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r, <br />C�7 L�1 � <br />H <br />x <br />> H C/� <br />K�n <br />oxo <br />hC N'i1 <br />V1 N <br />��o <br />�/��g <br />y� V CC] <br />9 H tl1 <br />, <br />r HH <br />g�' <br />H <br />nd� <br />��� <br />Z H cn <br />H O f/� <br />�� � <br />... ., � <br />�11 <br />�_E'I <br />. <br />everett <br />e =- _ <br />, <br />,_ <br />� l� .� �9� I�J y( �. 41 'TI ` �1 <br />City of Everett �w ` � � �_ �: _ • � ' _ <br />�, n <br />3r �9'.'r i:�i: ��"y: <br />i �J .: K � <br />� �. � A M � <br />Sewer Appiica#i�� ��nd�,Permit <br />" `} . � �: <br />..: �3;: ��,? yC''�`a�_;= <br />~ �-'�=:.:`5 :n3:�u �._� <br />NO. �Ss�O DATE <br />Service Address " ""'"" "" O1"'� Utility Account No. <br />Billing Address T^ °^ 3T6 — <br />CHART NO. <br />City, State, Zip ��-�+1----38�0� — Permit Fee $ <br />Owner xs� Connection Charge <br />Connection by pMn � ""` �""� !" � <br />Address <br />Trunk <br />Lateral <br />TO POSTING ���/9�- <br />E. � � ���+ <br />/ �1 <br />Total Connection Charge $ '''^ ^^ <br />Phone zan nana — Utiliry Development Fee <br />Legal Description: <br />Lot <br />Block <br />Piat <br />Unpiatted Description: <br />Water <br />Sewer <br />Total Development Fee <br />Sewer Bond Dislrict —� <br />Abulting Lot Lfne <br />N, S, E, W <br />Type of Permit -- -- -^�'on Approved By <br />Remarks <br />IMPORTANT! <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Issued By x puRhee <br />Customer Signature <br />E <br />g.'�ij_=�r���. <br />Inspection By `�" �` �`"`� <br />Date Inspected /'/�'Sz <br />INSPECTION <br />NO. Z86�U <br />n. <br />