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everett <br /> = TO PQSTING A�'R o s zoos <br /> � <br /> City of Everett � - � - ; '� � � "� � <br /> _ ., ' y.r ' ,r C <br /> _. .... ./ +e: �� L 1 <br /> .. , y � <br /> ._. .. I� ..t .a , <br /> Sewer Application ar�d��Peyr1mi# _ . ' <br /> 3 � 1� lJ � �. � '�i .� � � � 1� <br /> � � i� .3 � � — _ - a j :aJ J � <br /> NO. Z R 4 H J_ DATE <br /> 1Sct.�2I". �1941 ._ . _ . �. .:. .� '. <br /> Service Address _5729 Glennwood nve Utility Account No. <br /> Billing Address 16000 ttill Cresek Blvd �110 <br /> City, State, Zip M�11 Creek wn 98012 permit Fee $ 30.00 <br /> Owner � Nicholas Connection Charge <br /> Connection by �er ��ze c� �1�� �� Trunk $ 330.00 <br /> Address Lateral $ 395.00 <br /> Total Connection Charge $ 725.00 <br /> Phone 337-6611 Utility Development Fee <br /> Legal Description: Water $ 261.00 <br /> Lot Z of Short Plat 1202-22-89 Sewer g 6B8.0o <br /> Block Total Development Fee $ 949.00 <br /> Plat <br /> Unptatted Description: Sewer Bond District iii <br /> Abutting Lot Line <br /> N, S, E,W ft. <br /> Type o( Permit Nex connection Approved By ; <br /> Remarks Issued By _�iuqhes <br /> Customer Signature <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> InspectionBy � �"�+��'�� 'y^ <br /> CALL 259•8810 FOR INSPECTION <br /> Date Inspected /'/ y-9� <br /> SEE SKETCH ATTACHED NO. 28481 <br /> ir�sr�r_c1 ior� <br />