Laserfiche WebLink
�everett <br />City of Everett <br />Sewer Appiicati�on �nd Permit <br />NO. 2 8 3 S 1 DATE �/iz/ai <br />Service Address ��'+ �� � L�L' c.4�� Utility Account No. <br />CHART NO. <br />��/ �°5�` l <br />�����ai <br />8flling Address <br />Ciry, State, Zip . Permit Fee $ =� I U <br />Owner 2ga eu�6� Connection Charge <br />Cor,nection by rim cy.eo. u�,w <br />Address <br />— xv�rrtt itl 98208 <br />Phone ��y �;� <br />Legal Descripti��n: <br />Lot <br />Block <br />Plat <br />Unplatted Deschptlon: <br />TypeofPermit Altered serof�� <br />Remarks <br />IMPORTANT! <br />CALL 1-500-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Trunk $ __ <br />Lateral $ _ <br />Total Connection Charpq,,� ���. � g <br />i <br />Ulility Development Fee ���y�,.,H.;�� <br />Water `�I�'� ltD.(JO <br />I.iu"C ; . <br />Sewer $ <br />Total Development Fee $ _ <br />Sewer Bond District <br />Abutting Lot Line <br />N, S, E, W _ <br />Approved By _ <br />Issued By <br />Customer Signature <br />ft. <br />Inspection By ���� ��— _ <br />Date Inspected �"3� 5� <br />INSPECTiON <br />No. 28351 <br />� <br />