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�'1� . ' - � _ � � �. .0 �r� .. �� � � �,_' �_�_ _ :�.-. ' . . <br /> ' � � � - ,. � � � -' � ��..- . ; �� � � , . �: <br /> . .,. ' r- . } , . -� �� �� ,: � <br /> � rc — ' � 1 <br /> � <br /> .� h :r � �� �I ., •-�<. 4 . 'i�::. <br /> CHART NO. <br /> everett . -L.� ,� :, {_; .:• <br /> � 1� �j1 . <br /> :� <br /> �, <br /> ,_' � s �,' `_ - <br /> � � = � �- - . <br /> Ci3y of Everett� - , ,.- _ � - <br /> Sewer Applicati�n ar�d I�errrnit <br /> , _ _ _ _ J - _ _ <br /> � . :� � , . _ , - <br />. � J r �--� r - - - - ._ . _ ^" - � <br /> J� � �. .�. ... �. ._ � , <br />, NO. ��.�. GATE , ilurct� 11 tq�i <br /> Service Address ?"�'9 ` " *'^• � ny� — Utiliry Account No. ; <br /> BillingAddiess --z-m--='n.' I <br /> 3 Q.QO <br /> Cily, State, Zip _ Permit Fee $ <br /> Owner , Connection Charge <br /> Connection by �"' � � �n cuw � � < <br /> Trunk $ "" n� II <br /> Address <br /> Lateral $ 450.00 _ <br /> �i Total Connection Charge $ 7^0 40 <br /> II Phone 337 715z _. Utility Development Fee <br /> I Water $ _ '161.0�_ <br /> Legal Description: <br /> Sewer $ F^^ nr <br /> � Lot <br /> Tolal Development Fee $ ` ; <br /> Block <br /> i Plat <br /> Unplatted Description: Lot 'i SP ]�–��� Sewer Bond District <br /> ••� � TT <br /> IAbutting Lot Line <br /> i N, S, E,W n� <br /> Type of Permit :7er• connection�— ApProved By <br /> Remarks <br /> Issued By MBLF�ret :"•cLeod <br /> Customer SignaWre <br /> IMPORTANT! <br /> CALL 1-8�0-424-5555 48-HOURS <br /> PRIOR TO DIGGWG j�y�,� <br /> Inspection By <br /> �ALL 25H-8810 FOR INSPC-CTION .�/-L s'-i/ <br /> I Date Inspected _ <br /> I <br /> i No. 28171 <br /> SEE SKETCH ATTACHED <br /> Iir,iqi'u.�:�Tl!�P' �I <br />