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CHART NO. <br /> everett <br /> TO POSTING 3 �- <br /> City oi Everott �='�y'�' -��lr�+ o�L3u cGtt <br /> i <br /> MOOIl2Bbld <br /> Sewer Applicatioi� and Permit �'� ��-°� <br /> c►�a; sw.ao <br /> NO. 2$616 DATE _ <br /> Service Address Utility Account No. <br /> Bllling A(MreeS • w <br /> Cky, Stete.Z!P �-10 l�2W Permit Fee $ �o_oo <br /> Owner Connection Charge <br /> Connection by �= Trunk S — <br /> Address Letera� S— <br /> Total Connectlon Charge E <br /> Phone UtIINy Development Fee <br /> Lepal Descriptlon: Water S <br /> Lot Sewer $ <br /> glock Total Development Fee S_ <br /> Plat _ <br /> Unplatted Descriptlon: Sewer Bond District <br /> _ Abutting Lot Line <br /> N,S. E,W h• <br /> Type of Permit Approved By x � <br /> Rem�rks Issued By— ' — ' " <br /> CuatomerSignature,_;� ' � <br /> IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING � � , <br /> , InapedionBy �'S'G'—�� — <br /> CALL 259-8810 FOR INSPECYION <br /> Date Inspected 3- z - � '_" <br /> SEE SM.ETCH ATTACHED NO. ZH616 <br /> INSPECTION I <br />