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.-, <br /> ClTi�F EVtAFTT <br /> UTILITIES <br /> PERN9lT <br /> Date: 06/28/96 CMWO #: <br /> Service Address: 2715 �STfI ST 2 Change Request <br /> Billing Name: EV�RETT HOUSING AOTHORITY <br /> Billing Rddre�sa: PG BOX 1547 <br /> City, State, Zip: EV�;RETT WA 98201 <br /> Phone: 303-1103 <br /> Lega1 Deacription: Lot 0 B1Y. 0 Addr�: I <br /> Frontage: No. of Units: <br /> WATER 3ER9ICE <br /> S.O. No. 90 S�� e S O �pplication No. 30553 <br /> Fixed: �Y Peposit: f� gODq <br /> Svc. Size: 4" Svc. Type: �H Water Permit �'e=_: <br /> $60.00 <br /> Setter Installation Date gY <br /> Meter No. _ Size Brand <br /> Meter Inatallation Pate gY <br /> Water on Off Locked Out gY <br /> Remarks:'— -- -- <br /> I TSG <br /> , SEWER SERVICE <br /> m-i o. : — <br /> Permit Type: LID P7o. : <br /> SystAma Uevelopment Fees: Sewer Permit 9ee: $0.00 <br /> Water $0.00 <br /> � Sewer $0.00 <br /> � 'fGTAL: $f`.00 <br /> Bond IZI Connection Charge: <br /> Trunk $0.00 <br /> Lateral $0.00 <br /> TOTAL: $0.00 <br /> Remarks: <br /> Inspected by Date <br /> a � � n n r� D Grand Total: $60.00 <br /> v � <br /> JUL 0 2 ?996 <br /> . . .......................... Public Works CoPY <br /> CITY OF EVERETT <br /> Buiidin� Division <br />