alteration <br /> ❑ Side Sewer— New Installation <br /> E3 Install Backwater Valve (outside the building) <br /> ❑ Cap off Sewer <br /> ❑ Install Water Meter <br /> FEE <br /> /73 PERMIT# �k <br /> IV Signature Date U <br /> REVISED 11/19/2014 <br />