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v CITY OF EVE-RETT <br /> 7 . s x ITTILITIES <br /> �=',% r ' PERMIT SERVICES <br /> `.. PERMIT <br /> 3200 CEDAR STREET <br /> I` .' ?H �,,,!'"Z9,1'4',401' <br /> '' - EVERETT,,WA 98201 <br /> a (425)257 8810;_: <br /> PERMITNI MBER U1804 013 DATE <br /> JOB ADDRESS 0 8 APR ..-2111 <br /> 2 184 <br /> ,8811 4TH PL SE L GALDESCRIPTION: <br /> DESCRIPTION SIDE SEWER REPAIR APN. 00402600003100 <br /> OWNER B-RIEN GERALD-M&PEGGY A TENANT' <br /> 8811 4TH PLACE S E ' coWVTEACTOR BEST PLUMBING GRQUP LLC <br /> EVERETT WA 98204 4129 STONE WY N _' <br /> SEATTLE WA • 98103 <br /> PHONE <br /> PHONE 2066331700 <br /> IWATER SERVICE <br /> SERVICE SIZE'= SERVICE TIDE FRONTAGE NO:OF UNITS SERVICE ORDERNQAPPLICATION NQ <br /> Y I ± <br /> SETTER INSTALLATIONDATE BYS _ <br /> METERNO. _- - _ SIZE' ; #1 BACKFLOW DEVICE..SERIALNO�_. _ _ <br /> AE.NO. #2BACKFLOW DEVICE SERIAL NO. _ <br /> BRAND MODEL NO. <br /> METER ISTALLATIONDATE -- BY - - - - <br /> .WATERON_ OFF_ LOCKED OUT `BY TSG I"g"f " <br /> REMARKS' - <br /> ISEWER SERVICE , _ _ •: I <br /> PERMIT,TYPE REPAIR ' -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 2 ' <br /> ;,=,n <br /> c>, G <br /> INSECTED BY' -DATE }..,, <br /> I'FEES <br /> _ <br /> r ; <br /> SEWER UTILITY FEE $30:00 <br /> TOTAL FEES $30:00 <br /> IPERMIT NUMBER U1804,013 <br /> " ADDRESS COPY <br />