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r <br /> i <br /> i <br /> I <br /> I <br /> CHART NO. <br /> everett � <br /> , <br /> . � ;� � <br /> `" — <br /> � j N; ,�1 ��' � 10 t�a5 IIJ�h <br /> Clty of Everett ,r��s o c � � <br /> � �. ��� <br /> Sewer Application and Perr��t� � � �-� ; : ,.;�;,r? t � <br /> � �� � J� ' ,� ri <br /> No. 27907 DATE y�.�6io�1 <br /> Service Address Utiliry Account No. <br /> Billing Address .�510 v ''� •trmJ""""' <br /> City,State, Zip • ' ++� o W► f1BZ75 Permit Fee $ �•a� <br /> Owner Connection Charge <br /> Connection by Trunk $ , <br /> Address Lateral $J;sn nn <br /> Total Connection Charge $�:�,� <br /> Phone Utility Development Fee <br /> Legal Description: Water $ _ <br /> Lot Sewer $ , <br /> B�� Total Development Fae $ . <br /> Plat x •« c� i vi � �i�n�_a�rto <br /> Unplatted Descdption: Sewer Bond District !�` ' �� <br /> Abutting Lot Line <br /> NSEW ft. <br /> Type of Permit Approved By <br /> Remarks Issued By <br /> Customer Signatu�' ,` <br /> - IMPORTANT! / � <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> �' � ; : <br /> inspection By <br /> CALL 259-8810 FOR INSPECTION <br /> Date Inspected <br /> i <br /> � <br /> SEE SKETCH ATTACHED No. Z7sO7 <br /> INSPECTION <br /> I <br />