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CHART N <br />everett <br />e <br />City of Everett <br />cira,;y 7-2 / 89 <br />Sc wer Application and Permit <br />N.,. 27091 DATE v_r^h 7 19E9 L— <br />Service Address Utility Account No <br />Biting Address <br />City, State, Zip <br />Owner (Mortgagor) <br />Billing Name <br />Connection By <br />Address <br />Phone <br />DESCRIPTION: <br />Lot -- Block <br />Plat <br />Unplatted Description <br />Permit Fee 30.00 <br />Connection Charge(s) 600.00 <br />Total Fee 30.00 <br />Utility Development Fee Ord. 1171-65 <br />rater 261.00 <br />sewer 688.00 <br />949.00 <br />Signed <br />Type Permit: __ -� <br />Remarks: <br />IMPORTANT! <br />CALL 1-800.424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8911 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Sewer District bond I <br />U3I1:/89 ".tWil 000 447Y7 kkii: <br />Monthly Sewer Service ' <br />Monthly Sewer ConlW1,13 $-,W-50 <br />PI_lz 4100.00 <br />Trunk &lid 00 ' rv1 __ <br />1Y 11 I'N ;291.31 <br />Lateral r-440X0 <br />L �4tll $15.00 <br />Abutting Lot Line I>fVNY $20.00 <br />{000'71M; ft. <br />N, S, E, W SEHtfi ^l�:0.011 <br />EtO 1 $600.00 <br />1171-5 $949.00 <br />Approved By #'-L <br />Issued By su,v q�ygen <br />Inspection By a <br />Date Inspected <br />NO. 27091 <br />INSPECTION <br />