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i <br /> CHART N0. <br /> everett ~� <br /> � <br /> �Y <br /> o� <br /> � <br /> � <br /> City of Everett � � � TO POSTI NG 2l z�19 � <br /> � <br /> .:: ., <br /> Sewer Application and�Permit <br /> °,�. ;� W � <br /> .. � � `� <br /> NO. 2 8 6�. 3 DATE p �__,___�a.,__1992 <br /> 141le E. <br /> Service Address � '�T{Te w.�. nT_ Utility Account No. <br /> Bflling Address — <br /> City, State, Zip ����t�98Z01 Permit Fee $ lp.,nn <br /> Owner Deh61. i.nrenn Connection Charge <br /> Connection by � Trunk $ <br /> Address Lateral $ <br /> Total Connection Charge $ <br /> Phone — Utiliry Development Fee <br /> Legal Description: Water $ <br /> Lot Sewer $ <br /> Block Total Development Fee $ <br /> Plat <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> N, S, E,W h• <br /> Type of Permit atteracien Approved By <br /> Remarks Issued By M. � � <br /> Customer Signature ,� � <br /> IMPORTANT! <br /> CALL 1-500-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> Inspection By ��� <br /> CALL 259-8810 FOR INSPECTION <br /> Date Inspected Z ' i� - `� Z <br /> SEE SKETCH ATTACHED No. 28613 <br /> INSPECTION <br />