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a,..� <br /> � <br /> t <br /> � <br /> '��� <br /> Q� � <br /> � � <br /> �� CHART NO. <br /> ��� everett <br /> ��� e � _ _ <br /> �� - � G. � � ;. TO PQSTING �, � <br /> p�g City of Everett= " � � , �s , � ;* <br /> -+f .. ..t ,�- "` ` . <br /> �~� Sewer �{��lica�io� a��id Permit <br /> g� = �� � � � � � � � _-� .=: <br /> ��� I �S � � .. � _ � _ _ <br /> NO. �g33� DATE <br /> �ow � _ <br /> Service Address Utility Account No. <br /> Billing Address <br /> City,State,Zip <br /> Permit Fee $ +� � <br /> Owner +� ^�-� * * — Connection Charge <br /> Connection by Trunk $ <br /> Address Lateral $ — <br /> Total Connection Charge $ -0 <br /> Phone Utility Development Fee <br /> �� Water $ "9 � <br /> Legal Description: <br /> ' Sewer $ avt en <br /> �� Lot _ <br /> Block Tatal Development Fee $�QQ <br /> j Plat <br /> I � Sewer 8ond District <br /> I �� Unplatted Description: <br /> I Abutting Lot Line <br /> I <br /> N�S,E,`N ft. <br /> I � ' Type of Permit xr� �*+�^"*�'Dt — Approved By <br /> � '� Remarks <br /> Issued By <br /> '� Customer Signature <br /> i i <br /> I � IMPOR7ANT! . <br /> \ CALL 1-800-424-5555 48-HOURS �'i <br /> PRIOR TO DIGGING ' I � <br /> Inspection By <br /> �!�� -�-- I I <br /> CALL 259-8810 FOR INSPECTION Date Inspected � �� II <br /> I I <br /> SEE SKETCH ATTACHED No. 28330 I � <br /> ' l <br /> INSPECTION ' i <br />