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4 UTILITIES <br /> • CITY OF EVERETT <br /> 1- '. FERMIT SERVICES <br /> PERMIT= <br /> " '" 4 3200CEDAR:SIRES T <br /> EVERETT WA 98201 <br /> hgI33 <br /> :.:; '; ` �.. �.'= (425)257 8810 :_ <br /> PERMIT-NUMBER U 705-042 - DATE:: <br /> JOB ADD 'ss r 4416 31ST AVE SE LEOAT,DESCRI.PTI©N LOT.OF THE PLAT OE THE'DOWN' <br /> DESCRWTION -3/4"METER ONLY,NEW SEWER CONNECTION,SYSTEM Dl -APN 290532001`02300 <br /> O u�ER tPOLYGON WLH LLC TENANT OVERLOOK AT RIVE1 FRONT' <br /> 11624 SEE 5TH ST SUITE`100 .•.-•:,--,CONTRACTOR POLYGON WLH LLC <br /> BELLEVUE WA' 98005 11624 SE 5TH ST-SUITE-100 . <br /> ' BELLEVUE .- WA, 98005 <br /> P1ONE .- ?4255867700 • <br /> PHONE; <br /> 4255867700 <br /> ._ ' CATER SE1tVICE - <br /> SERVICE SIPF SERVICE TYPE FRONTAGE _NO,OFUNITS SERVICE ORDER NO APPLICATION N'O <br /> DOM/FI . <br /> -.,..:.,,..-..:,,.:•..---::::-..:::.;3/4.":1• 0.00 SO 14001 = •APP 18990 <br /> BETTEEINSTALLATIONDATE ':-;;11,V;,,,:::-.--_::...--.•.',-•:•:: <br /> e- METER NIJ 9 ' "*�� SIZE-,`• 5/t `.#1 BACKFLOW DEVICE SERIAI.NO' _ - <br /> kF:.NO - - '#2 BACKFLOW DEVICE SERIAL NO. - -_ <br /> BRAND - .Pi/ / �:. - `•MODEL NO. <br /> "METER ISTALLA N DATF/O "4/l- ;47BY 'f� <br /> WATERON_ OFFS_' LOCKEDOUT BY :... - - <br /> TSG <br /> REMARKS 3/4"METER ONLY°. <br /> '-t...::- ..:',-...':„.'1-7--,.-7,..,..:Z- 7,7, -:-1--,--;:-.',--r-L-;;;;:l..-r.,:-7::-:-_,,:.:1,..:7.:;',:'--":-,!: :=7, 12:-,r:.7:7,:'.i.....,,,..,...::,,,....:::.t4.51:;,*;::..i.' <br /> I <br /> �WEI�.SERVICE' <br /> PEREETNO SP 17284 REI T'' NEW CONNECTION LmNO <br /> REMARKS Please Note The City is responsible for struetur`aldefect in thee side sewer on the CityROW side per EMC 14:08.260: <br /> NEW CONNECTION <br /> INSPECTED BY - DATE. - _ <br /> - I <br /> ;i <br /> J <br /> FEES <br /> SEWERUTILIT`YFEE., $70;00 . ` E <br /> SYSTEM DEVELOPMElN1T FEES RESII $10,947:00 <br /> WATER UTILITY FEE' $480:00 _ <br /> JUS <br /> TOTAL,FEES $11,497 00 TYOFEVE{RE .„........:,..:.....,::..i..„..;,,...„,_...„:.,....:„ <br /> 0 <br /> ll ° 92017 <br /> TT <br /> - -m. Sir�lriCec <br /> PERMIT NUMBER•-. -....-•,-,-1470$.04 --...-..-_ <br /> UTILITIES COPY " <br />