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s CITY O:F EVERETT <br /> • G z -, 'UTILITIES <br /> 1 1' - PERMIT SERVICES <br /> ,�-' PIJ D IT <br /> 3200 CEDAR STREET <br /> EVERETT=WA 98201 <br /> E <br /> (42578810] <br /> PERMIT'NUMB1R `31902 006 D ATE. 0_ , .F _' 1y"t <br /> JOB ADDRESS <br /> 1717_MAPLE ST -; - - - ,,_- n- DESCRIPTION- <br /> DESCRIETION SIDE SEWER REPAIR A'N 00:605400400500; <br /> OWNER TAYLOR.GREC,GORY;S TENANT <br /> -1717 MAPLE ST - CONTRACTOR <br />' EVERETT WA 98201 ' MR ROOTER <br /> 2000.5-116Th;ST ` _ <br /> SEATTLE =WA _. . 98168. <br /> PHONE <br /> PHONE 2066512917 <br /> ` WA- ER-SERVICE <br /> «I <br /> -SERVICE SIZE _ - SERVICE TYPE, - --FRONTAGE'., - NO OF UNITS - SERVICE ORDER NOf,•� - APPLICATIONNZO- <br /> rY :3'''S''':'. __ 0.00 <br /> ,T; • ry <br /> _ c <br /> _ METERNO <br /> _ ,_ NI�BACKFLOW DEVICE�SERL9LN0-�` <br /> i� S.F NO - _ - .'42BACKFLOWDEICESERiALIJO . -i• <br /> _ <br /> �vIODEL NO'. <br /> _METEAISTALLATIONDATB= - - BY _ , _ _ - <br /> WATERON.. OFF ---..LOCKEDOUT ._.B-Y _ C7- - - TSG - t—` irlC.di' <br /> REEL RKS,-. <br /> ' - , <br /> SEWERSERVICE <br /> r PERMIT NO _ <br /> PERT9T TYPE REPAIR �tm No T <br /> .REMARKS Please Note The City is responsible.for structural defects ntthe_side sewer on the_,,City ROW side per EMC 1.4 0 r -,. <br /> � <br /> INSP E;CTED BY - 7'.:',.--;7;:.:',';,':' _ <br /> -" _ f - <br /> - - .s- --'.= '''''.'-'.."'=.""'•".'-'" - _ : . <br /> I <br /> SEWER UTILITY EEE„ $30.00 <br /> } <br /> TOTAL FEES <br /> IPERMIT NUMBER U1902 006 <br /> ADDRESS COPY; <br />