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<br /> a CITY OF EVERETT "
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<br /> PERMIT SERVICES
<br /> PERMIT
<br /> ”-,4 r ' t` 3200 CEDAR STREET
<br /> ti'm - : EVERETT„WA'98201
<br /> (425)257 8810
<br /> PERMIT NUMBER U1801 010 DATE 4/(iA jg”
<br /> JOB ADDRESS 2002 RUCKER A LEGAL DESCRIPTION,
<br /> DEsCRUTION SIDE SEWER REPAIR AIN; 0043,7442701701
<br /> OWNER ANDERSON DANIEL J TENANT
<br /> 2002 RUCKER AVE •CONTRACTOR MR ROOTER
<br /> EVERETT WA 98201 2000 S 116TH ST
<br /> SEATTLE WA_ 981'68
<br /> PHONE.
<br /> PHONE 20665:129!17
<br /> WATER SERVICE , '. .• .
<br /> SERVICE SIZE SERVICE TYPES: FRONTAGE NO.OF UNIT/S� SERVICE ORDER NO.,. APPLICATION NQ
<br /> 0:00
<br /> SETTER INSTALLATION DATE BY
<br />,-"•i:-'..:!•.':.,..--,:;;;;'-•--
<br /> • SIZE ,#1$ACIGFLOW DEVICES SERIALNO _
<br /> R:F NO - #2 BACKFLOW DEVICE '. '''O.
<br /> BRAND - - MODEL NO,
<br /> METER ISTATLA•TION DATE .BY
<br /> WATER ON_. OFF�i LACKED OUT - .BY _ TSG -
<br /> REMARKS:
<br /> SEWER SERVICE
<br /> PERMIT NO. SP 17660 ( PERMIT TYPE REPAiR LID NO I -
<br /> REMARKS: - ' Please Note:The City is,responsible fortructural defects in the side sewer:o]n the:City ROW"side per"EMC 14 08.260
<br /> SIDE SEWER REPAIR "
<br /> INSPECTED BY: DATE
<br /> 1 "''
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<br /> 10E§
<br /> SEWER UTILITY FEE $30;00A� ^
<br /> :CITY QF ' ..:
<br /> TOTAL FEES $30.00rn1
<br /> PERMIT NUMBER' U1804 010
<br /> I:
<br /> ADDRESS COPY
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