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everett <br /> CHART NO. f <br /> Tn ancTING � "��-�'`� <br /> City of Everett n��i�;v,: �,;�.��n +tx�,�d:��, t; ,� <br /> > .. <br /> Sewer Application and Permit �� �.� <br /> i�r�kg <br /> '�1#F' t�.50 <br /> NO. 2 8 6 4 5 DATE w.� ie_ i�� "��'"a'�" <br /> k!1CMY._^f:Ue4 • <br /> Service Address 270i �li�} aw Utility Account No. ��T' ��.� <br /> Billing Address �02>>1 it ���� <br /> !: °.,F�CH ti.SO <br /> Ciry, State,t '7��� �'t•� <br /> P av�wts, � lHei Permit Fee $ z_se <br /> Owr�er �zrtt wt�al e��iaa� �a� Gonnection Charge <br /> Connection by �.� Trunk � <br /> Address Lateral $ <br /> Total Connection Charge S <br /> Phone Utility Development Fee <br /> Legal Description: Water $ <br /> �-Ot Sewer a <br /> B� Total Development Fee S <br /> Plat <br /> Unplatted Description: Sewer Bond District _ <br /> Abutting Lot Line <br /> N, S, E,W n. <br /> Type of Permit G1!-Ot! Approved By <br /> RemaAcs Issued By J ac�*•�++ <br /> Customer Signature <br /> IMPORTANT! Q,�r <br /> �.�C <br /> CALL 1-8(l0-424-5555 48-HOURS �o y �� <br /> PRIOR TO DIGGING �� <br /> CALL 259-8810 FOR INSPECTION Inspection ey <br /> Date Inspeded <br /> SEE SKETCH A7TACNED No. 28645 <br /> INSPECTION <br />