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��� <br />ay <br />��H <br />> H CA <br />y zH <br />o xo <br />`-7 H '�J <br />y � C' <br />e� o � <br />�d <br />O H <br />�rg <br />�� n <br />9 H� <br />~Hy <br />g`� <br />H <br />C] C7 C� <br />�r�3-r <br />e� n <br />zym <br />H O [/� <br />everett <br />� '; <br />-- �•�- <br />Cit/ of Everett - '� ' " " <br />� " :i <br />�l w � µ ~ W!. �I1_ <br />Sev�er Applica�ion _and Permit <br />zo�"����� <br />[� ::i — ' � :c — <br />No. 28796^ �DA7E�' �/25/9z <br />S@NICB Addf25S SOl innr 7 flr <br />Billing Address <br />City, State, Zip �erett Aa 98201 <br />OWRBf — C,pn •�.p HPV1And <br />Connection by <br />Address <br />Phone <br />Legal Description: <br />� <br />F '1 Lot <br />�.. ,� <br />Block <br />� y, 1 Plat <br />Unplaried Description: <br />9� �'� <br />� s <br />Type of Permit Aiceration <br />Rertiarks <br />IMPORTANT! <br />CALL'I-800-424-5555 48-HOURS <br />PRIOFi TO DIGGING <br />CALL 259-$810 FOR INSPECTiON <br />SEE SKETCH ATTACHED <br />. <br />Utility Accounl No. <br />CHART NO. <br />TO P�S?I��G_ z-�o-_� <br />Pzrmit Fee S 10,C0 _ <br />Connection Charge <br />Trunk <br />Lateral <br />Total Conneclion Charge <br />Utility Development Fee <br />VJater <br />Sewer <br />Total Development Fee <br />� <br />$ <br />$ <br />$ <br />$ <br />� <br />Sev�er Bond District <br />Abu.ting Lot Lin� <br />N, S, E, W__ ft. <br />Approved By — <br />Issued By <br />Customer Signature •---�� <br />% % ' i� � , <br />Inspection By '/�� //� 1����r'� ."'���� <br />Date Inspected 2 - ��— �� <br />���'``o �-''�� <br />v <br />INSPECTION <br />No.2879a <br />