Laserfiche WebLink
" IC'-`4RT N0. — <br /> everett <br /> Clty of Evemtt o�;iar� s:�k <br /> o�a xu.t <br /> Sewer Application and Permit ' <br /> NOprl',6019 <br /> B SRqi 'L4.50 <br /> qp00296w7 <br /> NO. Z g 6 4 7 DATE �Mh�a, +ooz � �"'� <br /> B SG'171 14.� <br /> Service Address �'^� ^++�— •— Utllity Account No. ��^^^^^�°' — <br /> SEMER �.SD <br /> Billirp Address , "-'---- '--. ppr�l <br /> Gty,State,ZIP , Permit Fee $ 3 �CH � f4.50 <br /> pW�� .ram Connection Charge Q �� �"'� <br /> �iEC7; 3..3.�0 <br /> Connecdon by �+.� Trunk S <br /> Address Lateral $ <br /> Total Connectbn Charge S <br /> p�� Utilit� Qevelopment Fee <br /> Leyal Description: Water S _ <br /> �t Sewer $ — <br /> g� Tolal Development Fee S — <br /> Plat <br /> Unplatted Descriptio�: Sewer Bond District — <br /> Abuttfng Lot Line <br /> W� g� E�yy ft. <br /> Type of Permit t�w+�+ Approved By <br /> Remerks Issued By <br /> Customer Signature <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8810 FOR INSPECTION Inspectlan By_ — - <br /> Date Inspected <br /> SEE SlCETCH ATTACHED No. 28647 <br /> wsP�cTior, <br />