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�C� <br />tn <br />A � x <br />C H <br />9 H [n <br />� <br />H�� <br />�C c� <br />H xl <br />h] H �{1 <br />f/1 H <br />Hx <br />�HC7 <br />H C���] O <br />c�� o <br />9H� <br />, <br />r H H <br />g� <br />H <br />C'] C7 � <br />��� <br />zy�n <br />H O f/� <br />�� <br />% � �„1 <br />� <br />a � <br />� � 1 <br />everett <br />� <br />City of Everett = <br />Sewer Application and Permit ; <br />� <br />NO. 28 �� �. DATE Fr.b. in, 199? _ <br />�(,;(� ( LOit1 �arpi /1 _ <br />_.IflA=AB-3 /71fL'� <br />Service Address ' �'�� • Ulilily Account No. <br />Billing Address 15707 Adnirnity Fnv r 4 <br />City, State, Zip Lynnvood wA 93037 Permit Fee ffi 3rJ. r��� <br />Owner Jnaer, W. Schuler Connection Charge <br />Connection by Trunk $ <br />Address Lateral $ <br />Phone 54G-33o4 <br />Lega! Descript;on: <br />� JI <br />Block <br />Plat <br />Total Connection Charge $ <br />Utiiity Development Fee <br />Water �o <br />Sewer $ <br />Total Development Fee � <br />Unplatled Description: Sewer Bond District <br />Abutting Lot Line <br />N, S, E, W — <br />Type of Permit - connection (�L�- Approved By — <br />Issued B NuF,` <br />Remarks Y <br />Customer Signature <br />IMPORTANT! <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FGR INSPECTION <br />SEE SKETCH ATTACHED <br />Inspection By _ <br />Date inspected <br />�; �;�r��c, ; �r; <br />No. 28601 <br />(t. <br />