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_ CNART N0. — <br /> everett <br /> �; <br /> � <br /> �a �� oS �,•LJ <br /> � � � � � �U�/ ��4 <br /> City of Everett = _ `'• a � <br /> �: .7 �.�' w O <br /> � <br /> •M <br /> Sewer Applicatior� a�da�`�r�it i <br /> � _ r, t �� � , , <br /> � � = g , � � � <br /> NO. Z 8 2 S 7 DATE _� 9 il�i j � � <br /> 35�3 �cr�- I <br /> Service Address �� pa� � Utiliry Acccunt No. <br /> Billing Address � H°= �6 <br /> Ciry, State,Zip swntt wA 96206 permit Fee $ �� �•50 <br /> Owner ul� R■� Connection Charge <br /> Connortion by M�� Tnmk $— <br /> Address Lateral $— <br /> Totai Gonnection Charge $ <br /> Phone 252-7511 Utility Development Fee <br /> Legal Description: Water $ <br /> Lot Sewer $ <br /> Blodc Total Development Fee $ <br /> Plat <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> N, S,E,W ft. <br /> Type of Permit eaP ott Approved By <br /> Remarks ��Oli�h rinqla f�sily ho�e Issued By �*q�*+t �^*�� <br /> � <br /> Customer Signature , - - <br /> IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING �o���P�o,,,. ��i� <br /> CALL 259-6810 FOR INSPECTION �n a n By .b <br /> Date Inspected <br /> SEE SKETCH ATTACHED No. 28?57 <br /> INSPECTIOh <br /> I <br />