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5� <br />�K � <br /> p�^^„R".T's'�.aa°brvr,a•--'-�-�--�--1,�:..'�d,i�j'- �.C_ .� � __ _ .n�.',5..-P3!�'v^T'.'PyT�.^c'^^—;.; .. <br /> � . . . Fi��M�.:�1�.�F.-+.�.v. . <br /> , , • CHART NQ —_— <br /> tn nncrrNc ,�_�� <br /> ,:.:�„s� . �,,.�, �:,�,�,�,��, , � . <br /> .��:��� <br /> Sewer A.pplication and Permit ����� ��7��.-�� <br /> r��[� t�i�.�u <br /> trEi:H f11i�.�-a <br /> 12-22-9_ 110G 5:0.�+� <br /> 28997 DATE ' <br /> ��whr.� s:o.:a. <br /> ServiceAddress 47Zg Glenvood Ave UtilityAccouniNo. u'���'���' - <br /> 11l;ER 5'70.CA <br /> BillingAddress ��3 SE Everect riall Way PC CHDi] t7Z0.Ct� <br /> Everett WA 98208 �1 � 0 5��� �� <br /> Ciry,Stete,Zip Permit Fee $ c(�C� a^E'^.tY� <br /> Owner Ceorge Dno Connectlon Charge <br /> n <br /> Connectionby a+""r r�n�LL, �.�seti Trunk y 270.00 <br /> AAdress Lateral a 450.00 <br /> TotalConnectionCharge S ffi3Y&C 720.0� <br /> Phone 353-6500 Utility Development fee <br /> Legal Description: Water S Z=4.00 <br /> Lot Sewer g 589.0(1 <br /> Block Total Deve�opment Fee $ g13.00 <br /> Plat <br /> Unpiatted Description: Sewer Bond Dislrict _ II <br /> _ Abutling Lot Line <br /> N,S,E,W � n• <br /> TypeolPermit Hev connaction ppproved By <br /> Remarks Issued By � <br /> _ CustomerSigneture ��� �iO' �`"�— <br /> IMPORTANTI �/ <br /> CALL i-800-024•5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8810 FOR INSPECTION �nspection By '��'�+A� <br /> �" � � " Date Inspacted f- 7��'� <br /> SEE SKETCH ATTACHED <br /> INSF[CTION � _� �J-C°"7 <br />