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CITY OF EVERETT <br />UTILITIES <br />PERMIT <br />Date: 06/22/98 <br />CMWO <br />/: / Iv _// <br />1 Io <br />1 ` ! r 7 l <br />Service Address: <br />6424 BROADWAY <br />1 <br />_Change Request <br />Billing Name: <br />Billing Address: <br />City, State, Zip: <br />Phone: <br />ST VINCENT DE PAUL <br />5303 EVERGREEN WY <br />EVERETT WA 98203 <br />355-3525 <br />Legal Description: <br />Lot 0 Blk <br />Frontage: <br />0 Addn: <br />No. of <br />Units: <br />WATER SERVICE <br />S.O. No. 9779 Application No. 31322 <br />Fixed: Deposit: Y <br />Svc. Size: 4" Svc. Type: FIREWater Permit Fee: <br />Setter Installation Date --/(- [q K By "� <br />Meter No.UIU3�s2 Size X3a�y Brand /y4r'Pf+• c3Y <br />�ffSS <br />Meter Installation Date`/f— /if By V J - <br />Water On Off Locked Out By��l„ <br />Remarks:"— <br />TSG� o �G ( v <br />i n <br />$4,588.00 <br />SEWER SERVICE <br />e rmi o.: — U <br />Permit Type: LID No.: <br />Sewer Permit Fee: $0.J <br />Systems Development Fees: <br />ter $0.00 <br />Sewer $0.00 <br />TOTAL: $0.00 <br />Bond III Connection Charge: <br />Trunk $0.00 <br />Lateral $0.00 <br />TOTAL: $0.00 <br />Remarks: <br />Y <br />C <br />T <br />V I <br />Inspected by Date <br />Grand Total: $4588.00 <br />,j <br />�l v, <br />I <br />M Utilities copy <br />.F• <br />T <br />