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( everett •- CHART N0. <br /> � <br /> City oi Everott � � R <br /> �' K � TO POSTING. i �- <br /> Sewer Application ar�d�ermit <br /> � <br /> �. 28602 DATE _ �..��,� 19f2 <br /> Servioe Addresa 127 ���� ��� U;il;ry Account No. _ <br /> BIIIIngAddreet4 •�tn u�r.. �� ,„.� <br /> City, 5tate,Zip ��**�■ �� f1�103 Permit Fee E <br /> 1100� �O.A9 <br /> a"�� ---��� � n�---- Connoctlon Charpe <br /> Connection by e�e� Trunk $ <br /> Addresa Lateral ' I <br /> a <br /> — Totel Connectbn Charpe S <br /> Phone �++-���; Utility Development Fee <br /> Lepal Descriptlon: Water $ <br /> �t Sewer Z -- <br /> B� Total Development Fee S _ <br /> Plat <br /> Unplatted Deecriptlon: Sewer Bond Dlstrict <br /> Abutting Lot Une <br /> N� S� E�W R. <br /> Type of Permit �tlt cofrecTtor Approved 8y <br /> Remarke Issued By �� <br /> Customer Sipnature <br /> IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING � � <br /> CALL 259-8810 FOR INSPECTION Ioapection By� <br /> Date Inspected Z '��'�9z- <br /> SEE SKE7�H ATTACHED No. ZHGOZ <br /> IPISPECTION <br />