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everett "- CHART NO. <br /> `? T� �USf���'G � �' U-�1U <br /> T <br /> � ` <br /> City of Everett s �' � � e � <br /> r_: c, ,_, :� �,- <br /> tr -• r^• bl +-� <br /> , w .~•r <br /> Sewer Appli�atian and Permit <br /> ,� } � -- � � <br /> �.`' � ''' .s � � t- .LJyI <br /> ' � :e �i ''C — <br /> NO. Z`�.3'� DATE r.�,. 2s i9ni <br /> Service Address li�il lat 11v� is Utility Account No. <br /> Billing Address <br /> City, State,Zip �l�• M1► `l827S <br /> Permit Fee $ �o_ee <br /> Owner vi�im Ho�.s Connection Charge <br /> Connectfon by �.�.= Trunk $ 3ae_oo <br /> Address Lateral g <br /> Total Connection Charge $ »0.o0 <br /> Phone _ 356—sae� _ Utiliry pevelapment Fee <br /> Legal Description: Water g I�g,pp <br /> Lot 2 <br /> Sewer g �'n.� <br /> B�OCk Total Development Fee $ 6SO.00 ' <br /> Plat ���� - <br /> Unplatted Descrfptfon: Sewer Bond District �p��g =__ <br /> Abutting LotLine <br /> N�S� E�W ft. <br /> Type of Permit Na1l o0set8CPi0ei Approved By <br /> Remarics _ Issued By�� � <br /> Customer Signature , <br /> / / � <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING ,--1 <br /> ���_ <br /> CALL 259-8810 FOR INSPECTION Inspection By i <br /> Date Inspected � <br /> I <br /> SEE SKE';,H ATTACHED No. Z8321 <br /> INSPE-CTIOfJ <br /> � <br />