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1 <br /> x �� <br /> Ch <br /> H <br /> t' HVJ <br /> K� � CHART N0. — <br /> � H� everett <br /> y�i b <br /> ��OK � s �- <br /> � Hd � � O �Q'S��/tq �0//W(R/ <br /> O � -� y �+ � � J <br /> ��,g � � � s � � � � � � : _, <br /> H City ot Everett �_ • � �: ;. � :�, p � ;: <br /> x F.,� :� i S � „,�� �' ,� � �. �: � =d <br /> ry ,: �. � :. �rmit <br /> g y y Sewer A,�phcatinn �rid �P ,. <br /> � -: . , � , <br /> C]t7N ^ `,, :� y ` �. %� � � ^ � � vc;,,' � <br /> �� � z� -. � _ .,tr . <br /> y� No. 2i 9 9'f J � GATE �ctot�es-la,-usoa--- <br /> HO�n <br /> Service Address , Utility Account No. <br /> Billing Address ���'� <br /> Ciry, State, Zip ��miood. w' QR°°� Permit Fee $ 30 00 <br /> Owner Connecticn Charge <br /> Connection by Trunk � . <br /> Address — Lateral $ <br /> Total Conneclion Charge $ 270.00 <br /> Phone Utility Development Fee <br /> � � Water $ z2a.00 <br /> ' ' Legal Description� <br /> � SBwBf $ tao nn <br /> � LOi g - - <br /> ' t Block _ Total Deveiopment Fee $ �13 "^ <br /> ��� <br /> Plat �ta__Cii.t <br /> � 1 Sewer Bond Districl Aona Ti <br /> P ' Unplaried Description: <br /> � Abutting Lot Line <br /> �' N�S,E,W ft. <br /> '�' Type o(Permit Approved By <br /> ��� Remarks Issued By � <br /> ��� Customer Signature � <br /> ��� IMPORTANT! <br /> 1 ' CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> Inspection By �c`�`�— I <br /> CALL 259-8810 FOR INSPECTION .-_ ,- <br /> Dale Inspected � 3 - �� <br /> I <br /> I <br /> ' SEE SKETCH ATTACHED No. 27991 <br /> o-is��C��io�d I <br />