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4 <br /> CITY OF EVERETT <br /> TO P�JSTING � ' g '�"` <br /> UTILBTIES <br /> '�ERMIT <br /> Date: 02/06/97 CMWO $: � <br /> Serv?ce Addreee: 2415 40TH ST _Change Requee <br /> Billing Name: HENDERSON R!M <br /> Billing Addreae: 915 61ST AVE SE <br /> City, State, Zip: EVERETT WA 98205 <br /> Phone: 252-7226 <br /> Legal Deecription: Lot 0 filk 0 Addn: <br /> Frontage: No. of Unite: 1 <br /> i <br /> _ WATER SERVICE <br /> S.O. No. 9272 Application L7o. 308:5 <br /> Fixed: Y Depoeit: <br /> Svc. Size: 3/4 Svc. Type: CA Water Permit Fee: , .00 <br /> / , � <br /> Setter Installation Date gy �v,� �= <br /> Meter No. Size Brand <br /> Meter Inetallation Date ey <br /> Water On Off Locked Out By <br /> P,emarke:'— —' — <br /> Ts���r197 <br /> SEWER SERVICE I <br /> ermi o. : <br /> Permit Type: NEW CONNECTION LID No. : <br /> Sewer Permit Fee: $70.00 <br /> Systeme Development Feea: <br /> Water 5409.58 <br /> Sewer $691.42 <br /> TOTAL: $1,1O1.OG <br /> Hond III Connection Charge: <br /> Trunk $0.00 <br /> Lateral $0.00 <br /> TOTAL: $0.00 <br /> Remarke: <br /> Inepected by Date <br /> Grand Total• $1276.00 <br /> Utilities Copy <br />