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UTILITIES CITY OF EVERETT <br /> PERMIT SERVICES <br /> � � PERMIT <br /> 3zoo cED�sTx�eT <br /> EVEREI"T,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER UU11-006 �ATE: <br /> JOB AnDR1:SS ��923 3 RD �R SE Li GAL DF.SCRIPTION <br /> vEscaiNnoN SIDE SEWER REPAIR ^�'N 0076 1 60000 1 700 <br /> owNi,;k SMITH JIROMI T�NANr <br /> ]0923 3RD DR SE <br /> coNTKnc�oK ROTO ROOTER SERVICES CO <br /> EVERETT WA 98208 <br /> 10655 INTERNATIONAL BLVD <br /> TUKWILA WA 98168 <br /> P[iONE <br /> �xoNi: 4257732257 <br /> WATER SERVICE <br /> SERVIC'LCI"!.F I SF.RVICf:TYPL FRONTAGI: NO.OPUNI7'S SI:RVICEORDERNO. APPLICAl'IONNO. <br /> �.�� I <br /> SE'ITER I^STALI..A"f10.\DATE E;y <br /> VIETER\O._ _SILE #1 BACKFLOW DF.VICE SERIAL NO. <br /> RF.Vp. - _ I #2BACKFLOWDEVICESER]ALNO. _ <br /> e�� 'NODEI,NO. <br /> '.viETER IS'fALLA"1'ION DA'I'E_ �7y <br /> WATER OM1� OI+F_ _ LOCKED OUT HV TSG <br /> RC�.tARKS. <br /> SEWER SERVICE <br /> P[R�AI'I'h'U. SP'I /S 1 O PERMI7'"I�YPE LID\'(7. <br /> REPAIR <br /> REVIARKS: Please Note:7'he City is responsible for structural defects in the side sewer on the City ROW side per EVIC 14.08.260 <br /> -�� P.. <br /> MSPECTEDBY: I DATE: �.� 5 �`rj ! ; '��y+�;� <br /> i � <br /> � 1 t i <br /> FEES — � � <br /> SE Wf;R U"I ILI"1'Y FEE $30.00 �`I"�'� �� ��,'�,���� � <br /> Pern�iT S�rvice� <br /> "fOTAL FEES $30.00 <br /> PERMIT NUMBER U1711-006 <br /> ADDRI�SS COPY <br />