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CITY OF EVERETT <br />UTILITIES <br />PEFiMIT <br />tiug6 <br />TO PQSTING M�� ��� �� <br />Date: OS/03/96 CMWO M: <br />Service Address: 30318 4TH AVE W _Change <br />Billi.ng Name: DOTSON DAN <br />Billing Addresa: 10318 4TH AVE W <br />City, State, Zip: EVERETT WA 987.04 <br />Phone: 347-5353 <br />Legal Description: Lot 0 Blk 0 Addn: <br />Frontage: No. of Unite: 1 <br />4IATER SERVICE <br />S.O. No. 0 Application No <br />Fixed: Deposit: <br />Svc. Size: Svc. Type: <br />Setter Inat�llation Date <br />Meter No. Size <br />Ey <br />Meter Inetallation Dat� By <br />Water On Off Locked Out <br />Aemarke:— — <br />TSG <br />By <br />SEWER SERVICE <br />ermi o.: <br />Permit Type: NEW CONNECTION LID No.: <br />Syetems Development Fees: <br />Water 50.00 <br />Sewer 5814.00 <br />0 I <br />Water Permit Fee: <br />Sewer Permit Fee: <br />TOTAL: <br />Bund ZII Connection Charge: <br />Trunk 5330.00 <br />Lateral SO.DO <br />TOTAL: <br />Remarks: <br />:- <br />/ <br />Inepected Date�T � <br />Grand Total: <br />50.00 <br />$70.00 <br />S814.00 <br />$330.00 <br />$1214.OF <br />Public Works Copy <br />