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CITY OF EVERETT <br /> UTILI�'IES <br /> PERIWIT <br /> Date: 06/21/95 ��1W0 *: <br /> Service Addresa: 2936 LOMBARD AVE _Change Req�:eet <br /> Billing Name: WEBSTER RICHARD <br /> Billing Addreee: 11900 SILVER LK RD <br /> C.ity, State, Zip: EVF.RETT WA 98208 <br /> Phone: 337-3664 <br /> Legal Deecription: i�ot 0 Blk 0 Addn: <br /> Frontage: No. of Units: <br /> WATER SERVICE <br /> 5.0. No. 0 Application No. 0 <br /> Fixed: Depoeit: <br /> Svc. Size: Svc. Type: Water P�rmit F-ae: $G.00 <br /> Se!ter Inatallation Date_ ey <br /> Met:�r No. Size Brznd <br /> Meter Installation �ate By <br /> Water On Off Locked Out Byi <br /> Remarke:— — — <br /> TSG <br /> SEWER SERVICE _ <br /> ermi c. : <br /> Permit Type: CAP OFF LTD .tdo. : <br /> SewPr Fermit Fee: $1'.�.00 <br /> Systems Devel� :ment Fees: <br /> Water 50.00 <br /> Sewer $0.00 <br /> TOTAL: $0.00 <br /> Bond III connection Charge: <br /> Trunk $0.00 <br /> Lateral $0.00 <br /> TOTAL: S0.00 <br /> Remarks: C�'�� �� � _ <br /> '�� / � <br /> p �-� <br /> Inspected by �` Date <br /> Grand Total: $10.00 <br /> �� , � �G�� ✓� �I ��pgU � <br /> ��-�irPGt ���S�U'� <br /> I ., � �� Public Worke Copy <br /> �/ <br />