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CHART N0. ��-�' `' "� <br /> �_ :�tt —i' _. _ <br /> r -.._.-. <br /> City of Everett <br /> ��ewer Ap�licatian and P�r�o�r�# `� <br /> No. 2 8 0 6 6 DATE �- 2�/-.- `/ I ___ � <br /> Service Address ���N o�__ Uti;ity kccoun? No. ------ -- <br /> Bi!Sng Address -- — ._.-- <br /> City, State,Zip —.--- ?ermit Fr-�� � <br /> Owner _ -- Corinectiun Charge <br /> Connection by �f�.. b �' �L e 1-�"C� Trunk $ <br /> Address _ — __ La,eral $ <br /> — ----_—.—__ Tolal Connection Charge $ _ <br /> Phone ___.____._______ UtilityDevelopme.rtFee <br /> Legal Description: Water $ <br /> Lot __._� _ Sewer � <br /> Biock _— Total Development Fee $__— <br /> Plat <br /> Unplatted Descripticn: Sewer Bond District <br /> Abutting Lot Line <br /> — N, S, E,W fl. <br /> Type of Permit �@1_�e��4r_z_d � � Approved 9y _ <br /> Remarks ol /cJ'� Art/f�,u . n Dlit o (aJt/O Issued By_[�c>>v Nl � 1 I P. N <br /> 1.L-E o�. .-NA.,v f n' �C�itc�d CustomerSignature— <br /> S�� Sste�v.e2 /�-2e.�I'��!'��N Tc, <br /> �o� o� S�MPO�A�T! �., P�'C.. <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING ,o „ <br /> i CALL �59-8810 FOR INSpECTION Inspection ey� <br /> � ���� -�] • � , i o p �t S P, (� ��J . Date Inspected / - ��• �_ <br /> s � cL'- �u.l.esz. � ' �. /�Z ' N <br /> � SEE SKETCH A7TACHED No. ��3 U E� 5 <br /> � M� C ����� <br /> cus�or.�r r� coP��� <br />