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r <br /> CITY OF EV�RETf =!1 P 0 5-�1 N G _ ��R 2 2 �� <br /> g ��'ILaTIES <br /> PER�r11T <br /> Date: 08/OS/97 CMt90 �: <br /> Service Addrese: 528 47TH ST SE __Change Request <br /> Billing Name: WAP,BIS CONSTRUCTION <br /> Billing Addrese: 10832 WILLOW RD <br /> Cit}�, State, Zip: LK STEVENS WA 98258 <br /> Phone: 356-7767 <br /> Legal Deecription: Lot 2 Blk 0 Addn: SP #7-95 <br /> Frontage: No. of Unita: 1 <br /> WATER SERVICE <br /> S.O. No. 9475 A�+�lication No. 31018 <br /> Fixed: Y Depoeit: N <br /> Svc. Size: 3/4 Svc. Type: SFR Water Permit Fee: $650.00 <br /> Setter Installation Date By <br /> Mete•r No. Size Branc' <br /> Meter Znetallation Date ey <br /> Water On Off Locked out By <br /> Remarke:— — — <br /> TSG <br /> 5EWER SERVICE <br /> ermi o. : — <br /> Permit Type: NEW CONNECTION LIl; No. : <br /> Sewer Permit Fee: $70.00 <br /> syeteme Development Fees: <br /> Water 5482.00 <br /> Sewe: $814.00 <br /> . TOTAL: $1,296.00 <br /> Bond III Connection Charge: <br /> Trunk $0.00 <br /> Lateral $0.00 <br /> TOTAL: $0.00 <br /> Remarke: �_ rs�-G.��� 4�J � N�, S� 5 Y'2 ,,,.. �ro <br /> 30•- ,�,. N. @ �i� r-�..,� �_� a 4��, <br /> Inspected by_�:.x��"' � Date '�1�� �7 <br /> Grand Total: $2016.00 <br /> n � � � �C� <br /> LJ r. o � tyy� <br /> A`f Public Works copy <br /> ......... .................. <br /> CITY OF cVER�TT <br /> 8uildin;; Divis'ion <br />