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WATER./ SEWER UTILITY APPLICATION
<br /> GIT Y OF EVERET7 PERMIT SERVICES
<br /> 3200 CEDAR STREET EVERETT,WA 98201
<br /> =(P)425,257-8910 FAX FAX 425-257-8857 ;( ere epevere wa:gat I www everettwaa.govlpel its
<br /> • PROJECT•ApD
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<br /> liir Ave,'Everett WA 98201
<br /> IF APPL4CAS : b O! ITS1i)E tITY LIMITS CI BULGING AREA'
<br /> SF CI LOT
<br /> BUILDING TYPE - ISFR DETACHED USE
<br /> • R-A7'FRCtfEU ,CIIIULEX DMULTI-FAM4LY4 OF UNITS: ©COMMERCIAL Cli1�NDUSTRJAL
<br /> CHAN3EOF USEE • ..:SDINO' CI YESi: Feil TO
<br /> 4 /1
<br /> SER( t ecif t that appl )
<br /> Mft.YR(check,ail that A:431 )
<br /> EI SIDE SE1EirREPAIR Ci NEW WATER SERVICE INSTALLATION
<br /> CI SIDE SEWER ALTERATION C1 COMPLE I b•SERVICE I]M,ETER.ONLY
<br /> ©NEW SIDE SEWER INSTALi ((3N SERVICE 1 METER USE:
<br /> C7 INSTALL BA KWATEtALut fraitsidefi)ebliri C]SFR' 1.
<br /> CI SIDE SEW4R :CAP-OF
<br /> 0 t49LttAiU4I1 Y-,4/OF UNITS-
<br /> CI Slob SEWER
<br /> ryMRECONNECTION
<br /> CccrIVIER�it/Itjt.tIPLEI:10101ESTIC'WATER4ERVIOES REI T4 WATER:SERVICE TYPE/SIZE.i .+iedsid
<br /> C '4,AIt'DECLINING MU TIPLE DOMESTIC WATER S�ICES"F i' C I DOMESTIC:;
<br /> ,MY IViCILC1aF Ct€1 1 EL43�W1Vt1 1i7I.UNDER'SlNGL G?lilti<IERSHIP._ /4 : i, 2'; OTHER:
<br /> li?RIGATION: 314", 1"i, 2", OTHER:
<br /> C]I AM:OPTJIG TCa INSTALL MULTIPLE DOMESTIC WATER
<br /> •� y vs is CI-FIRE: 1": 2": 4", fi", 8x OTHER:
<br /> SERVICES FG?R M 1' aklt 9t 1/•eFAA�ItLl I.� VEI 1Y,1tYfENT UNDER
<br /> SINGLE OWNERSHIP;FILL.OUTRE1%ERSE# OF 7111SFt I 0 DOMESTIC/FIRE IES71G/Fii E Ct?MBE3< 1", 2", OTHER:
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<br /> ••w '0:;.; . . ;: sGrigny ,,,,„„„,„,,,,,,,,,4„4„,,,,,„,,,,,, �i , zOWNEizNAME: arb.LanOureux TENANT NAMEtllcomm „1.
<br /> QWNPR MAILUNG"ADDRESS: sEEr- ;9 O•Rainier
<br /> CITY Everett srWTWA zm 98201
<br /> owitlr:R PHONE425 356..7975:
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<br /> CONTRACTO
<br /> �-. rbt� �XhOCF18S Cts
<br /> NAME Camerons One LSC.tlba Nw tower&Drain ' -�M �.�
<br /> iccOADRESiPO BOX5557 O DS
<br /> .envri ilei ,
<br /> 3rA VYA 98155
<br /> TRACTOR i�Ho 20 -. 41-1.928
<br /> ICOPITRACToR.EMAIL:AtlCia@nwsetcorn
<br /> CONTRACTOR t.iC S IRED}.NW EW5D883p8'
<br /> EI. %or ft,,- i BUSINESS i iC: • REQUIRED z'537
<br /> PRL M1t Y C(*4T Ti 2.OAR C "CONTRACTOR I OTHER{P1ease specify)
<br /> ,CONTACT RIAME.
<br /> CONTACT PRONE;
<br /> 206.931 ' 8g
<br /> Spencer Chynoweth CONTACT I:spencerrnwsewer;i Om •
<br /> AGR M N Tele w ders�ned tag es to,
<br /> exfsbng v st rrhmey be estate,of id from Y w ;e t fu#sepns of the•Everett Mun/ova/. Code Tire.14 iterar�d rtor•such other fides and gatitonsrwr,
<br /> teras.wdhour icti;n,y rttest eh< lime to tune:;The centfirdharsolves,rife condition precedent to
<br /> tum"on-thewatereri fr +fsp;c0rsfa,oion end non m servfiaattrat.t'he;t k'iesd ern eowner,
<br /> wner or'fiar a€an
<br /> authorfzed.b payment comply
<br /> withlhe-or Tor C any tracto. Lew t 7e.cause,1 am the ox 0A ort am: Y
<br /> Jxe Awnerofthis to Et@r#cNm ttreidtirf of whTchappNcalloois macre and i carr+ vY1(Ii the State.Contractors'tractiirs Law t$27ItCiRratrd296 2tNlA W4C,
<br /> City of Everett Official Use Only
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<br /> ""--w,.. bate , Reg'8'0' ©10 .1 .
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