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PILITIES Q*TY OF EVERETT <br /> PERMIT SERVICES <br /> E err PERMIT <br /> 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1708-090 DATE 3, 1 AUG 2fljj <br /> JOB ADDRESS 10912 1 STAVE SE LEGAL DESCRIPTION <br /> DESCRIPTION SIDE SEWER REPAIR AI>N: 00391500000600 <br /> OWNER DABITZ DORENE TENANT <br /> 10912 1ST AVE SE CONTRACTOR SOUTH WEST PLUMBING <br /> EVERETT WA 98208 <br /> 2401 SW ALASKA ST <br /> SEATTLE WA 98106 <br /> PHONE <br /> PHONE 2069321777 <br /> WATER SERVICE <br /> SERVICE SIZE I SERVICE TWE FRONTAGE NO.OFUNITS SERVICE ORDER NO, APPLICATION NO. <br /> I <br /> 0.00 <br /> SETTER INSTALLATION DATE By <br /> METER NO. SIZE _ _ #1 BACKFLOW DEVICE SERIAL NO. <br /> R.F.NO. I 42 BACKFLOW DEVICE SERIAL NO. <br /> BRAND MODEL NO. <br /> METER ISTALLATION DATE BY <br /> rn °� <br /> WATER ON OFF LOCKED OUT BY rT; <br /> TSG i <br /> I� <br /> REMARKS: <br /> C--)yy r--i n _ <br /> " 'F- <br /> :F-9 i <br /> r-r•7 F'�-1 <br /> Imes <br /> SEWER SERVICE <br /> PERMIT NO. PERMIT TYPELID NO. <br /> REPAIR <br /> E <br /> REMARKS: Please Note:The City is responsible for structural defects in the side sewer on the City ROW side per EMC 14.0§4 ,;• <br /> f•J f_.A <br /> t'�►-`i'J <br /> INSPECTED BY: <br /> D.A I t. <br /> FEES <br /> SEWER UTILITY FEE $30.00 <br /> TOTAL FEES $30.00 <br /> PERMIT NUMBER U1708-090 <br /> ADDRESS COPY <br />