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� � � CHART NO. <br /> � I <br /> eve�ett <br /> � � � <br /> � � � �, <br /> y TO POSTING -i%�.,..�.._- <br /> p � Clty af Ever�:t <br /> � p Sewer Application and Permit <br /> � � <br /> 4 p NO. Z H 1�i.� DATE _��.�--- <br /> � � � ress — UIIIity Accounl No. — <br /> Service Add � <br /> Billfng Address �=4 �� �� �pt H <br /> Ciry, Stflte,Zip �--- Permit Fee $ , <br /> r <br /> Owner __ Connection Charge <br /> Conneclion by Trunk $ <br /> Address Laterel i,,;�p� � _ � ,, � <br /> _ Total Connection Charg�}�' \ <br /> Ulilfly Development Fee ���� b7`7.W <br /> ���� Phone _ _ �p+S— '�I.I;ri f15.00 <br /> j Logal Descdption: Weter rN:U�S +1�n m-- - <br /> • ; t�li �1i t'4 ���� <br /> Sewer �i ��I - <br /> L� Lot ��i— — — <br /> r;u��u� �ro.00 <br /> i �� Block Total Development Fee � , <br /> FILC ���.� <br /> ; Plet — i�[4�Ili J 1 i� <br /> � I�� � NllCl' IF. <br /> I �,�� Unplatled DescripHon: _ — Sewer Bond District — ���,� <br /> Abutling Lot Line '��k ��•� <br /> I l'71-5 1B1 i.OD n. <br /> '�� _ N� S�E,W . . <br /> i ��1 <br /> Type of Permit _ Approvad By <br /> ! Remarks _— Issued By �� - J__y <br /> ��• ' __ Customer Signature ' <br /> �, <br /> � IMPORTANTI <br /> �� � l <br /> CALL 1-800-424-5555 48-HOURS F <br /> PRIOR TO DIGGING �� <br /> TION Inspedlon BK..r� � <br /> CALL 259-8810 FOR INSPEC Date Inspectod ���G '�� <br /> SEE SKETCH ATTACHED r,o. 28163 <br /> INSPE�.TION I <br />