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��� <br /> o�x � <br /> C N <br /> �Htn <br /> � CHART NO. <br /> K y� everett <br /> �a y� � :_. <br /> o�� `: TO POSTI lu`' 3-3'-� <br /> H �g City of Everett �= � � � � 8 � ° �' � <br /> �, •._ c - .a �, ;� o o- <br /> �r �] �.: �> �; �.� � ��: �: �- 4'� ', <br /> 7r hl ..1 ..� . . _. _� �a i w <br /> �y� �ewer Applicatior� and P"�r�nif <br /> gyy :� �- . -: ::; � � � _ " - = <br /> n d� '.;, S ` � ti �... � C� =� `a. W �-+ � <br /> ��� � NO. 2$7aG 6ATE �� ,,,��,�_ <br /> '3��' Service Address 9��3��E Utility Account No. <br /> Billing Address -�-z;'—�..,,� <br /> City,Stale, Zip , _ Permit Fee $ ap.,�q <br /> Owner sc.t ^«�s�=na Connection Charge <br /> Ce'�ection b �^'�" � r ` "'� Trunk $ <br /> 1' 6Mrh <br /> Address Lateral S <br /> Total Connection Charge $ -p_ <br /> Phone �58..ys�a Utility Development Fee <br /> '�1 LegalDescription: Water $ i�a nn <br /> ��' Lol �y Sewer $�� 00 <br /> '�1 Block Total Deve�opment Fee �,SII. nn <br /> ��' Plat ��.�9�,.a �n.,-..,.e ni� tl <br /> '�' � Unplatted Description: Sewer Bond District -- <br /> ' ' Abutting Lol Line <br /> � <br /> '-1 N,S, E,W ft. <br /> ' ' Type of Permit Approved By <br /> � <br /> f-1 Remarks Issued By <br /> ' 4 Customer Signature <br /> � <br /> 's1 IMPORTANT! <br /> ��� CALL 1-800-424-5555 48-HOURS I <br /> PRIOR TO DIGGING � <br /> Inspeclion 6y ��1�/�i°'� I <br /> CALL 259-8810 FOR INSPECTION <br /> Date Inspected �• 3�- s s <br /> SEE SKETCH ATTACHED No. G�7� � <br /> INSPECTION �. <br />