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I <br />CHART NO. <br />TO POSTING ►t-z3.9�� <br />s <br />Sewer Application In` Perini, J <br />py r U fG S W .•� <br />CiJg <br />29792 DATE 7-8-94 <br />Service Address _ 5611 Rockefeller P_•e <br />Billing Address =617 3ocksfel3.er Ave <br />City, State, Zip Everett WA 96203 <br />Owner John Thom;?con <br />Connection by Owner M" -3>0 <br />Address <br />Phone 348-6778 <br />Legal Description: <br />Lot 5 <br />Block 8 <br />Plat Laurel Heights <br />Unplatted Description: <br />Type of Permit <br />Remarks <br />new connection <br />IMPORTANTI <br />CALL 14800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />Utility Account No. <br />PermitFbe $ 70.00 <br />Connection Charge <br />Trunk $ — <br />Lateral $ — <br />Total Connection Charge $ <br />Utility Development Fee <br />-0- <br />Water $ 17'�j•GD <br />Sewer $ 4/ 1• 9 . <br />Total Developirant Fee $ 650.00 <br />Sewer Bond District <br />Abutting Lot Line <br />N, S, E, W <br />Approved By — <br />Issued By <br />Customer Signature <br />ME <br />Inspection By <br />Date Inspected <br />SEE SKETCH ATTACHED , 2 9 7 ? <br />INSPECTION <br />ft. <br />1 <br />