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UTILITIES CITY OF EVERETT <br /> PERMIT SERVICES <br /> �T PERMIT <br /> 3200 CEDAR STREGT <br /> EVERETT,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1711-041 �.aTE: �� '��j� ���` �'i�'� � <br /> JOBADDRESS 4I 19 GRAND AVE LEGALDESCRIPTION <br /> DEsca�PTioN SIDE SEWER REPAIR ^PN 00596201000900 <br /> °��k ST MARY JENNIFER&JONATHAN TLNANT <br /> 41 19 GRAND AVE <br /> coN�ancroR JIM DANDY SEWER& PLUMBING <br /> EVERETT WA 98203-2225 <br /> 6202 214TH ST SW <br /> MOUNTLAKE TERR WA 98043 <br /> PHONE <br /> Px°NF 2066331141 <br /> WATER SERVICE <br /> SERVICGSI7,E I SERVICETYPF, FRONTAC[ NO.OFUNITS SERVICEORDERNO. APPLICA7'IONNO. <br /> I <br /> �.�� I <br /> SETiER MSTALLAI'ION DAT[ gy <br /> �TER\O. SV.E #IBACKFLOW UEVICE$ERIAL:VO. <br /> A.F.NO. - I #2 BACKFLOW DEVICE SERIAL NO. � <br /> BR� MODEL NO. <br /> METER ISTALLA'IIUN UATE yy <br /> WATER ON OFF _ LOCKED OUT__ 13Y TSG ' ' <br /> REMARKS ..__ .. , <br /> i�> '_ <br /> i:[: <br /> .... ._,.-� �: <br /> �.�.;'�.:: =--; i....� <br /> _ :7 <br /> SEWER SERVICE <br /> PERMIT NO. SP_��S^O PERMIT TYPL LID NO. - <br /> 't REPAIR <br /> REVIARKS: Please Note:The City is responsible for structural defects in the side sewer on the City ROW side per EMC 14 08.2�0' : <br /> ,:-� _ ; <br /> ._....i: :r�..:__.. <br /> ':.., <br /> WSPECTEDBY: I DATE: �....'.�''.' <br /> FEES <br /> SEWER U"rlLl'I'Y FEE $30.00 <br /> TOTAL FEES $30.00 <br /> PERMIT NUMBER U1711-041 <br /> ADDRESSCOPY <br />