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- � <br /> i <br />�I <br /> U�tILITIES �� �QST�NG ��'"�'-'--y`' <br /> PERMiT <br /> Date: 03/20/95 CMWO #: <br /> Service Addrese: 5428 25TH AVS W _Change Requeet <br /> Billinq Names COUN'PRYWOOD HOMES INC <br /> Billin4 Addresa: 144:0 BEL-RF:D RD #200 <br /> City, State, Zip: BELLEWE WA 58007 <br /> Phone: 644-2323 <br /> Legal Deecription: Lot 57 Blk 0 Addn: POWDERMILL HIGHLANDS 2 <br /> Frontage: No. of Units: 1 <br /> __ WATER SERVICE <br /> 5.0. No. 8417 Application No. 29960 <br /> F'ixed: Y Depoeit: <br /> Svc. Size: 3/4 Svc. Type: RES Water Permit Fee: $105.00 <br /> Setter Inetallation Date 8y <br /> Meter No. � 6� �'�Size� Brand <br /> Meter InstalJation Date �^�-3-�/o By� <br /> / <br /> Water on ✓ Off Locked Out 8y <br /> Remarke:— — — <br /> TS� <br /> SEWER SERVICE _ <br /> ermi o. : <br /> Permit Type: NEW CONNECTION LID No. : <br /> Sewer Permit Fee: $70.00 <br /> Systems Development Fees: <br /> Water 5600.00 <br /> Sewer $0.00 <br /> TOTAL: $600.00 <br /> Bond III Connection ChargeTrunk 50.00 <br /> Lateral $0.00 ' <br /> TOTAL: $0.00 <br /> Remarke: <br /> Inspected by Date <br /> Grand Total: $775.00 <br /> � � � V �r� <br /> L-� <br /> QPR 0 91996 <br /> Utilities Copy <br /> .................................... <br /> CITY OF EVERETT <br /> Buildin� Div'ssion <br />