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CHART NO. <br /> everett <br /> :>�-�,� -f-� �>�3��.ty 7-//-4/ <br /> City af Everett ��'7;'lit,'yl lit:i:ilil flLlii�i)!';(:i"/ , <br /> ! <br /> . . . !.re��res�z� <br /> Sewer �,pplication and Perrr�it =��Nh a;�,.��: <br /> i IiF.Ct.' tiO.V[i <br /> �I No. �8326 DATE Suly � - 19q1 <br /> Service Address »�n v .� Utili!y Account No. <br /> Billing Address " <br /> City, State,Zip „ � ggr---- Permit Fee $ 10.00 <br /> Owner k �irwash Connection Charge <br /> Connection by Trunk $ <br /> Address Lateral $— <br /> _ �L_yy� � —__ Total Connection Charge $ <br /> Phone 7{3 }ggy — Utility Development Fee <br /> I_egal Description: Water $ <br /> Lol Sewer $ <br /> Biock — Total Developrnent Fee $ — <br /> Plat <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> N,S, E,W _ n. <br /> Type of Permit ygparo Approved By <br /> Remarks Issued By s �ckNall <br /> _ CustomerSignature _� <br /> IMPOR7 ANT! <br /> ' CALL 1-ti00-424-5555 48-HOURS <br /> PRIOR TO DIGGING � / <br /> C��� <br /> Inspection By <br /> CALL 259-8810 FOR INSPECTION <br /> Date Inspected �-�' ��� <br /> SEE SKETCH ATTACHFD No. 2832G <br /> WSPECTION <br /> I <br /> i <br />