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TILITIES �Ty OF EVERETT <br /> PERMIT SERVICES <br /> ' � PERMIT <br /> 3200 CEDAR STREET <br /> EVERETT. WA 98201 <br /> (425)257-8810 <br /> PCRMIT NUMBER U1607-014 nAr�: `7,_�� ,_ <br /> .ioa aDDxEss 6502 EVERGREEN WAY LEcn�UtscruPrloN BEVERLY HILLS DIV 3 BLK 000 D• <br /> n�scK�r�r�oN CAP SEWER DUE TO DEMO APN: <br /> 00393000001500 <br /> owN�-:R ,IT MADISON rcNnrr� <br /> PO BOX 31609 <br /> SEATTLE �oNTxACTOK OLYMPIC GENERAL CONTRS LLC <br /> WA 98203 2] �0 MADISON ST <br /> EVERETT WA 98203 <br /> �'1iONL 2066195555 <br /> Pi�oNi: 425317085 I <br /> WATER SERVICE <br /> SERVICE SIZI; I SERVICE TYPF, FRONTAGF: h'O.OP UNRS SERVICE ORDER VO. APPI,ICATION NO. <br /> Q.Q� I <br /> SETTER INSTAI,LATlO\'DATF__ gy <br /> .ti1[TER NO. ._ SIZF,_ kf BACKFLOW VEVICE SERIAL,NO. <br /> R.F.NO. - — I p2 BACKFLOW DEVICE SERIAL NO. <br /> RRAND MODEL NO. <br /> MeTBR ISTALLATION DA'I'E___ .__gy <br /> W ATHR Oh_ OFF_ LOCKED OUT__— gY .� <br /> _— _ — TSG ,, <br /> ,_. <br /> — „ <br /> ;__.� ,,.„: <br /> REMANKS'. . <br /> :6:.!' �i t -T s i . .. .. . ;y-9 <br /> _;� _., ..�..: <br /> �:::�.� ��.. <br /> �, .. <br /> .. .�,..._ :......�i _..: ; . .:.:.. <br /> SEWER SERVICE " <br /> PtR�1I'I��'O C7�'�L��� PER\AITTY'PL , LID1'O. � <br /> JI� V CAP OFF <br /> , <br /> REMARKS: Ylease Note:7'hc City is responsible for structural deTects in thc side sewer on the�'aXy diC)W side per�;11��:14.Q8;260 ,,,:. ' ^ <br /> INSPk!CTGD BY: I DATE' ... ... <br /> FEES <br /> SEWER UTILITY FEE $10.00 <br /> T07'AL FI:ES $]0.00 <br /> PERMIT NUMBER U1607-014 <br /> AllDRF,SS COPY <br />