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UTILITIES <br /> CITY 017-,.E. VERETT ` <br /> PERMIT SERVICES <br /> PERlYIIT <br /> ,if DAR STRUT <br /> 3200:CE <br /> ," EVERETT WA 98201 <br /> -(7425)257-8810 <br /> P Rly4IT�NUMBER U1808-013 DATE O ( �i,G 2®18 <br /> JOB ADDRESS 1124 LOMBARD AVE .LEGAL DESCRIPTION <br /> D.ESCRIP`ION SIDE SEWERREPAIR ATN . 005:47321702200 ` <br /> OWNER; HALE FRANCES-R ` TENANT <br /> li2`4LOMBARDAVE • <br /> EVERETT WA, X8201=14,0 CONTRACTOR HOLMSTADS PLUMBINGINC - <br /> ' PO:'BOX 5635 <br /> ' • EVERETT WA 98206- <br /> PHONE <br /> PHONE- 425259.9131 <br /> WATER SERVICE;:= <br /> ' SERVICE SIZE -SERVICE TYPE FRONTAGE -':NO.OF UNIT.$. - SERVICE ORDERNO. APPLICATION NO - <br /> i <br /> _.SETTERINSTALLATION <br /> METER NO SIZE .:#I BACKFLOW DEVLCE SERIAL NO'" - <br /> RF(NO - �#2BACKFLOWDEVICESERIALNO <br /> TIRAND _ - MODEL NO,- - <br /> -METER ISTALLATION DATE- BY <br /> "WATERON=:OFF LOCKEDOUT ABY' - TSG _ <br /> . i. - - - - - <br /> ISEWER SERVI.E <br /> PERMITNO. - PERMIT TYPE LID NO <br /> SP-17796 y REPAIlZ I I•_ <br /> s ` REMARKS; Please Note The City is resp►onsible;for structural det'eds in the side-sewer on the City ROW side per;.EMC 14:08 260- <br /> SIDE SEWER REPAIR <br /> DATE <br /> FEES <br /> SEWERUTILITY FEE $30.00 <br /> - AUG 07 2018 <br /> • `CITYOEEVE <br /> REIT <br /> Permit=Services <br /> TOTAL FEES. $30.00 <br /> PERMIT NUMBER- - ` u1.40-01:3----, <br /> a ADDRESS COPY <br />