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� <br />everett - <br />e= _ <br />.i Sl �' b' 'r-, ' J°1 Yi rj c._. � _ 4 a% -i 1 <br />City of Everett:, . : - ' , ,= .,3 - _ •' .' = <br />4 i � '� +[ G � -• �_: ^ �"_ . <br />Sewer Ap�i�icatio�wand;Perr.r�t,' <br />�� ti`���?�{�� �_�;�`;�;��:`z���'Y��� <br />^�JTG:[�.a - •�: _.:_'L �.="`t:4 .. �:ii.; <br />NO. ����u DATEr—„�.�9, �993^ <br />Service Address 2110 n-C-D Rl^hlaqd AVQ Utility Account No. <br />Billing Address <br />City, State, Zip Permit Fee $ <br />Owner _�a�aao,r •,•,w��� <br />Connection by p� �� k C•• w�" <br />Address <br />Connection Charge <br />Trunk <br />CHART NO. <br />To Posrir�c a - z�� -�3 <br />:� <br />Lateral $ <br />Total Connection Charge $ <br />Phone Utility Development Fee <br />Legal Description: <br />Lot '--" • r . �p — <br />Block <br />Pldt e� vi�w..��� �ww.. r.. w.�....�� <br />UnplaBed Descriptfon: - <br />Water <br />Sewer <br />Total Devetopment Fee <br />E��,,,, � ,� <br />$ �...�599sB�- <br />$ Iilff7l�E1t 703 00 <br />Sewer Bond Dislrict _�tfian�t - <br />Abutling Lol Line <br />N,S,E,W <br />Type of Permit u... r�v *rm Approved By <br />Remarks <br />IMPORTANT! <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />S@E SKETCH ATTACHED <br />Issued By J ��11 <br />Customer Signature � � � � <br />Inspection By ``�"��"'"""' <br />Date Inspected � - 1 -� 3 <br />No. 28635 <br />INSPECTION <br />ft. <br />