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everett CHART N0. <br /> Clty of Everett u��,,.u,��i ��:�;�,�u, a��sn°Krso � r!z <br /> • • . Hc0.11k72� � <br /> ewer Application and Permit �.� <br /> PLH CN <br /> !I[IOD2B40.^' <br /> NO. 2$402 DATE �a,,.« �n, 199� � <br /> �:tisF� ut.�w <br /> Service Address 6 Utility Account No. <br /> Billing Address --��E-379L1�-�'-�6 <br /> Cfty,State,Zip �tti., ea oa»q Permit Fee $ ao.00 <br /> Owner 9o�toq ao — Connection Charge i <br /> Connectlon by Trunk $ I <br /> Address Lateral $ <br /> Totel ConnecQon Charge $ _ A„ <br /> Phone Utility Development Fee <br /> LegalDescrfption: Water $ i�1�3_M <br /> Lot Sewer $ - <br /> Block Total Development Fee $ i ila_�5 <br /> Plat <br /> Unplatted Description: Sewer Bond District g�� �y <br /> Abutting Lot Line <br /> N�S� E,W _ ft. <br /> Type ol Permit ��� �,���m Approved By <br /> Remarks Issued By S ��^—» _ <br /> Customer Slgnature � <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING � ,, ,. , � <br /> Inspectfon B /�r <br /> CALL 259-8810 FOR INSPECTION • ��'-- <br /> Date Inspected 7 _ <br /> SEE SKETCH ATTACHED No. �P� '��'' <br /> INSPGCTION <br />