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CmOF�RM <br />UTILITIES <br />PERMIT <br />Oates 06/10/99 CMWO *: <br />Service Addrese: 4619 21ST DR SW <br />Billing Name: NORTH CREST DEVELOPMENT <br />Billin4 Address: PO BOX 340 <br />City, State, Zip: EDMONDS WA 98020 <br />Phone: 425-774-3181 <br />T; POSTING FEB0 2 2001 <br />_Change Request <br />Legal Description: Lot 3 Blk 0 Addn: BUSH GARDENS <br />Frontage: No. of Units: 1 <br />WATER SERVICE <br />S.O. No. 10131 Application No. <br />Fixed: Y Deposit: N <br />Svc. Size: 3/4 Svc. Type: SFR <br />Setter Installation Date By <br />Meter No. Size Brand <br />Meter Installation Date By_ <br />Water On Off Locked out <br />Remarks:— <br />TSG <br />By <br />SEWER SERVICE <br />No.: <br />Permit Types NEW CONNECTION LID No.: <br />Systems Development Fees: <br />Water <br />Sewer <br />Bond III Connection Charge: <br />Trm:k <br />Lateral <br />Remarks: <br />Inspected bye. <br />31674 <br />Water Permit Feet <br />Sewer Permit Feet <br />'82.00 <br />$814.00 <br />TOTAL: <br />$0.00 <br />$0.00 <br />TOTAL: <br />Date <br />$130.00 <br />$70.00 <br />$1,296.00 <br />$0.00 <br />E <br />$1496.00 <br />Cx Y. <br />Works Copy <br />O� Sep <br />C" <br />