Water_Meter_Record.pdfOf E ram
CITY OF EDMONDS
1215TH AVENUE NORTH - EDMONDS, WA 98020
I PHONE: (425) 771-0220 - FAX: (425) 771-0221
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STATUS: ISSUED ENG20150123
Permit Number: ENG20150123
Job Address: 18300 SUNSET WAY, EDMONDS
,ROPE. y. O.
RTC LLC SELECT HOMES
144 RAILROAD AVE STE 310 16531 13TH AVE W SUITE A107
EDMONDS, WA 98020
DESCRIPTION OF WORK:
Install side sewer for new single family residence (BLD20150007).
METER SIZE:
N NEW SERVICE FROM CITYMAIN TO PROPERTYLINE
N ASPHALT/CONCRETE CUT
N FINAL PATCH BY CONTRACTOR
OWNER NAME:
BIL LINGADDRESS:
LYNNWOOD, WA 98037
LICENSE #: SELECHI110KN EXP: 12/31/2016
INSTALLATION FEE: $0.00
CONNECTION FEE: $0.00
STREET CUT DEPOSIT: $0.00
N SFR MN
IRRIGATION eN APARTMENT / CONDO - UNITS: 0
N DUPLEX FIRE CONNECTION N MIXED USE -COMMERCIAL FLOORS: 0
N TRIPLEX OTHER: RESIDENTIAL UNITS: 0
N COMBO FIREIDOMESTICBACKFLOW ASSEMBLYREQUIRED
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STYLE:
METER READING
MANUFACTURER'S #:
METER LOCATION:
SERVICE MATERIAL:
DATE OF WORK:
REMARKS:
U/B ACCOUNT:
READ AFTER ADDRESS:
PROJECT NUMBER:
LOCATE REQUEST #:
DATE CALLED:
AND
RECISTER #:
PRESSURR O Q'M:0
WORK BY:
* * *ATTACH DRAWING WHEN NECESSARY***
ROUTE: _
WATER SUPPLIER:
ISSUED
TYPE OF REPAIR
= Asphalt Roadway/Walkway
= Concrete Sidewalk
0 Concrete Curb
MNy\N0601 M
( Ft X Ft ) = Sq. Yds
( Ft X Ft ) = Sq. Yds
( Ft X Ft ) = Sq. Yds
( Ft X Ft) = Sq. Yds
( Ft X Ft) = Sq. Yds
( Ft X Ft) = Sq. Yds
Lineal Ft
Lineal Ft
Lineal Ft
Total Repair Costs:
Less Street Chit Deposit:
Invoice/Refund:
ENG20150123
REPAIR COST
$0.00