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,��- <br /> � �� � <br /> m � x , <br /> 9Ht~p <br /> 4 <br /> y � � <br /> ''� ,,.3� CHART NO. , <br /> � H � everett <br /> V] N <br /> z � <br /> � �� - <br /> � �g = _=; �` ` <br /> H� � City of Everett „; �;; �: <br /> � y� . . = .. T� r�sTt�c � zG_� v <br /> gyH Sewer Application and Perm�t_ _ ' <br /> �e� - = _ <br /> �� `" ? _ . <br /> xy� NO. 27917 DATE � I <br /> H O V� <br /> Service Address Utility Accoun[No. <br /> BillingAddress ��n�� ��s*� n,., � <br /> City,Stale,Zip Permit Fee 5 z 50 <br /> Owner . Connection Charge <br /> Connection by Trunk $ <br /> iAddress Lateral $ <br /> Totat Connection Charge $ � <br /> i <br /> � `�. Phone Utiliry Development Fee � <br /> � <br /> Legal Description: Water � <br /> � �� <br /> �� � Lot Sewer $ <br /> � <br /> Block Total Development Fee $ <br /> �+ Piat <br /> I �—'. <br /> Unplalled Description: Sewer Bond Dislrict <br /> Abutting Lot Line <br /> ""� N�S� E�W ft. � <br /> Type of Permit Approved By �' <br /> �� I; <br /> ��.�� Remarks Issued By � , i <br /> i Customer Signature � � <br /> I�.��. IMPORTANT! � <br /> CALL 1-800-424-5555 48-HOURS ,� , ' � ' <br /> PRIOR TO DIGGING ' ��� ��,'�� < <br /> Inspection By �� � <br /> CALL 259-8810 FOR INSPECTION <br /> Date Inspecled <br /> I SEE SKETCH ATTACHED No. 27917 <br /> I � <br /> ;iJcp��iln;.i �, <br /> i <br />