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� �� <br /> o � x ...- <br /> p H <br /> � Hfn <br /> y �� CHART N0. <br /> "y� everett <br /> �a�ie°c <br /> ��� e = ._ .. _ _ _ T� POST�N � 3 <br /> �° �'g City of Everett ' ~' �• � " - � _ = G ��—_ � <br /> �� O `r .Y �F _' . _ i <br /> . ., '1 � ` . <br /> � y . . ,.�� t .._ . .��;. . .. � :.. •, <br /> � y� Sewer Application and�4Permit :�; 4 ,� � <br /> h L Wt�� µ � y I <br /> n 3 : .J I <br /> �d y � '[ :i :� f. � {, `? ,. �.:_ la. �. ._i <br /> �t`�� No. 28553 DATE - I <br /> HOtn <br /> Service Address —19.13�Sa — Utility Account No. -- <br /> Billing Address <br /> Clty, Slate,Zip Rw u YA 98Y04 Permit Feo $ gg,w <br /> Owner ^'r......... 6 (Iwhlwr ConnectionCharge <br /> Connectlon by n... Trunk $ — <br /> Address Lateral $ — <br /> Totat Connection Charge $ <br /> 1 <br /> � <br /> Phone �sa nno Utility Developmenl Fee � I <br /> ' 1 Legal Descripllon: Water $ �y �,,,;— , <br /> '�' Lot Sewer $ Ran_nn <br /> � 1 Block — Total Development Fee $ 9L.4 00 <br /> ��� 1 <br /> Plat _ � <br /> � •� Unplatted Descriptlon: Sewer Bond District I <br /> ��' I <br /> Abutting Lot Line <br /> !t ft. �II <br />� N,S, E,W <br /> i � Type of Permit Ner eonn.ecien Approved By <br /> '�' Remarks Issued By �wp! — J <br /> ��� Cusromer Slgnature_ — I <br />'I 1 IMPORTANTI <br /> ' CALL 1-800-424•5555 48-HOURS <br /> PRIOR TO DIGGING i <br /> ���s(•I...Y., ! <br /> Inspection By— <br /> CALL 259-8810 FOR INSPECTION z _� _�` <br />' Date Inspected _ <br /> SEE SKETCH ATTACHED No. 28553 i <br /> ir�sr�-ci iora <br />