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everett <br />City of Everett <br />TO POSTING 3 ��9� <br />SEwer Application and P�rmit <br />NO. Z��3% DATE �_��_�1 <br />Service Addr2ss 7117 d 5 R LaWER RIDGE ED Utility Account No. <br />Billing Address PO BOR 2153 <br />City, State, Zip r•.vr+unrr v� os�n� <br />Owner nnuvaHk CflNCTRp!@TAN <br />� <br />Connection by � ,�,.,w.� �:. <br />Addre^,s <br />Phone <br />Legal Description: <br />Lot <br />Block <br />Plat _ <br />Permit Fee $ <br />Connection Charge <br />Trur k <br />Lateral <br />CHART NO. <br />� �;`�' $��5�� <br />o�. c•�c< <br />� � '� <br />u .� r> -- <br />a �� inO; ��O -,:� c. <br />� � � <br />u <br />����������� <br />a;t�� = c'c �_':.��� <br />$ <br />$ <br />— Total Connection Charge $ ` ._ <br />290-8479 Utility Development Fee <br />Water $ 261.00 <br />Sewer $ fi88.Q0 <br />Unplatted Description: <br />Type of Permit �EW CONNECTION <br />Remarks <br />IMPORTANTt <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Total Development Fee $ 949.00 <br />Se�Ner Bond District I i�ETIRED) <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />Issued By ������'S '�, �! <br />` ', I' <br />Customer Signature <br />Inspection By 7 ���e ,,,,, c,.„ <br />Date Inspected l-iy -� '- <br />INSP�CTIOf� <br />No. 28537 <br />ft. <br />