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40 <br />C H <br />�Hrn <br />H � <br />K 0 <br />H0 <br />Otl H i1 <br />En H <br />OH <br />HMS <br />0. C3�Z+1 <br />H H <br />y <br />H <br />C] CJ l�rr�+nff <br />H En <br />HOC+ <br />�C:) <br />,i <br />C :) <br />UM' <br />LLj <br />U'l <br />everett <br />e <br />City of Everett <br />Sewer' ation and Perrr <br />T <br />NO. T9 DATE x .� 10--- <br />Service Address <br />Billing Address --- <br />City, Stale, Zip It -- <br />Owner nab -- <br />Connection by <br />Address — ---- -- <br />Phone _II3ff--- <br />Legal Description: <br />Lot—�35.-------- -- <br />Block --- - <br />Plat .—wsiwc�------------ <br />Unplatteo Description: _--- --- - <br />Type of Permit ------- <br />Remarks-- <br />IMPORTANTI <br />CALL 1-800-424.5555 48-I;OURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit Fee $ <br />Connection Charge <br />Trunk <br />Lateral <br />Total Connection Charge <br />Utility Development Fee <br />Water <br />Sewer <br />Total Development Fee <br />Sewer Bond District <br />Abutting Lot Line <br />n. <br />N. S. E, W _----- <br />Approved By <br />Issued By <br />Customer Signature <br />Inspection By <br />Dale Inspected <br />INSPECTION <br />/Jrr7 i 84- 1- <br />NO. 27953 <br />