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UTILITIES CITY OF EVERETT <br /> PERMIT SERVICES <br /> s_ PERMIT <br /> 3200 CEDAR STREET <br /> EVERETT,WA 98201 <br /> (425)25`7-8810 <br /> PERMIT NUMBER U1801-015 DATE: Z <br /> JOB ADDRESS 517 ALVERSON BLVD LEGAL DESCRIPTION �� �� <br /> DESCRIPTION SIDE SEWER REPAIR APN: 00496813004600. <br /> OWNER CHURCH IN EVERETT.. TENANT <br /> 517 ALVERSON BLVD <br /> EVERETT WA 98201-1009 CONTRACTOR MR ROOTER <br /> 2000 S 116TH ST <br /> SEATTLE WA 98168 <br /> PHONE <br /> PHONE 20665,12917 <br /> WATER SERVICE <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO OF UNITS SERVICE ORDER NO. APPLICATION NO. <br /> 0.00 <br /> 1 <br /> Sb11ERINSTALLATION DATE - BY. - <br /> METER NO.' SIZE #1 BACKFLOW DEVICE SERIAL NO. <br /> RF.NO. 52 BACKFLOW DEVICE SERIAL NO. <br /> .BRAND MODEL NO. <br /> METER ISTALLATION DATE BY <br /> _ m '1','t <br /> WATER ON_ OFF_____ LOCKED OUT - BY TSG - _I. i. G31-4 <br /> ° <br /> REMARKS: - ,--i. R <br /> SEWER SERVICE 9.11.1.- I <br /> m }a <br /> PERMITNO. SP-17572 PERbIITT]PE REPAIR 1 LIDNO. - - b;.) <br /> REMARKS: Please Note:The City is responsible for structural defects in the side sewer on the City ROW side per EMC 14.0, 2 .e-.,. - <br /> r......1 L'.1 <br /> P <br /> X08 `� � <br /> I1�3PRGT$D BY. .. _ 1 DATE: I- . <br /> FEES I, <br /> SEWER UTILITY FEE $30:00 <br /> TOTAL FEES $30.00 <br /> PERMIT NUMBER U1801-015 <br /> ADDRESS COPY <br />