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� � <br />H <br />9H�T,U�i <br />~T.H <br />� H 7�tl <br />��iIM� <br />fA H <br />��� <br />OH <br />��g <br />4� O❑ <br />�HtC <br />HH <br />gy <br />H <br />O qty W <br />C+1 <br />O� <br />� <br />:: :i: <br />;� <br />i ��' <br />i <br />���� <br />I <br />�:`, <br />:� <br />=� _ -, <br />,� � � <br />� <br />Sewer Application an� Permit <br />� ,i �i <br />c i _� _s w <br />_, r.i t. <br />�- 2 � � � � DATE rl 7-26-93 <br />�HART NO. <br />ro �osriNc_ �-�.,,� <br />Service Address ZZ8 Sk� Everatt M,:il k�ay <br />Billing Address <br />City, S�ate, Zip Everett WA 98208 <br />OwflBf Olivia Farlc Aseociates <br />Connection by Lynnwood Septic Tanl: Co Inc <br />Address PO Box 12466 <br />Mill Creek WP. 98012 <br />Phone 481-42;0_ __ <br />Legal Description: <br />Lot <br />Block <br />Plat <br />Unplatted Description: <br />TypeofPermit Altcration <br />Remarks <br />IMPORTANT! <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259•8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Accounl No. <br />Permit Fee $ _ 30. <br />Connection Charge <br />Trunk $ <br />Lateral $ <br />iatal Connection Charge $ <br />Ulility Development Fee <br />Water $ <br />Sewer $ <br />Total Deveiopment Fee $ <br />Sewer Bond District <br />Abutting Lot Line <br />N, g� E, yV ft. <br />Approved By <br />Issued By Tnt <br />, <br />, ' ,' .. '�/^ ;, ,...�—. <br />Customer Signature� `� " = �1 ' ^' �"' <br />i <br />Inspection By <br />Date Inspected � � <br />INSPECTION <br />, <br />I <br />� <br />. 2�:5�3 <br />----- -- --- — I <br />