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i <br /> y„r, Cw1`iRT NO. <br /> everett <br /> s <br /> ,� <br /> �- <br /> s <br /> � <br /> _ � � � <br /> Ciry of Everett ' �.*. ^�� TO POStING �G� <br /> �; <br /> Sewer Application and Pe��� � <br /> �+r � � G Z � <br /> c l '�i W <br /> �fK1 � G ::. Ji _. <br /> NO. 2$2$H DATE �ta�+y �ooi <br /> Servioe Address 1��_____3_�:-1►w Utiliry Account No. <br /> Billing Address �� DO°"O°d <br /> d <br /> City, State, Zip �*+��. � °a��1 Permit Fee $ 2.50 <br /> Owner y�t.; t�rCa�rddg Connection Charge <br /> Connection by o� - Trunk $ <br /> Address Lateral $ <br /> Total Connection Charge $ <br /> Phone IS9-26'+� Utility Development Fee <br /> Legal Description: Water $ <br /> Lot u Sewer $ <br /> g�� � Total Development Fee $ <br /> Plat <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> N, S, E,W h• <br /> Type of Permit C►B-� � Approved By <br /> Remarks f d'�T Issued By <br /> � ' Customer Signature � � �-�� �� <br /> a <br /> MPORTANTI � �/'�, <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8810 FOR INSPECTION Inspection By <br /> Date Inspected <br /> SEE S�CETCH ATTACHED No. ZH2H� <br /> _ INSPECTION <br /> P <br /> � <br /> � <br />