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• <br /> UTILITIES CITY OF EVERETT <br /> PERMIT SERVICES <br /> •,4 � PERMIT 3200 CEDAR STREET <br /> • EVERETT,WA 98201 <br /> 01$ z/q., (425)257-8810 <br /> PERMIT NUMBER U1805-006 DATE <br /> JOB ADDRESS 6200 12TH DR SE LEGAL DESCRIPTION <br /> DESCRIPTION 4"DOM/COM SERVICE TAP ON 8"MAIN-COST ESTIMATE APN: 28050600400900 <br /> OWNER CATHOLIC HOUSING SERVICES TENANT ATHOLIC HOUSING SERVICES <br /> 100 23RD AVE S CONTRACTO DAWSON CONSTRUCTION LLC <br /> SEATTLE WA 98114 PO BOX 30920 <br /> BELLINGHAM WA 98228 <br /> PHONE 2063285654 <br /> PHONE 3607561000 <br /> WATER SERVICE I <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO.OF UNITS SERVICE ORDER NO. APPLICATION NQ <br /> * </> DOM/FI <br /> JV r 0.00 SO-14280 APP-19266 <br /> SEI LER INSTALLATION DATEBY <br /> METERNO. '7 1 q+2/g i 1.,/ SIZE q i+ #1 BACKFLOW DEVICE SERIAL NO. <br /> RF.NO. M 41 it S til i C #2 BACKFLOW DEVICE SERIAL NO. <br /> BRAND <br /> MODEL NO. <br /> 4 V <br /> METER ISTALLATION DATE 'i. •"'(�pg BY Fe.1-- (�"" q 1 V <br /> WATER ON 4 OFF_ LOCKED OUT BY TSG <br /> 4"TAP ON 8"WATER MAIN,INSTALL D.I.PIPE ACROSS BERDSHIRE THEN CONNECT TO CONTRACTOR INSTALLED 4"D.I.PIPE AFTER PURITY. <br /> REMARKS: CREW WILL TAP,CROSS ROAD AND DO CONNECTION AND INSTALL METER IN PIPED THROUGH VAULT.CITY TO EXCAVATE,SHORE AND <br /> SEWER SERVICE I <br /> PERMIT NO. PERMIT TYPE I LID NO. <br /> REMARKS: Please Note:The City is responsible for structural defects in the side sewer on the City ROW side per EMC 14.08.260 <br /> INSPECTED BY: I DATE <br /> IFEES <br /> WATER UTILITY FEE $12,575.00 ;moi i7-7--T s' \ <br /> 's 11 <br /> 11 MAY 2 3 2018 I ,i <br /> [- mss j <br /> CITY OF EVERETT <br /> Permit Services <br /> \\ TOTAL FEES $12,575.00 <br /> \, PERMIT NUMBER U1805-006 <br /> UTILITIES COPY <br /> t <br />