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R <br /> . 4T� <br /> 1 <br /> � <br /> �Su� CHART N0. <br /> ��� everett <br /> H I <br /> R�� �0 P�StIKG._���— <br /> � �'1�„a� 6o�GF�n Ua7wpte��� a:.�i <br /> o�� I City of Everett ! <br /> �JOQ:"�b0i � <br /> o� � Sew�r Application and Permit �� R�°•°° <br /> �v� pi t�.a� �� <br /> �� � c �:�+a� �a.so ' . <br /> c��ur a�.ao <br /> a No. 2 8 5 4 2 DATE 12-16-91 ' " <br /> � i ,n.00 <br /> � 4012 Colbv Av. Utilit ACCouniNo. !�� g:�,o,� _ �I <br /> Service AGdress Y �u! �s i�,�s,� <br /> '�� II Biliing Address 17Q1 41ac St /10� <br /> Ciry,State, Zip a v, oa�ni Permit Fee $ 30.00 <br /> Owner William P. Bruet Conneclion Charge ' <br /> Connection by �G BrAndvold Trunk $ <br /> Address 5307 139th SE lateral $ - <br /> /, . <br /> � Snnhnmt rth VA 9829D Total Connection Charge $ -- — <br /> � C', Phone 568-9342 — Uliiity Development Fee <br /> 1 � Legal Descriplion: Water $ 104 23 <br /> ��� Lot 27 6 28 Sewer $ 2�4•�� <br /> � <br /> Block �1 Total Development Fee $ 379 00 __ <br /> ._� Plat Climax land Co lst add Citr of Everatt <br /> i L�' Unplatted Description: Sewer Bond District — <br /> Aburiing Lol Line � <br /> � � <br /> �I� N,S, E,W (t. <br /> Type of Permit Kew connection Approved By <br /> � Hughea <br /> � ��� Aemarlcs Issued By <br /> �� Cusromer Signature <br /> � <br /> ��+( IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING � <br /> Inspection By � `�'����" "— <br /> CALL 259-8810 FOR INSPECTION Z _�X _y L <br /> Date Inspected <br /> SEE SKETCH ATTACHED No. �I.S�A Z <br /> IP:�!'�CTION <br /> � I <br />