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�.��� <br /> � <br /> � <br /> � <br /> ;:. <br /> ��� _ _ <br /> d � <br /> s� ia CHART NO. i <br /> ��� I everett <br /> ��� TO POSTING �� a <br /> �= e _ :� � Q� - ;� � �; � $ �� <br /> �� City of Everett � `" :? .� :� - '•� �' � � �, �' <br /> ��g ,Y �; � n <br /> Q� � Sewer Application and Per�it ; ;� � � s � � � � �; � <br /> �y� � , s � �.. � � I. <br /> 1-�H � � � LL � wr.. � ��! ;., � � a� c"3. I <br /> g�� NO. 2HSC>G DATE �yy--- <br /> � Utility Account No. <br /> y o� Service Address <br /> Billing Address <br /> Cily,State,Zip <br /> Permit Fee S �� �� <br /> Owner E $� �Y �J Connection Charge � <br /> Connection by Trunk $ I <br /> Address Lateral $ I <br /> Total Connection Charge $ <br /> Phone Utility Uevelopment Fee I <br /> \ $ � - <br /> �C�, Legal Description: Water <br /> � Sewer $ <br /> � Lot . <br /> Total Development Fee $ <br /> ,_�1 Block <br /> L� <br /> ' . Plat °t.^� °^ <br /> Unplatted Description: — <br /> Sewer Bond District I (retired) <br /> � �� Abutting Lot Line <br /> N,S.E,W n <br /> �z� I I <br /> �� Type of Permit Approved By j <br /> ' . i <br /> Remarks Issued By <br /> �-::_ _ I <br /> __. . ._._ <br /> I 'l� I <br /> � Customer Signature y <br /> �� <br /> ' IMPORTANT! � <br /> i <br /> �� CALL 1-800-424-5555 48-HOURS ' <br /> PRIOR TO DIGGING i <br /> Inspection By C' `�e%"� � � <br /> CALL 259-8&10 FOR IhlSPECTION Date Inspecied 5 '� 5 � 7 Z '� �I <br /> SEE SKETCH ATTACHED <br /> No. 28fi66 , � <br /> INSP�CTION � I <br />