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CITY OF EVERE77 <br />UTILITIES <br />PERMIT <br />PaL•e: 08/21/96 CHWO f: <br />Service Address: 3215 RUCKER AVE _Change Request <br />Billing Name: HEINZEN/YONKE <br />Billing Address: 641 SHINE RD <br />City, State, Zip: PT LUDLOW WA 98365 <br />Phone: 437.0468 <br />Legal Description: Lot 8 Blk 769 Addn: <br />Frontage: No. of Unite: 1 <br />WATER SERVICE <br />S.O. No. 0 Application No <br />Fined:' Deposit: <br />Svc. Size: Svc. Type: <br />Setter Installation Date By <br />Meter No. Size Brand_ <br />Meter Installation Date By <br />Water On Off Locked Out By <br />Remarks:— — <br />TSG <br />.Permit No.: SEWER SERVICE <br />Permit Type: CAP OFF LID No.: <br />Systems Development Fees: <br />Water $0.00 <br />Sewer $0.00 <br />Bond III Connection Charge: <br />Trunk <br />Lateral <br />Remarks: <br />Inspected by <br />G <br />$0.00 <br />$0.00 <br />0 <br />Water Permit Fee: <br />Sewer Permit Fee: <br />TOTAL: <br />TOTAL: <br />Grand Total: <br />$0.00 <br />$10.00 <br />$0.00 <br />$0.00 <br />$10.00 <br />Public Works Copy''. <br />