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�� <br />O�t p 6 1991 RECEIVED <br />����' ������� ���APR 0 5 1997 <br />CITY �F EVEPETT <br />uPERIVI TS <br />� ��,o :: <br />Date: 04/O1/97 <br />Servica Addrese: 2016 LINCOLN ST <br />N�e, JELLI5�6241�Y <br />Billing Addrees: p� �OX <br />8illingtate, Zip: LYNN2��5893 <br />city. 5 <br />phone: � <br />B1 <br />Legel Deecr:ption: Fronta9e� <br />Change <br />WA 9g036 <br />p Addn� No af Units: <br />WATER SEkVICE � <br />ppplication No• <br />S � po, 9321 <br />Fixed:,Y �eP�BSvc.NTYPe� �UP <br />,.c, Size: 1�� uate BY� <br />Setter installation �8rand <br />Z � �C Si2e1� �, / > <br />Metec No. � 7 8y <br />Meter Inetallation Date �o /� BY <br />Water on � <br />Off� Locked Out_� <br />Remarks: <br />TSG_ � <br />SEWER SERVICE - <br />ermL o.: LID No.: <br />e: NEW CONNECTION <br />permit TyP <br />ment Feea: g701.00 <br />pevelop Water 51,183•o� <br />Syetema $eWer <br />Bond III Connectior. Char9eTrunk <br />Lateral <br />gemarke: <br />Inspected by <br />$0.00 <br />Sp.00 <br />UTILITY SERVICES <br />Watet Permit F'e� <br />$ewer Permit Fee: <br />TOTAL: <br />TOTAL: <br />� �J �' � I <br />I `' � ,� � ) <br />I1 i <br />) ,,F;; 0 ] "�997 <br />:;Tv cF t�;�F���, <br />,�.��:i�s,�, <br />�,�..: „ <br />$130.U0 <br />570.00 <br />$1,884.00 <br />$0.00 <br />Grand Total: $2084•00 <br />Ptilitiee Svcs CopY <br />