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, <br /> : � ��n ��STING - c — .- <br /> CITY OF EVERETT O�.\\� <br /> � UTILITIES " �� <br /> PERMIT o�� <br /> Date: 09/23/94 CMWO #: 4 <br /> Service Addrees: 4815 EVERGREEN WAY B��/d� E�fq•"'••••.. <br /> Billing A dress: 320 108TH AVE NE #406 0/V)S�a�rT <br /> � � City, State, Zip: BELLEWE WA 98004 <br /> Phone: 453-0324 <br /> Legal Deecription: Lot 0 Blk 0 Addn: <br /> Frontage: No. of vnite: <br /> _ WATER SERVICE <br /> S.O. No. 8215 Application No, 29758 <br /> Fixed: Y Deposi�: N <br /> Svc. Size: 1 Svc. Type: COMM Water Permit Fee: $750.00 <br /> Setter installation Date 6y <br /> Meter No. Size Brand <br /> Meter Inetallation Date By <br /> Remarke: <br /> HOLLYWOOD VIDEO STORE <br /> Backflow Prevention May Be Required <br /> SEWER SERVICE <br /> �ermit No. : 29867 <br /> Pt�rmit Type: NEW CONNECTION LID No. : <br /> Sewer Permit Fee: $70.00 <br /> Syetema Development Feee: <br /> water S0.00 <br /> Sewer S��TOTAL: $0.00 � <br /> Bond IZI Connection ChargeTrunk $0.00 <br /> Lateral $0.00 <br /> TOTAL: S0.00 <br /> Remarke: <br /> NO SYSTEMS DEV FEES <br /> /% <br /> inspected by l y��"� -Date ��'��' �� <br /> Grand Tota1 S820.00 <br /> Permite expire if work ie not commenced within 180 daye or <br /> ceasea for more than 180 daye. <br /> Public Worka Copy <br />