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q. <br /> ��1 Y � <br /> � <br /> ���� � �.: � � <br /> � � � <br /> CHART NO. <br /> ��� l everett <br /> �w ;! <br /> �. e -- ,� 6 <br /> �� CTI NGT�'�- <br /> �� Cityof Everett a,;'o�'�^ io:acr��i oix���a:�ti� crxi . <br /> iy � .. <br /> �y� � Sewer Application and Permit ����' �-��� <br /> �rr�.�� ��ws.uo I <br /> ,��e� ! r,�a: �s^s.co <br /> ��� ' NO. 2 8 6 3 3 DATE ■. � a ��x <br /> o� Service Address �—r�—�9�` `.�..�«--- Utiliry Accouat No. -- <br /> — : <br /> ' Bilii�g Address <br /> t Ci.y,State,Zip �►nill� 1tu 9l�70 P�rmit Fee $ �0.� — <br /> ' <br /> Owner ��+ m= Connection Charge <br /> Connection b�� � — Trunk $ <br /> Address Lateral $ <br /> Total Connection Charge $ 1+ — <br /> �, p��e _6S0 �7� Utility Development Fee <br /> r--..- <br /> ��� ! Legal Description: Water $ e� oe <br /> � 217.00 � <br /> � � Lot Sewer $ <br /> , i <br /> B�� Totai Developmont Fee $ ._ 299•00 i <br /> , , ��1 � <br /> ; • <br /> Plat <br /> � Unplatted Description: Sewer Bond District <br /> � i <br /> � �_1� Abutting Lot Line ', <br /> N,S, E,W n' � <br /> � � <br /> i ��� Type o(Permit Ns�l CmeniaC"rrw Approved By <br /> i <br /> Remarks Issued By J laockve11 i <br /> ; 1 '_' Customer Signature <br /> L. <br /> IMPORTANT! � <br /> `� CALL 1-800-424-5555 48-HOURS ! <br /> PRIOR TO DIGGING � �C`F;`��7i� <br /> CALL 259-8810 �OR IPlSPECTION Inspection e; .� � � ��� I <br /> Dale Inspected ���Q� ' <br /> �I <br /> SEE SKETCH ATTACHED N0. 28633 i <br /> INSPECTION <br /> i <br />