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5Yy . '_�.. ._ •. . . . . . . . . . . , . <br /> CITY OF EVERETT NOV 1 0 1997 <br /> UTILITIES �p pOSTII�� _ ___- <br /> PERMIT <br /> Date: 10/20/97 CMWO #`: <br /> Service Addreea: 10110 EVERGREEN WAY <br /> Change Requeet <br /> Billing Name: HART•S ATHLETIC CLUB <br /> Billing Addreas: 14575 BEL RED RD <br /> City, State, 21p: BELLEWE WA 98007 <br /> Phone: 641-0096 <br /> Legal Deecription: Lot 0 Blk 0 Addn: <br /> Frontage: No. of Unite: <br /> WATER SERVICE <br /> S.O. No. 0 Application No, p <br /> Fixed: Depoeit: <br /> Svc. Size: Svc. Type: <br /> Water Permit Fee: $0.00 <br /> Setter Inetallation Date gy <br /> Meter No. Size Brand <br /> Meter inetallation Date gY <br /> Water On Off Locked Out gy <br /> Remarke:— — — <br /> TSG <br /> ermi o. : <br /> SEWER SERVICE <br /> Permit Type: AyTERATION LID No. : <br /> Syeteme Development Feee: Sewer Permit Fee: S30.00 <br /> Water $0.00 <br /> Sewer $0.00 <br /> TOTAL: $0.00 <br /> dond Iii Connection Charge: <br /> Trunk $0.00 <br /> Lateral $0,00 <br /> TOTAL: $0.00 <br /> Remarke: <br /> WORI( BY OWNEA <br /> InepectRd by i3-r(�P � -z,� Date /�{ - L�-f 7 <br /> Grand Total: $30.00 <br /> Public Worka Copy <br />