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CITY OT EVERET "
<br /> UTILITIES ..:
<br /> ;_ ' '. ' PERMIT SER ICESS
<br /> �4 PERMIT
<br /> .v �z 3200 CEDAR STREET
<br /> 4 Seo � , `..
<br /> EVERETT WA 98201
<br /> PERMIT NUMBER V 1903-025" DATE:
<br /> �' � �b�Rs>�0�9
<br /> JOB ADDRESS 1720 LOMBARD AVE LEGAL DESCRIPTION
<br /> DESCRIPTION SIDE SEWERREPAIR APN. 0043823500210.0
<br /> OWNER DERAITUS CHRIS -- TENANT
<br /> 1720 LONIBARD AVE CONTRACTOR
<br /> EVERETT :„ 98203-1551 JIiVI DANDY SEWER& :••:::;:':::-''',UBING.
<br /> 6202 2,:
<br /> MOUNTLAKE TERR "WA,:•,::' .:98043 :'
<br /> PHONE
<br /> PHONE 2066331141
<br /> ._ W4TER SERVICE..,,
<br /> SERVICESIZE- :S_ERVICE TYPE - FRONTAGE NO:OF UNITS SERVICE•ORDER NQ ". APPLICATION NQ
<br /> -,0-.:0-19:-..-f,'-1-,.,,,:•7-:7-7., : .
<br /> .SETTER INSTALLATIQN DATE BY'
<br /> METER NO. r SIZE ;#1 BACKFLOW DEVICE SERIAL'NO."
<br /> #2 BACKFLOW DEVICE SERIALNO
<br /> BRAND `'-::MODEL NO.- - - -
<br /> METERISTALLATIONDATE BY -
<br /> r WATERON_ OFF_-';LOCKEOOUT BY
<br /> ,. TSG
<br /> REMARKS: -
<br /> �I
<br /> SEWER,SERVICE 'i
<br /> PERMIT NO. - PERMIT TYPE REPAIR - LID NO., `.- -'
<br /> REMARKS: Please -.:,..,:,:::,-„:;;7,,,,,,,,,,„....
<br /> The City Is responsible for structural defects�n the`side sewer on the City ROW side,per EMG 14 0l �( .
<br /> -7 -
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<br /> 3
<br /> -DAT., ;::':•!-;-:-.-_-,.::::-:f:'.'.:.-&;,,:„=''-1,: ',:':,,'-,-.:::."':', '',,','.,;.4,-:7,.:-.„.-1.,'.,',:,.;::-';';--':,,:---:'''..r'''',,'''.,"'„-';' ,7::,.;,,,,':,:,--it '!;',:::::':::::''':';',T,--,E
<br /> `.is ,:. . :.-.
<br /> 1 FEES
<br /> SEWER UTILITY FEE $30:00.'
<br /> TOTAL FEES,' $30.00'
<br /> ;;; PERMIT NUMBER' 41:100.3-4);5
<br /> ADDRESS COPY
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