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� � � <br /> H <br /> � CHART N0. <br /> i <br /> ��� everett .,, <br /> Ky � %= � <br /> � NH � '� ?� TO POSTiNG � -z6 -�L <br /> - �� <br /> � y � City of Everett = `'• _ _ - _ � v: <br /> T C'J <br /> O H i . .. � � .s-c. <br /> H <br /> �� g Sewer Appli�ation and�Permi^� :: <br /> �iy� �--., :� .. _ _ `_� � x _i � i <br /> z `= 3U= �=� I <br /> g y H NO. ;Z H Z 9� DATE "��v �s i�9i � - -- - <br /> oG �n <br /> �� � Service Address _ �50.L*^^��r�� "� Utility Account No. <br /> H � � Billing Address 12031 7th Pl sE � <br /> Ciry, State, Zip Lai:e stevens t:n5e258 Permit Fee $ 30.oo #ScA3s7�sxd <br /> Owner �uah�+�Sr� Connection Charge <br /> Connection by xnt nq�+ r��4t Trunk $— <br /> Address g111 31st Ave xe Laterai $ <br /> .�p.-..a..ii1� Total Connection Charge $ -�' <br /> Phone r.sn_s�iz Utility Development Fee � <br /> Legal Description: Water $ �F QS <br /> ��1 71.05 <br /> Lot �"��* r � � Sewer $ <br /> '�' Block Block 313 Total Development Fee $ 9Q•�� <br /> '�' Plat itilton`s 2nd Addition <br /> �vl Unplatted Description: Sewer Bond Dislrict � �'ti` � i <br /> p�e Abutting Lot Line � <br /> ��' N, S, E, W h• <br /> '�' Type of Permit Nev ronnaeeion Approved By <br /> 10' <br /> s <br /> Remarks '� Issued By Nwraarat enrT.eod � <br /> 1�' � /�-r / <br /> '�' � � �i /1� Customer Rignature <br /> ✓• ' <br /> ��� IMPARTANT! <br /> ��' CALL 7-500-424-5555 48-HOURS <br /> + PRIOR TO DIGGING <br /> � <br /> Inspection By <br /> � C�LL 259-8810 FOR INSPECTION <br /> Date lnspected <br /> SEE SKETCH ATfACHED ND• 282Q6 <br /> INSPECI"ION <br />