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C3 <br />LO <br />Sewer Applicatio <br />29431 <br />ti s� <br />�4 <br />n and ,Permit <br />`t o Ci 4t <br />G <br />DATE 9/29/93 <br />Service Address 1302 hemlock <br />Billing Address 1401 Pnpl,r <br />City, State, Zip Everett NA 98201 <br />Owner Everett Housing Authority <br />Connection by DEB plumbing <br />Address 3032 95th Dr SE <br />Everett NA 98205 <br />Phone <br />Legal Description: <br />Lot <br />Block <br />Plat <br />Unplatted Description: <br />Type of Permit Alteration/Repair <br />Remarks <br />IMPORTANTI <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />I CALL 259.8810 FOR INSPECTION <br />Utility Account No. <br />Permit Fee $ <br />Connection Charge <br />CHART NO <br />TO POSTING_l , 3 <br />Trunk <br />Lateral <br />Total Connection Charge <br />Utility Development Fee <br />Water <br />Sewer <br />Total Development Fee <br />Sewer Bond District <br />Abutting Lot Line <br />N, S, E, W tt. <br />Approved By <br />Issued By /� b — —_ <br />Customer Signature �(' �•� 1'� ' '�%� `' <br />Inspection By (7c6e�n.a•, <br />Date Inspected /`�- 30 93 <br />SEE SKETCH ATTACHED <br />INSPECTION 2 9 1 <br />