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CHART NO, <br />everett <br />ti <br />4 <br />City of Everett 8 S 8 3 <br />Sewer App�ieatWn-fand Permit <br />NO. Mile DATE _ November 2 , 1990 <br />Service Address 17 Utility Account No. <br />bil'Irg Address a -ter ;,eaeii ---- <br />City, State, Zip - zQLi.V4- 98pei --- Permit Fee $ <br />Owner John C _2 "ryaL-Ctin'jard Connection Charge <br />Connection by <br />Address <br />Phone --- <br />Legal Description: <br />Lot — <br />Block <br />Plat <br />Unplatted Description: . <br />Type of Permit <br />Remarks ._ <br />IMPORTANTI <br />CALL 1-800-424.5555 48-1 <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Trunk <br />Lateral <br />Total Connection Charge <br />Utility Development Fee <br />Water <br />Sewer <br />Development Fee <br />� ewer Bond District <br />4buttiLot Line <br />f�N, S. E. W — <br />' Approved By _— <br />ft. <br />Issued By % - <br />�� u mer Signature - - - — -� <br />� I <br />Inspection By _ <br />Date Inspected <br />INSPECTIOIJ <br />NO. 2SO04 <br />