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m CK - <br />e <br />City of Everett <br />Sewer <br />NO. 28 <br />Servioe Address <br />Billing Address <br />City, State, ZIP <br />Owner <br />Connection by <br />Address <br />Plane <br />Legal Description: <br />Lot _ <br />Block _ 744 <br />Plat <br />��r <br />g <br />ass <br />CHART NO <br />TO POSTING 6 z <br />d Permit <br />DATE 32. +oat — <br />Utility Account No. <br />Permit Fee $ <br />Connection Charge <br />Trunk <br />Lateral <br />Total Connection Charge <br />Utility Development Fee <br />Water <br />Sewer <br />Total Development Fee <br />Unpletted Description: Sewer Bond District <br />Abutting Lot Line <br />N, S, E, W tt. <br />Type of Permit Approved By <br />Remarks church to apartments) Issued By <br />p Ua Customer Sianature <br />IMPORTANT! <br />CALL 1-800-424-5555 48-HOUR <br />PRIOR TO DIGG!NG <br />CALL 259-8810 FOR INSPECTION Inspection By <br />Date Inspected <br />SEE SKETCH ATTACHED <br />NO.28116 <br />INSPECTION <br />