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CHART N0. <br /> everett <br /> T� D(►cTINf _ 3�0 � <br /> City of Everett a����s%v: ��:r.;en �xx�n�v� ►ssr <br /> i <br /> Sewer Application and Permit ��' �t�.� <br /> Clifal I I O.OD <br /> N0. 2 S F�7 DATE Marah 6. 1992 _ <br />, Service Address ��*R ��'! � Uplity Account No. <br /> Blllinp Address " ' <br /> I� �` Clty, Sfet9,Zlp ^w �� w ���^� PBfIDit F88 $ '.0 DO <br /> fd ; Owner �� ������� Conneotlon Charge <br /> Z <br /> ; Connoctlon by .'.i^ �-� Trunk S <br /> Addresa Laterel $ <br /> q,y�� �p yo�g� Total Connedion Charge $ <br /> Phone Utilfly Development Fee <br /> Legal Descriptlon: Water $ <br /> � Lot Sewer $ <br />' � g�� — Total Development Fee S <br /> � Plat <br /> i <br /> � Unplatted Descdption: Sewer Bond Distdct <br /> � Aburiing Lot Line <br /> N, g, E,yy ft. <br /> s <br /> � Type o(Permit .,��r�r�.. Approved By <br /> ti " <br /> �: Remerks Issued By /� <br /> � ,' / -; <br /> r <br /> CusromerSignature�, �' '�-- ` <br /> � <br /> IMPORT/',NT! <br /> i <br /> CALL 1-600-424-5555 48••HOURS � ' <br /> PRIOR TO DIGGING <br /> ` � � ! C.1/ _ <br /> " CALL 259-8810 FOR INSPECTION Inspectlon By <br /> Date Inspected 3/ (�' / �j Z- <br /> SIEE SKETCH ATTACHED No. ZBGZ7 <br /> INSPECTION <br /> I <br />