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r��A�r No. ----------- <br /> � evcrett <br /> I � : <br /> � � City oi Everett • � <br /> A�x . : . . _ � Tn r�st�Hc_ ��- > G�- <br /> ;,�y Sewer` Appl�catian;and_ Permet <br /> � ; <br /> u xo ' NO. 2864H ` DATE. __ �o;�— __ � <br /> ";1 H�V I <br /> � �� i Service Address —j�CAwsawc-Sc------ Utiliry Account No. — — ; <br /> H C � Billing Address ( <br /> � �g � 1 <br /> ��� � ' City,State,Zip _Ao].ingsoa-wl.--�&29.3 Permit Fee $ _.�Ag_ I <br /> � y� Owner —+�.,�r,w�eoroacLao Connection Charge � <br /> y y Connecuon hy �- Trunk $ E <br /> N � <br /> � C y I Address __� Lateral $ � <br /> C��� � Total Connection Charge $ <br /> � <br /> •30N � f <br /> � Phone _�q.pqu— Utility Development Fee � <br /> iLegal Description: Water $ 460 00 I <br /> � � Lot - ------- Sewer $-}2�-2-.0: � <br /> Blo:k Total Development Fee $ �R» 00 i <br /> � <br /> ���"� Plat ( <br /> � � <br /> Unplatted Description: -_- Sewer Bond Dislrict -. <br /> I <br /> �� � Abuttirg Lot Line ' <br /> _ N, S, E,W h• <br /> � <br /> � �1 Type of Permit N.� rnnneetinn _ APPfOVBd Dy ' <br /> Remarke _ Issued By—x Iluqh_ <br /> ��1 _ _ ___ _ Custom,ar SignaWre <br /> I IMPORTANT! <br /> ' ( I <br /> � � CALL 1-800-424-5555 48-HOURS <br /> PRIOH TO DIGGING I <br /> ��1� Inspection By �G"�� - <br /> CALL 255-t1810 FOR INSPECTION I <br /> Datelnspected �� fz <br /> I I <br /> I SEE SKETCH ATTACHED No. 2R648 I <br /> � WSPECTION �I <br />