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evere!t <br />City of Everett <br />Sewer Applicat <br />No. 26260 <br />r <br />i„ <br />, <br />� <br />.x <br />� �? 8 S <br />r <br />a � `� 4 <br />M M r� <br />ior� .� Permit <br />�t�3 ����� <br />DATE � + 1, 1991 <br />Service Address 816 sr�ukrnd Ad <br />Billing Addresa "' — <br />Cfty, State, Zip swptt-w7►-9Y30Y <br />Owner <br />Connectlon by <br />Address <br />Phone u�-���} <br />Lepal Descriptlon: <br />Lot <br />Bbck <br />Plat <br />Unplatted Descrlption: <br />Type of Permlt <br />Remerks I <br />IMPORTANTI <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />�ART N0. <br />Se y+-E- � �us�„� 6 —i¢-4I <br />Permit Fee $ �0.00 <br />Connectlon Charge <br />Trunk $ <br />Laterel $ <br />Total Connection Cherge E <br />Utility Development Fee <br />Water $ <br />Sewer $ <br />Total Development Fee S <br />Sewer Bond District <br />Abutting Lot Line <br />N, S, E, W n. <br />Approved By <br />Issued By r��'�'`t �*—^� <br />Customer Signature <br />/ <br />� <br />Inspection By <br />Date Inspected � � <br />INSPECTION <br />No. 28260 <br />