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_ � __ <br /> ------ ------ <br /> -------- --- <br /> --- - - - - - --- - - — ------- ,.. _ <br /> r. - ._ . : ;,._ _:;, �-. ,._ ICHART NO. -- 'i <br /> t.' <br /> � TO POSTIiVG co—��-T �, <br /> I r Gi O `J II � <br /> I <br /> � _ �� � T � <br /> Se�nrer Application and _P�rm�,it _� , � . 'i <br /> _ �. , <br /> - � _ ; : <br /> 29� '�:s oa�re `� 9 °4 �, <br /> �I <br /> Semice Address 21?.1 Hoaard Av�� _ Utiliiy Account No. - ' <br /> i <br /> Billing Address r� 130:{ 3014 __ I <br /> City, State, Zip Ev�,rett WA 98203 Permit Fee $ '�•�� ' <br /> Owner The Treduay Cocp Corinection Charge <br /> Connection by �r,r��.r Trunk � <br /> Address — Lateral $ � <br /> Total Connection Charge $ ��� ' <br /> Phona 347'-�'-�'�` Utiliry Development Fee ; <br /> Legal Descriplion: <br /> Water g 179.00 <br /> 16 S 17 Alk ii of Plnei�ur�t � 471.00 il <br /> , Lot — Sewer <br /> Block — <br /> TotalDevelopmentFee $ �5�•00 ' <br /> Plat — <br /> IUnpiatted Description: -- Sewer Bond District i <br /> 'I __ Abutting Lot Line ' <br /> � _ N, S, E,W tt' <br /> � <br /> Type ot Permit new cormaccinn Approved By I <br /> Remarks . Issued By ' <br /> I __ Customer Signature — <br /> I <br /> I IMPURTANT! <br /> I ; <br /> � t:ALL 1-800-424-5555 4�-HOURS <br /> I PRIOFl"f0 DIGGlNG <br /> � Inspection 8y �x� <br /> ' t,ALL 253-(iE310 FAR INSPECTION ��� �j; <br /> � Date Inspected �— <br /> I I <br /> 'I SEF SKETCH ATTACHED , ?Q� �� I <br /> I INSPECTION <br /> I _ _ <br /> , -- __ _ _ <br /> -- ���;�� _ - <br />