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i <br /> CITY OF EVERETT � � f � <br /> UTILITIES : �; f�QS}I�C _ <br /> PERMIT <br /> Date: OS/O1/96 CMWO #: <br /> Service Addreae: 5915 25TH AVE W 1 Change Request <br /> Billing Name: COUNTRYWOOD HOMES INC <br /> Billing Addreee: 14410 BEL-RED RD <br /> City, State, 2ip: BELLEVUE WA 98007 _ <br /> Phone: 649-8159 <br /> Legal Deacription: Lot 2 Blk 0 Addn: POWDERMILL DIV 1 <br /> Frontage: No. of Unita: 2 <br /> WATER SERVICE <br /> S.O. No. 8892 Application No. 30435 <br /> Fixed: 'Y Deposit: <br /> Svc. Size: 3/4 Svc. Type: SFR Water Permit Fee: 5105.00 <br /> Setter installation Date By <br /> Meter No. Size Brand <br /> Meter Inatallation Date BY <br /> . Water On Off Locked Out By <br /> Remarke:— — — <br /> TSG <br /> SEWER SERVICE <br /> ermi o. : <br /> Permit Type: NEW CONNECTION LID No. : <br /> Sewer Permit Fee: 570.00 <br /> Syatems Development Feea: <br /> Water 5600.00 <br /> Sewer 50.00 <br /> TOTAL: $600.00 <br /> Bond III Connection ChargeTrunk 50.00 <br /> Lateral $0.00 <br /> TOTAL: 50.00 <br /> Remarks: <br /> /��^ / <br /> Inspected by� .�' — Date v�f '� <br /> � � � �r� 'l�t 1 5775.00 <br /> r,�av u �. ��°b <br /> ...CITY OF EVERETT , <br /> BUIIL�i��J <br /> Divis�lic Works Copy <br />