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CITYOFEVERE7T �� �osriNc �yi� <br /> UTILITIES <br /> PERMIT <br /> Date: 10/02/95 CMWO /: <br /> Service Addresa: 2210 EVERETT AVE <br /> eilling Name: _Change Requeat <br /> Billing Addrese: OLSON MAURICE <br /> +�:^:^.,: Cit PO BOX L <br /> ����' � ' Phone;State, Zip: LYNNWOOD XX WA 98046 <br /> Leqal Deacription: Lot 0 Hlk 0 Addn: <br /> Frontage: <br /> No• of Unite: <br /> WATER SERVICE <br /> S.O. No, p <br /> Application No. p <br /> Fixed: Depoeit: <br /> Svc. Size: Svc. Type: <br /> Setter Inetallation Date— Y— Water Permit Fee: S0.00 <br /> B <br /> Meter No. Size <br /> Brand <br /> Meter Inetallation Date— Y <br /> B <br /> Water On Locked Out <br /> Remarks:� Off_ — By <br /> TSG <br /> ermi o. : SEWER SERVICE <br /> Permit Type: CAP OFF <br /> LID No. : <br /> Syeteme Development Feea: Sewer Permit Fee: <br /> Water $0.00 S10.00 <br /> Sewer $0.00 <br /> TOTAL: $0.00 <br /> Bond III Connection Charge: <br /> Trunk $0.00 <br /> Lateral $0.00 <br /> Remarks: TOTAL: $0.00 <br /> �I � �L� � <br /> J�- / <br /> �J �H 5�2�",�O�l O �^ �� '� <br /> Date <br /> � <br /> Grand Total: $10.00 <br /> Public Worka Copy <br />