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I <br /> *ILITIES QSTy OF EVERETT <br /> PERMIT SERVICES <br /> PERMIT <br /> 3200 CEDAR STREET <br /> EVERETT, WA 98201 <br /> 425)257-8810 <br /> PERMIT NUMBER U1611-077 DATE: t,?-I/ <br /> JOB ADDRESS 4410 30TH DR SE LEGAL DESCRIPTION LOT OF THE PLAT OF THE TOWN; <br /> DESCRIPTION 3/4" METER ONLY,NEW SEWER CONNECTION, SYSTEM D] I APN: 29053200102300 <br /> OWNER POLYGON WLH LLC TENANT OVERLOOK AT RIVERFRONT <br /> 11624 SE 5TH ST SUITE 100 CONTRACTOR POLYGON WLH LLC <br /> BELLEVUE WA 98005 <br /> 11624 SE 5TH ST SUITE 100 <br /> PHONE 4255867700 BELLEVUE WA 98005 <br /> PHONE 4255867700 <br /> WATER SERVICE <br /> SERVICE SIZE SERVICE.TYPE FRONTAGE NO.OF UNITS SERVICE ORDER NO. APPLICATION NO. <br /> 3/4" DOM/FI I 0.00 <br /> S - <br /> O 13867 APP-18857 <br /> P 18857 <br /> SETTER INSTALLATION DATE BY <br /> METER NO. SIZE 11 BACKFLOW DEVICE SERIAL NO. <br /> R F.NO. <br /> 42 BACKFLOW DEVICE SERIAL NO. <br /> BRAND_ <br /> --- MODEL NO <br /> METER ISTALLATION DATE By <br /> WATERON_ OFF_ LOCKEDOUT BY _ TSG <br /> REMARKS: 3/4"METER <br /> SEWER SERVICE <br /> PERMIT NO. SP-17030 PERMIT TYPE NEW CONNECTION LID NO. <br /> REMARKS: Please Note:The City is responsible for structural defects in the side sewer on the City ROW side per EMC 14.08.260 <br /> NEW CONNECTION <br /> INSPECTED BY. I DATE: <br /> FEES <br /> SEWER UTILITY FEE $70.00 <br /> SYSTEM DEVELOPMENT FEES $7,962.00 n fj(&,g <br /> WATER UTILITY FEE $480.00 l�f <br /> SEC - 1 1016 <br /> CITY OF <br /> TOTAL FEES $8,512.00 Permit $VERET7 , <br /> PERMIT NUMBER U1611-077 <br /> ADDRESS COPY <br />