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UTILITIES CITY OF EVERETT <br /> ,.. '� RECEIVED PERMIT SERVICES <br /> , -, , PERMIT <br /> MAY 2017 3200 CEDAR STREET <br /> EVERETT;WA 98201Ojv UTILITY SERVICES (425)257-8810 <br /> PERMIT NUMBER U1703-071 <br /> JOB ADDRESS 4414 30TH DR SE ' o_.4.--z LEGAL DESCRIPTION Section 32 Township 29 Range 05.0 <br /> DESCRIPTION 3/4"METER ONLY,NEW SEWER CONNECTION,SYSTEM D] APN: 29053200102300 <br /> OWNERPOLYGON WLH'LLC TENANT OVERLOOK AT RIVERFRONT <br /> 11624 SE 5TH ST SUITE 100 CONTRACTOR POLYGON WLH LLC <br /> BELLEVUE WA 98005 11624 SE 5TH ST SUITE 100 <br /> BELLEVUE WA 98005 <br /> PHONE 4255867700 <br /> PHONE 4255867700 <br /> 1 WATER SERVICE I <br /> SERVICE SIZE SERVICE TYPE FRONTAGE NO.OF UNITS SERVICE ORDER NO. APPLICATION NO. <br /> 3/4" DOM/FI.: 0.00 SO-13951 APP-18940 <br /> 'SETTER INSTALLATION DATE BY: 5// <br /> METER NO_16 / 7( 9 SIZE <br /> #1 BACKFLOW DEVICE SERiAI,NO <br /> �, #2 BACKFLOW DEVICE SERIALN . <br /> BRAND • "IP.'ejilli/.4'1•••(....". �/` MODEL NO.. <br /> METER ISTAt�L/AT/ION DATE <br /> 7- 2-/IBY ` �� / <br /> WATER ON OFF_`:LOCKED OUT BY - TSG" <br /> REMARKS. - 3/4"METER ONLY To <br /> po <br /> STIC_ ib t <br /> SEWER SERVICE - I <br /> PERMIT NO. PERMIT TYPE NEW CONNECTION- I;LID NO. I <br /> SP-172"15 <br /> REMARKS: Please Note:The Cityis responsible for structural defects in the sidesewer on the City ROW side per EMC 14.08.260 <br /> NEW CONNECTION <br /> INSPECTEDEY. I DATE: <br /> FELS <br /> r/ <br /> SEWER UTILITY FEE" $70.00 G <br /> SYSTEM DEVELOPMENT FEES-RESII $10,947.00 <br /> WATER UTILITY FEE $480.00 -'A V <br /> Q9 2017 <br /> CITY ops, <br /> pet.ill,t sz RETT <br /> TOTAL FEES $11,497.00 <br /> �j © � � ✓ IPERMITNUMBER U1703-071 <br /> ` UTILITY SERVICES COPY <br />