Laserfiche WebLink
.� <br />everett <br />City of Everett <br />c <br />i <br />�: <br />f � �7 � <br />c �.�r» «: a-, <br />► <br />Sewer Application and �e��t r <br />rA �- 4 � � � � � <br />� �,��� ��a <br />NO. Q%$O4 DATE <br />Servfce Address 4003 4tarxl Ave. Utiliry Account No. <br />B(Iling Address ��� SE 8tiros+rCt Mal�ipy <br />CHART NO. <br />�o�S�.� <br />`' CJ' ll <br />rl i r2 A Q � <br />.f;{-aoti <br />� � - � <br />ai 4 1� �! <br />�V �r�`1 <br />�=—�s��� <br />������ <br />Cily, State, Zfp �p�, �,y4 gp�p�_ Permit Fee $ c.,,.. Z�� <br />• <br />.�. <br />Connection by <br />Address <br />atrna <br />Phone 347—a�a <br />Legal Description: <br />Lot 2 <br />Bbck 3.. <br />Plat p�L�� y�}.� <br />Unplatted Desc�iption: <br />Type of Permit <br />Remarks <br />� <br />IMPORTANTI <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHEQ <br />Connection Charge <br />Trunk <br />$ <br />Lateral $ <br />Total Connection Charge $ <br />Utility Development Fee <br />Y.'ater <br />Sewer <br />Total Development Fee <br />Sewer Bond District _ <br />Abutting Lot Line <br />N, S, E, W <br />Approved By _ <br />E <br />� <br />$ <br />Issued By ����; <br />Customer Signature <br />Inspection By � v4 �C��� <br />Date Inspected �/ �' �d <br />INSPECTION <br />NO. Z7SO4 <br />ft. <br />