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� �i <br /> � i <br /> � <br /> ' i <br /> . CHART NO. � <br /> everett � <br /> � <br /> Cfty of Everett <br /> Sewer Application and Permit <br /> NO. ZH4� 5 DATE .,_ ��?a, iooi _ <br /> Service Address 3827 rrida3 r��� Utility account No. <br /> Billing Address „ <br /> Ciry, State, Zip _ a e y Permit Fee $ }g,AH <br /> Owner ,acc r c •son Connection Charge <br /> Connection by Trunk $ <br /> Address Laterai $ <br /> Total Connection Charge $ <br /> Phone Utiiity Development Fee <br /> O0 ��/!lt 1:-i"Tii i�OU�)�t8c5ri i ! , <br /> Legal Description: Water $, _ � <br /> NibAl'£��i[l:� <br /> Lot Sewer ���� , <br /> Block Total Development Fee c'�"$� �tU.O� _ <br /> Plat <br /> Unplatted DescripNon: Sewer Bond District <br /> Abutting Lot Line <br /> N,S, E, W ft. <br /> Type of Permit �e a "�'"� Approved By <br /> Remarks F � _ Issued By <br /> 382�{ �nra•. a .. � �. <br /> Customer Signature <br /> �ar�k /' <br /> b ��,MPORTANT! � � �/ne Cur'P�y cfet�s a�c cV � <br /> /'lil v�i vl�.`�. / . <br /> CALL 1-800-424-5555 48-HOURS u��'ISlk� �c{��1�� ,,�-p� (a.L� � <br /> PRIOR TO DIGGING �K W� �i,i„-� <br /> CALL 259-8810 FOR INSPECTION Inspection By � ���� K/►Q� <br /> Date Inspected j �� <br /> SEE SKETCH ATTACHED No. 28405 <br /> INSPECTION I <br /> ( .. <br />