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��� <br /> � ��y � <br /> A � x <br /> > H [~A <br /> y ��e CHART N0. <br /> K y �, everett <br /> � �H e TO POSTING S . �U �� z_ <br /> ��� � .;��., ��,�a,,,;�; .�u, <br /> H/� � g City of Everett ''�� •�'S� � <br /> Y�w � � <br /> ,.I. .i <br /> i�ll{}Q.41.i.!: <br /> � H� Sewer Application and Permit �� �ra� � ������ <br /> t;i:n.,u�ti��;it.:: <br /> gv� H �,r.i�r� ,:,�,i <br /> ���, r,�a:�i( :',_„�� <br /> � t+ NO. Z�3 H 6 DATE a �.,r i z_ i voi <br /> a N Service Address �a�� o+ �« Ulility Accounl No. <br /> Billing Address 119zo tfiabretson m�- <br /> Ciry, State,Zip �*� +� �» wn nn�s� Permit Fee $ 2.50 <br /> Owner — Connection Charge <br /> Connection by �iz� Trunk $ <br /> Address Lateral � <br /> Total Connection Charge $ <br /> . " • Phone �� Utility Development Fee <br /> � �� Legal Description: Water $ <br /> ; <br /> 1 � Lot 3y Sewer � <br /> �� <br /> � ���� Block 1�s -- – Total Development Fee $ <br /> I <br /> Plat <br /> � <br /> � ��� Unplatted Descriplion: Sewer Bond District <br /> I � <br /> Abutting Lot Line <br /> (-,�' NSEW ft. <br /> Type of Permit ran nrc Approved By <br /> ,� Remarks Issued By <br /> �� <br /> � Customer Signalure <br /> ' IMPORTANT! <br /> �1���� / ��., <br /> CALL1-800-424-5555 48-HOURS N� ��'��� I <br /> � PRIOR TO DIGGING '���' <br /> I g��� <br /> Inspection By , <br /> CALL 259-8610 FOR INSPECTION <br /> Dale Inspected <br /> I <br /> ', SEE SKETCH ATTACHED No. 28386 <br /> wsr��crior� � <br />