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� <br /> � <br /> i <br /> �"� <br /> D� x i <br /> p M <br /> �HV� <br /> K� � CHART NO. — <br /> �� � I everett <br /> �� � Pj - r0 posri,y,; � <br /> ��g - _ , <br /> �� � I Clty of Everett = : , �`\ I <br /> �H� Sewer A lication :a ��d`� rrrtit �� � <br /> gyH �p � :' ', �� . __ .: _ ' I <br /> � �, :_ _ . � � :.- _ - _ _ _. <br /> � - = 4 _- � <br /> N0. 2$6�.4 DATE " s �,'' io� ioa�� ' � <br /> ��� .. _ <br /> Service Address Utility Account No. i <br /> BIIIing Address ^^.-;ux–l�Cl kS OY-7L <br /> City, S�a�e, Zip S�u� 9Al2L Permit Fee $ _�p,nn _ <br /> i <br /> Owner Connection Charge i <br /> Connectlon by N a r+ w Concr Iar — Trunk $ I <br /> I Address ���>> » • �v� 41 La�eral E <br /> I 1 <br /> iF.dmond� WA 4H026 Total Connection Charge $ i <br /> '�1 Phone nR–R2no Utility Development Fee I <br /> �i � <br /> ��' Legal Description: Water $ <br /> '�' Lot --- Sewer E I <br /> +�' Block To�al Development Fee E � . <br /> I <br /> '�1 Plat i <br /> ' ' Unplaqed Descrlptlon: Sewer Bond District — <br /> Abutting Lot Line � <br /> 1�' N,S, E,W h• I <br /> Type ol Permit ,�� ���_�,�n Approved By <br /> ' Remarks Issued By— H. Hughee ; <br /> �' Customer Signature I <br /> ��' IMPORTANTI � <br /> � <br /> � CALL 1-800-424-5555 48-HOURS <br /> I PRIOR TO DIGGIrIG / �--�- � <br /> / yi ; <br /> Inspection By�—���/ l ��� <br /> CALL 259-8810 FOR �NSPECTION / <br /> Date Inspec�ed —�_ ' ' ( ` = <br /> � � , <br /> SEE SKETCH ATTACHED rao. 2S�iI. � <br /> � I <br /> '�NGi�':CiION I <br /> I <br />