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CITY OF EVEFETT <br />UTILITIES <br />PERMIT <br />NAR 0 g �� <br />TO Q�STIN� _ <br />Date: 09/29/95 CMWO �: <br />Service Addrese: 1430 MADRONA AVE _Change <br />Billing Name: ASTEMBORSKI LEONARD <br />CityinStatere2ip: EVERETTTMORE AVEWAA98201 <br />Phone: 266-3563 <br />Legal Deecription: Lot 2 Blk 0 Addn: SP ,f12-90 <br />Frontage: No. of Unite: 1 <br />WATER SERVICE <br />S.O. No. 8702 Application No. 30245 <br />Fixed: Y Depoeit: N <br />Svc. Size: 3/4 Svc. Type: SFR Water Permit Fee: <br />Setter Inetallation �ate gy <br />Meter No. Size Brand <br />Meter Inetallation Date gy <br />Water On off Locked Out gy <br />Remarke:— — — <br />TSG <br />SEWER SERVICE <br />ermL o.: <br />Permit Type: NEW CONNECTION LID No.: <br />Syeteme Development Feee: <br />Water $600.00� <br />Sewer $1,013.00 <br />Bond III Connection charye: <br />Trunk <br />Lateral <br />Remarke: <br />Inepected by l'.�c� /�,,s,.. <br />$0.00 <br />50.00 <br />Sewer Permit Fee: <br />TOTAL: <br />TOTAL: <br />�'I a- iL <br />$650.00 <br />S70.00 <br />$1,613.00 <br />$0.00 <br />. Grand Total: $2333.00 <br />� � � V �n <br />L�/ <br />SFP 291995 Public wozka copy <br />.................................... <br />CITY OF EVERETT <br />Building Division <br />