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everett CHART NO. -- <br /> � Y <br /> Clty O}EVeIB1t _ _ � _ �, _ �, , <br /> r <br /> l ' - ._ .: _ � 'r'�r':{ . <br /> Sewer Application �nd Per�ii� .� ' <br /> � � : �; _ - , fz � x� �� <br /> �� <br /> ;� : -,� -: _ � 3 I <br /> �_ _ � � � � -: _ <br /> No. 28358 �ai� �,. �e ,�, <br /> Service Address 16u adqs°°r fn Utilily Account No. <br /> Billing Address — 919 — BDeh tl p __ <br /> CIry,State,Zip ��ee, �n �eeeu __ permit Fee S �0.00 <br /> �'+^ef �r9ta +a�rt -- Connection Chttge <br /> Connection by _ Trunk § <br /> Address _� teral S <br /> --��I� Total CannecPon Charge y <br /> Phone __ J Ulility Development Fee <br /> Legal Description: \�' � Water $ i:�_oe <br /> Lol `� � Sewer y <br /> Block ' Total Deveiopment Fee S 72�•OcL_ <br /> F�at ���� � <br /> Unplatted Descdpqon: ^ Sewer Bond District �� �1 __ <br /> �� Abuttfng Lot Line <br /> � <br /> N,S,E,W ry, <br /> Type of Pertnit m amac�al Approved By __ <br /> Remarks �o �i Issued By � +�*r» � <br /> Cusromer Signature <br /> IMPORTANT! <br /> CALL 1-800-424•5555 4B-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8810 FOR INSPECTION Inspectien ey <br /> Date Inspected <br /> SEE SKETCH ATTACHED r,o. 28356 <br /> iNSPECTION <br />