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UTILITIES CITY OF EVERETT <br /> AilliA 1,4 PERMIT SERVICES <br /> PERMIT 3200 CEDAR STREET <br /> D3 9�t� EVERETT,WA 98201 <br /> (425)257-8810 <br /> PERMIT NUMBER U1706-028 DATE: <br /> JOB ADDRESS 4421 31ST AVE SE LEGAL DESCRIPTION <br /> DESCRIPTION 3/4" METER ONLY,NEW SEWER CONNECTION, SYSTEM D1 APN: 00574700100102 <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 /> BELLEVUE WA 98005 <br /> PHONE 4255867700 <br /> PHONE 4255867700 <br /> IWATER SERVICE I <br /> SERVICE SIZE SERVICE TYPE FRONTAG P: NO.OF UNITS SERVICE ORDER NO. APPLICATION NO. <br /> 3/4" DOM/FI 0.00 SO-14012 APP-19001 <br /> SETTER INSTALLATIONDATE <br /> DDATE BY <br /> METER(5 ` 456 / V� SIZE 5/V -� #1 BACKFLOW DEVICE SERIAL NO. <br /> R.F.NO. I/ _ __ <br /> N ��/ #2 BACKFLOW DEVICE SERIAL NO. <br /> BRAND I�i-4c�i�✓F•'n+c�� MODEL NO. <br /> METER ISTALLATTIIONN SATO /I 0/7 BY 74447 <br /> WATER ON V OFF LOCKED OUT BY <br /> TSG <br /> REMARKS: 3/4"METER ONLY <br /> ISEWER SERVICE I <br /> PERMIT No. SP-17293 PERMIT TYPE NEW CONNECTION I 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 /> I FEES I <br /> SEWER UTILITY FEE $70.00 az Us? <br /> r.,.. <br /> SYSTEM DEVELOPMENT FEES-RESII $10,947.00 �;.,'- i <br /> WATER UTILITY FEE $480.00 <br /> 0 <br /> JUN i92017�To TN�� 7 �7/ K <br /> CITY OF <br /> EVERETT <br /> = <br />