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g F 1 i TY OF'E= ERETT <br /> !TILITIES _ <br /> r � R. ��R��CS <br /> ^�s� r�� � ,� 320 cED�STREET <br /> EVFRETT4.WA 98201. <br /> (45) 57 8810,,,r,_,,, <br /> P iM _ TUMBER UI706 061 ,DAT ` ' <br /> JOB ADDRESS 562£7 BROADWAY LEGAtDESCRIPTION <br /> DESC TION E FOR.NEW SFR DETACHED APN <br /> 2800500206500-: <br /> OWNER. FITZ'GERAI D HAUD&DORIS TENANT <br /> 38111�1ST PL�E - � � , <br /> CONTRAOTOR AI L ABOUT CONCRETE Z,LC." <br /> EVERE�"I' WA 98208 <br /> 2015 MARINE DR <br /> PHONE <br /> TULAL <br /> IP WA :98271 <br /> Pxoz 2062407507 <br /> I a u e _ r �1 <br /> ti WATERrSE$VIGEx -� r� <br /> SERVICE SIZE SERVICE TYPE - FRONTAGE. NO OF UNITS SERVICE:_ORDER NO APPLICATIONNO, - " <br /> SETTER INSTALLATION DATE BY i, = 4. - <br /> METER NO{ _ -SiZE gill BACKFLOW DEVICE-.SERIAL N'O y - <br /> uE, <br /> RF NO _-� - .: <br /> ., ..:; . ..'1 __.,t: .. -'- DEVICE SERIAL NO ' -- <br /> BACKFLOW <br /> zBRAND "- _ - - _ <br /> - - _ -.MODEL NO; _ -- _ - <br /> • <br /> -�`METERISTALi ATIONDA IT BY, - _ <br /> WF.TERON OFF LOCK•ED OUT BY TSG <br /> MA S WATER INSTALLED WITH SHORT PLAT UNDER U0704 037;' <br /> I 3 ,SEWE SER CE - <br /> RERMTT NO - r'SP 17314 PERMITTYPE �c NEW CONNECT,O.l`1 `LID NO - <br /> I .I. <br /> REMARKS. Please Note The C ty is responsible for structural defects in the side sewer on the City ROW side per EMC 14 08,260 <br /> INSPECTED BY I BATE <br />, <br />,-:'::::f:''',:'-'A-'''':"i <br /> f w is rte. 1�EES y x _ <br /> - .3- ask �. <br /> SE�VERi�TILxI;I'PEfi $70 QO <br /> JUN 2 3 2017- j. s <br /> T ® T1�,�,: �� C[pY OF_EVERETT <br /> 1.. T" err>r��t.Sery ides <br /> TOT 1L'FEES $70 00 <br /> PERMIT� IITIVIBER 171706 061 <br /> ADD LESS COPY <br /> - <br />