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�.:fi'r':�nw-"r.ra..�.�-.�, ,., <br /> CHART N0. <br /> everett <br /> I �St��- <br /> 1 -8-9i <br /> City oi Everett <br /> Sewer Application and Permit <br /> N0. 279Q5 DATr occ z9, ig90 <br /> Service Address 1319 Broadwav — Utiliry Account No. <br /> BillingAddress Si30 23Ct+ Cs <br /> City, State, Zip _��tt � gggd} Permit Fee $ ,_so <br /> Owner Connection Charge <br /> Connection by _ Trunk $ <br /> Address Lateral $ <br /> Total Connection Charge $ <br /> Phone Utility Development Fee <br /> Legal Description: Water $ <br /> Lot 9 + north 1/2 oE 10 Sewer 10�:'��a%'0 ".:^3Ft1 f.�JCq1N+�3�5 �i�l <br /> r <br /> Block �i Total Development Feeu�-�5Mk <br /> F.; ��FfH 34.�[] <br /> Plat e------ ^----� .��- itOlhk7495 <br /> S(=WC� t2.�[3 <br /> Unplatted Description: Sewer Bond Dfstrict ��� ��;__ <br /> Abutting Lot Lfne <br /> N,S, E,W ft. <br /> Type oi Permit , �it (:a - f � Appraved By <br /> Remarks Issued By <br /> (�l"istomer Signature <br /> IMPORTAN ! L��/� <br /> �'' r�� �o <br /> CALL 1-800-424-5555 48-HOURS � <br /> PRIOR TO DIGGING <br /> CALL 259-8810 FOR INSPECTION Inspectian Dy <br /> Date I�spected _ <br /> SEE SKETCH ATTACHED No. 2�T�9J� <br />� <br /> INSPECTION <br />