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CHART NO. — _ <br /> everett <br /> � TO POSTING_3 /a-�3 <br /> .; � <br /> ,o x x I City of Fver�tt _� _ -� �: �: <br /> � <br /> - .= �=� �� I <br /> > %, � <br /> C H ,:� <br /> H�� S��nr�r A�plication a�d:� Pzrmi#� �� �� " <br /> r? H I ^. _ _ • _; _' ... 1 _ <br /> I n _ :a ;a � <br /> � y� i - 4 .� _� = 5a• �= �i <br /> � i~ j Nt�. ZR�iF � DATE -' 6/2/�i � - <br /> � y d I Service Address 7910 E 61en Dr Utility Account No. <br /> � �g Billing Address 'L721 11Gth St SE <br /> �y � I Cit ,State, Zi �erett tin SpZi�6 30.00 <br /> Y P Permit Fee $ <br /> rHy j Owner —_ �.reac Nor[hwefl[ Const ConnectionCharge � <br /> gdN Connectionby LW}i�aelcl,oe. _ Trunk g E <br /> z �y Address Lateral $ <br /> y �y Total Connection Charge $ 1 <br /> i <br /> Phone Utility Development Fee . <br /> _ Legal �escription: Water g 179.00 <br /> Lct -�� Sesoer $ 47] _�e �, <br /> 'e„�. Block Total Development Fee $ �4CL p0 <br /> �! Plat ,•ver-�een !'�ae , <br /> '�v Unplatted Description: Sewer Bond District , <br /> �� <br /> Abutting Lot line I <br /> Iw�� N,S, E.W }t. I <br /> .�..�. <br /> Type of Permit �tev t:onnection Approved By <br /> ( �� Remarks Issued By �B <br /> Customar Signature _ <br /> ��I�1 IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS � <br /> �,,,� PRIOR TO DIGGING I <br /> � CALL 259-8810 FOR INSPECTIQN Inspectian ey ��A���W«� <br /> Date Inspected � ����`�t <br /> SEE SKETCH ATTACHED No. 28663 <br /> INSP=C110GI I <br />