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CITY OF EVERETT <br />UTILITIES <br />PERMIT <br />�� p�STIN� ocT o s ,ss� <br />Date: 09/16/97 ��� �° <br />Change Requeet <br />Service Addreee: 3127 GRAND lVE (B) — <br />Billinqg Addreee: 13 ODPACIFIC AVE�NTS <br />City, State, Zip: EVERETT WA 98201 <br />Phone: 259-5101 <br />Leqal Deecription: Frontage:elk 0 Addn: No. of Unite: <br />WATER SERVICE <br />S.O. No. 0 Application No. <br />Fixed: Depoait: <br />Svc. Size: Svc. Type� <br />Setter Inetallation Date BY <br />Size Brand <br />Meter No. — <br />Meter Inetallation Dnte�_ BY <br />Water On_ Off_ Locked out_ , BY. <br />Remarke: <br />TSG <br />SEWER SERVICE <br />erm o•: <br />Permit Type: <br />CAP OFF LID No.: <br />L <br />Water Permit Fee: <br />Sewer Permit Fee: <br />Syeteme Developr.9nt Feee: Water $0.00 <br />Sewer $0.00 <br />TOTAL: <br />Bond IIT Connection ChargeTrunk S0.00 <br />La eral $0.00 <br />-/� TOTAL: <br />1'P .-J'O k+ �t � <br />Remarks: C <br />,/ �M�s sor o.+ 4�"� <br />%D <br />�� �'/ /�� <br />inerected by <br />Date <br />Grand Total: <br />�� ����� . <br />� "' ���.��. <br />5�'' : J�P� � <br />• � r�� <br />. •''�F Q��" <br />..••'G�e J`��j���i <br />$0.00 <br />S10.00 <br />$0.00 <br />$0.00 <br />$10.00 <br />Public Worke Copy <br />