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I'+ � <br />��1� <br />everett <br />e � <br />� <br />�. � ���: n, <br />City of Everett � r = �j -' � o � ; <br />^! �!. N , V� <br />Sewer Application and P�rm�t_ � <br />; `>�������. <br />NO. Z S 41 % DATE �s*�z14�. io", <br />Service Address 6��^ p�^^���'!9+ ^t A Utility Account No. <br />CNART NO. <br />TO POSTING y� � q <br />y 1 <br />o? �; <br />L � �I <br />;���, <br />BIIIIngAddress ��e Riiii° �'a- <br />CI{y� SlAte� Zlp Q—��� �� eeron _ PBffT�il F8e $ �0_00 <br />Owner —��esb�+r-- Connection Charge <br />Connection by ��r Trunk $ <br />Address <br />__ Laterel <br />$ <br />Total Connection Charge $ �'' - <br />Phone �74-15�7 Utility Development Fee <br />Legal Descdptlon: Water $ 1�9 ^^ <br />Lot a sewer $ a71.00 <br />Block <br />Plal A+�qnr++� '^��'^�^� <br />Unplatted Descripllon: <br />Type of Permit � <br />Remerks <br />IMPORT/�NTI <br />CALL 1-800-424-55!i5 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOIi INSPECTION <br />SEE SKETCH aTTACHED <br />Total Devolopment Fee 3-65� nn <br />Sewer Bond Dislrict �d I Y��ad1 <br />Abutling Lot Line <br />tJ, S, E, W <br />Appraved By <br />Issued By <br />Customer Signature <br />n. <br />� <br />Inspec'IonBy �'/" � — <br />Da�o Inspected ��� �!' ��� <br />wsi�ecrior� <br />No.2sai7 <br />4 <br />