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� <br /> CITY OF EVERETT <br /> UTILITIES <br /> PERMIT <br /> Date: 06/21/95 <br /> CMFlO #: � <br /> ,Chanye ��tec�uest <br /> Service Address: 2936 LOMIIARD AVE � �� <br /> Billing Name: WEBSTER RICI�IARD � <br /> Billing Address: 11900 SILVER LK RD / \� <br /> City, State, Zip: EVERETT WA 96208 , �, <br /> Phone: 337-3664 � �V <br /> �V <br /> Lega1 Description: Frontage:Blk 0 Addn: N6 f Uq�'ks ,�� <br /> C �� � <br /> �� J <br /> Sv <br /> WAiEA SERVICE �/ ��v '` — - <br /> Applica o �70• yU '0 y <br /> S.o. No. o �� - ,�, ��.�a <br /> Fixed: Deposit: Water Permit Fee: S0.00 <br /> Sv0. Size: Svc. Type: ��[ ��. �� <br /> v <br /> Setter Installation Date � BY'��� � <br /> Meter No. Size rand �\� <br /> / �' �� <br /> i <br /> Meter I:istallation Date BY �' � <br /> � <br /> Water On_ Off__ L ck d/ �t BYJ�-- <br /> Remarks: <br /> � � ���� <br /> .� � � <br /> .�� <br /> TSG � ' - <br /> � , �� <br /> � WER EB�I�. <br /> Permi o. : / <br /> Permit Type: CAP OFF � L D No. : <br /> Sewer Permit Fee: $10.00 <br /> Systems Development F�es� Water 50.00 <br /> � Sewer $0.00 50.00 <br /> TOTAL: <br /> % <br /> Bond III Ca�nection ChargeTrunk 50.00 <br /> f Lateral $�•�� $0.00 <br /> / TOTAL: <br /> Remarks: � <br /> / <br /> i� <br /> Inspected by <br /> Date <br /> Grand Tota1: $10.00 <br /> Public 47orks copy <br /> _ <br />