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<br /> T U.TILITIES -
<br /> CITY OF EVE TT -
<br /> PERMIT SERVICE=S
<br /> PRlYIIT i 3200°.CEDAR STREET
<br /> - : ,. _,
<br /> _ EVBRET�' SVA 98201 -
<br /> (425125:7 8810
<br /> PERMLT TUMBER U1807=025,'-,::--":;:'—_:-';,-:
<br /> ° , DATE !/jQ J
<br /> JOB R1DDR SS 9106.4TH'PL SE LEGAL DESCRIPTION
<br /> DESCRIPTION' SIDE SEWER REPAIR APN 00402600001500
<br /> t OWNER COUDARE`DARREL t;--86:CAROL A • TENANT
<br /> 91064TFIPLSE
<br /> coNTRACTOR ROTO 1�OOTER SERVICES CO
<br /> EVERETT: .. WA 98208
<br /> ' 1.0655 INTERNATIONAL BLVD
<br /> TUKWILA WA, 98168
<br /> = PHONE= • 4254732257
<br /> ' .
<br /> WATER SERVICE.'
<br /> SERVICE SIZE - - SERVICE TYPE. FRONTAGE - .'NO.OF UNITS - - SERVICE ORDER NO`" --'-APPLICATION NO
<br /> c.
<br /> 0 00
<br /> - - SETTERINSTALLATIONDATE '--k7,;'.-.::.;„.''1,-';_:';-:_,--,-':.:::,',:
<br /> - BY--'- ."- _ _ - - _ - -
<br /> - 'METER NO - _-- ---`. 'SIZE >-_ - - - SBI BACKFLOW DEVICE SERiALNO - - -
<br /> RF.NO #2 BACKFLOW DEVICE SERIALNO-- -
<br /> BRAND 3 .": Th ' 4'4yODP,49,- ,::'-'-..,,..--',:L',,:'',;_',:-:,1-:-,,r';:,:.',:1.--rr);.-2-,_''''--.,1-''.-i-::,_'_.'':'-.,;:
<br /> METER ISTALLATION DATE -1:---' BY - - /- -
<br /> WATERON_'OFF_-LOCKED OUT BY -1-11'. - - - - - _
<br /> TSG
<br /> REMARKS -'F-71',I
<br /> „ SEWER SERVICE_ I:r.7�
<br /> z PERMIT NO :::';.7:,...i.',.-.„,7.,...-:,.-.:,:4:.:.-7.,,
<br /> ERMIT TYPE ).,..-1-,I - - C
<br /> REPAIR `
<br /> REM ARKS▪ - Please Note,The City is responsible for structural defects to the`§ide-sewer on"the City ROW side_per EMC 14 0$ . _
<br /> -4i-
<br /> SIDE SEWE▪R REPAIR ' p
<br />' ` c7 I •-. a
<br /> INSPECTED BY- - - - I_-.DATE - _
<br /> ...._. _. ..s-. .,, +'IiLS... ..... ....I,.-i 3„.,:i-:t-r...,...,:-:::::,,,,,,:::_.-7;,-:-;::7,,.„-.1.,::..,,,„,:i..„,,
<br /> n --z, w._,, ... ..�, . 4 >_ r,,, ...... � -.s... -
<br /> .
<br /> q ,
<br /> 3 SEWER UTILITY FEE_ $30:00
<br /> TOTAL FEES $30.00
<br /> _
<br /> U 0'
<br /> PERMIT 1,UMBER- 18 7 025
<br /> ADDRESS:COPY:.
<br />
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