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��� <br /> H <br /> C H <br /> � Hti <br /> H�� <br /> KH� <br /> �H� CHART NO. + <br /> oy�� everett f / <br /> �d I _ ?n pOSTiNG � u �z <br /> � � <br /> ��'g � �� �� � � � � �: �: <br /> �. <br /> :s �= w � M <br /> �y City of Everett .- � ' . , � � "' <br /> w y _ ... . _. � .� � <br /> r <br /> � w Sewer Application a+�c�1 Permi� � � <br /> � ., � � ��f <br /> ��:w ` �� G i '�'� ._ � :� � � '� 2 � � " I <br /> � J� <br /> N0. 285�2 DATE 1/3n1�z I <br /> Service Address E424 rariaiaa Ao� Utiliry Account No. <br /> Billing Address E 4020 xntnc Ave <br /> � Suokane ,�'n 99202 Permit Fee $ �1 30.00 <br /> City,State,Zip. <br /> OWOBf _ I�nnnhrnok n��• Connection Charge <br /> Connection by � � Trunk $ <br /> Adtlress Laleral $ <br /> _ Total Connection Charge $ — <br /> i1 Phone _ — Utilily Developmenl Fee <br /> �' Water $ 174.00 <br /> Legal Description: <br /> ' ' Lot zl — Sewer $ <br /> 1�' Block — Total Development Fee $ 179.00 <br /> � Plat <br /> ' Unplaried Description: Sewer Bond District �'�t� <br /> � 1 Abutting Lol Line <br /> ��I N,g� E,W ft. <br /> �1 Type ot Permit ttew connectton Approved By <br /> ' Issued By �R <br /> � Remarks <br /> �� Customer Signature— <br /> �I IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> Inspection By �"�r'` <br /> CALL 259-8810 FOR INSPECTION 3„ u, - s < <br /> Date Inspected <br /> SEE SKETCH ATTACHED NO. 25�81' <br /> Ih!SI'I::Cl1r�I I <br />