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` ' GTYOFEVERETf TO POSTING MAY Q 21996 <br /> q UTILITIES <br /> ; PERMIT <br /> ��o +_ <br /> Dat�= O1/OB/96 �Change Request <br /> g�rvic� Addraess 113 FOREST CT <br /> Billinq Namej �SSSTR�E�N J <br /> Billing Addrees: WA 98012 <br /> City. Stata, Zips B�T�38_0159 <br /> � Phones p Addn: SYINNAICER pT 1 <br /> tion: Lot 15 elk pp, of Unite: <br /> y�qal Da�crip Fran,,sge: <br /> WATEA SERVICE <br /> Application No. 30322 <br /> g.0. No. 8��9 105.00 <br /> Deposits Water Permit Faes 5 <br /> Fixeds Y q Svc. T7(PB7 �S <br /> Svc. Size: 3/ <br /> g�ttor Inetallation Date _�By <br /> Siza_ Brand <br /> x�ter No.� By <br /> Nster Inetnllation Date Loc�--- By <br /> Wat�r On_,_ Off� <br /> gomarkss <br /> TSG�_ <br /> SEWER SERVICE <br /> @ o. : <br /> LID No.: 570.00 <br /> Yarmit Type= NEW �NN��TION Sewer Permit Fee: . <br /> Syetems Development Feee: Water 5482.00 1 296.00 <br /> Sewer <br /> $814.00 TOTAL: S r <br /> Bond III Connection CharqeTrunk Stl.00 $0.00 <br /> Lateral <br /> $0.00 TOTAL: <br /> gemarks: <br /> ,�-% .�---- Da e � �� � - <br /> Inepected b ran Total: $1471.00 <br /> ,IAN 08199� <br /> . ....... .................. <br /> CITY OF p���RonT <br /> buildin� <br /> Public Works Copy <br />