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:�ewer Application and Permit <br />N° 29566 <br />DATE 12-28-93 <br />Service Address 6�31 Beverly Blvd <br />Billing Address _ <br />City, State, Zip <br />Owner City of Everett <br />Connection by Chevron (USA) <br />Address <br />Phone <br />Legal Description: <br />Lot <br />Block <br />Plat <br />Unplatted Descrfption: <br />Type o( Permit alteration <br />Remarks PgYment made as part of Public <br />Works 6 BldR pecmit iasued 12-22-93 <br />IMPORTANTI <br />CALL 1-80fl-�424-5555 48-HOURS <br />PRIOH TO DIGC3ING <br />Utility Account No. <br />Permit Fee $ -0- <br />Connection Charge <br />Trunk $ <br />Lateral $ <br />To!al Connection Charge $ <br />Utility Develepment Fee <br />Water $ <br />Sewer $ <br />Tatal Development Fee $ <br />Sewer Bond Distnct _ <br />Abutting Lot Line <br />N, S, E, W <br />Approved By �'M <br />Issuad By � <br />Customor Signature . <br />a����o <br />DEC 281993 <br />ft. <br />Inspection By ................ ................... <br />CALL 259-8810 FOR INSPECTi'JN -- <br />Date Inspected Bufidin� Divisio� <br />SEE SKETCW ATTACHED <br />CUSTOMER COPY jv ° 2 9 5 6 6 <br />