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�br.i �tJSTING � �a-� -�I� <br />CITY OF EVERETT <br />UTILITIES <br />PERMIT <br />'/-') �'n"`����' <br />/ / <br />/ G '�'c� <br />15 <br />� � �` i�,r F� <br />Date: 09/07/94 CMWO #: � �' l i(OfOY �J (/'� <br />Service Address: 114 W INTEACITY AVE <br />Billing Name: BLANK LYLE E <br />Billing Addrese: PO BOX 2266 <br />City, State, Zip: EVERETT WA 98203 <br />Phone: 355-4725 <br />Lzgal Description: Lot 4 elk 0 Addn: SHORT PLAT #23-94 <br />Frontage: No. of Units: <br />S.O. No. 8193 <br />Fix=d: Y Depoeit: <br />WATER SERVICE <br />Applicatic� No <br />29736 <br />Sv�. Size: 1 Svc. Type: FES Water Permit Fee: <br />SEtter Installation Date By <br />Meter rro.�/G 3 k 373! size� erand ��C�¢Zi�sw <br />--T— / <br />Meter Installation Date /a �y�y /5'�" By `t��G��. <br />TJ—� <br />Remarks• <br />Gf'"�W ' D�u' <br />Backflow Prevention May Be Required <br />SEWER SERVICE <br />Permit No.: 0 <br />Permit Type: <br />Systems Development Fees: <br />Water <br />Sewer <br />Bond III Connection Charge: <br />Trunk <br />Lateral <br />Remarks: <br />Inspected <br />LID No.: <br />Date <br />Sewer Permit Fee: <br />$0.00 <br />$0.00 <br />TOTAL: <br />$0.00 <br />$0.00 <br />TOTAL: <br />Grand Total <br />$750.00 <br />, $0.00 <br />$O.UO <br />$0.00 <br />$750.00 <br />Utilities Copy <br />