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CHAR'r NO. I <br /> everett ,. rTo �rtr1E+ <br /> �� 1n-3�-9d <br /> � ____�__-----� <br /> � sc <br /> 4 <br /> City of Everett :� " ; <br /> N + <br /> ti <br /> Sewer Appiication and Perp�i� . ,� <br /> a` � � � <br /> q � , <br /> �a <br /> NO. 2 7.9� 9 DA1 E seet��zs 1990— <br /> Service Address Utiiity Account No. — <br /> Billing Address <br /> City, State, Zip �-ttR <br /> Permit Fee $ 30.00 <br /> Owner Connection Charge <br /> Connection by Trunk $ <br /> Addreas Lateral $ <br /> Total Connection Charge $ <br /> Phone .�++ Utility Deveiopment Fee <br /> Legal Description: Water $ <br /> Lot Sewer $ <br /> Block Total Development Fee $ <br /> Piat <br /> UnNlatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> NSEW ft. <br /> Type oi Permit x■�_---"-- _. __�..«�.,q Approved By <br /> � b��q Issued By <br /> Remarks <br /> ! ! �� �c� �� Customersignature — <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS � i <br /> PRIOR TO DIGGING ��„%' ��� ' <br /> Inspection � <br /> CALL 259-8810 FOR INSPECTION c3 � S �J <br /> Date Inspected <br /> � <br /> SEE SKETCH ATTACHED No. 27919 I <br /> I INSPECTION � <br />