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CM OF FARM <br />UTILITIES <br />PERMIT <br />s- g7 <br />z > "�4- <br />90STING rrT 19 -Qn <br />Date: 01/08/97 CKNO /: ��f/ �l7 ��1`—�OY3�0 <br />Service Addrees: 6533 OLYMPIC DR _Change Request <br />Billing Name: BLANK LYLE <br />Billing Address: PO BOX 2266 <br />City, State, Zip: EVERETT WA 98203 <br />Phone: 355-4725 <br />Legal Description: Lot 2 Blk 0 Addn: SHORT PLAT 34-96 <br />Frontage: No. of Units: 1 <br />WATER SERVICE <br />S.O. No. 9228 Application No. 30771 <br />Fixed: Y Deposit: <br />Svc. Size: 3/4 Svc. Type: SFR Water Permit Fes: <br />Setter Installation Date G' /s =�f 7 By A'I' C ) , <br />Meter No. J411 qp y ly/ Size_ Brand <br />Meter Installation Date�� By iQ . <br />Water On Off Locked Out By� <br />Remarks:— <br />TSG 1,311Q? <br />SEWER SERVICE <br />ermi .. <br />Permit Type: NEW CONNECTION LID No.: <br />Systems Development Fees: <br />Water <br />Sewer <br />Bond III Connection Charge: <br />Trunk <br />Lateral <br />Remarks: <br />Inspected by <br />Sewer Permit Fee: <br />$482.00 <br />814.00 <br />TOTAL: <br />$0.00 <br />0.00 <br />TOTAL: <br />_ Date <br />CITY..OF EOVRol) <br />©tf14%n9 <br />Total: <br />$650.00 <br />,i <br />$70.00 <br />$1,296.00 <br />$0.00 <br />$2016.00 <br />Utilities Copy <br />