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CITY OF EVERETT <br />UTILITIES <br />PERMIT 5 9s <br />Date: 08/11/95 CMWO 0: <br />Service Address: 16 74TH ST SW _Change Request <br />Billing Name: DOW DENNIS <br />Billing Addrese: 16 74TH ST SW <br />City, State, Zip: EVERETT WA 98203 <br />Phone: 353-5562 <br />Legal Description: Lot 0 Blk 0 Addn: <br />Frontage: No. of Unite: 1 <br />WATER SERVICE <br />S.O. No. 0 Application No <br />Fixed: Depovit: <br />Svc. Size: Svc. Type: <br />Setter Installation Date By__ <br />Meter No. Size Brand <br />Meter Installation Date <br />Water On Off <br />Remarks:— <br />TSG <br />By <br />Locked Out_ By <br />SEWER SERVICE <br />erm o.: jujij <br />Permit Type: NEW CONNECTION LID No.: <br />Systems Development Fees: <br />Water 5814.00 <br />Sewer $0.00 <br />Bond III Connection Charge: <br />Trunk $0.00 <br />Lateral $0.00 <br />Remarks: <br />n <br />Water Permit Fee: <br />Sewer Permit Fee: <br />TOTAL: <br />TOTAL: <br />Inspected by P (D�a(\t�j <br />L%'�; V Grand Total: <br />OP� 01�l <br />$0.00 <br />$70.00 <br />$814.00 <br />Em <br />$884.00 <br />G\0`,\a�1 V�V Public Works Copy <br />