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ICHARTNO. — <br /> everett <br /> � TU POSTING ��'� z s -�� <br /> �"' I � = � <br /> �H --� - - _ - - - <br /> �°�H City of Everett � _ - - _ _ - <br /> r-a� �� ; ,r I <br /> K z� � Sewer Application and Permit . =� . J ! <br /> � ~� _ - _ � . ��T _' � <br /> � o,�i I� NO. 2 7� 5�. DATE ---c.�wsr--��,,- 1},e^ �. .. i <br /> �3 C7 I <br /> � �g � Service Address � ` � Utility Account No. �I <br /> H" � BillingAddress , i <br /> r '�� I City,State,Zip _�` , . �` Permit Fee $ 3n.t�p I <br /> �'r-, � Owner ��., Connection Charge � <br /> i <br /> � i�i� � Connection by Trunk S }}g,g� � <br /> y o cv'ir �' Address Lateral S - � <br /> i — - TotalConnection Charge $�+n pp _ I <br /> � Phone _ Utility Development Fee i <br /> Legal Description: Water $ <br /> �-� Lot �1 _ Sewer $ 471.68 i <br /> � Block - Total Developner�Fee $ 65U.Co � <br /> I <br /> ` Plaf I <br /> �� � j -�-Tosra�n '�� <br /> I <br /> IUnplatled Description: Sewer Bond Distri;t � <br /> 0� � I Abutting Lot Linr, � <br /> N, S, E,W __ fl. I <br /> „y�� Type of Permit ��ew 6an�reee#en Approved By I <br /> Remarks _ — �ssued By.��� � <br /> � ° I� — Customer S.gnature <br /> IMPORTANT! <br /> y�� I <br /> � CALL 1-600-424-5555 48•HOURS i <br /> PRIOR TO DIGGING �' � / <br /> �nspectien By_�����"`� <br /> CALL 259-88f 0 FOR INSPECTION <br /> Date Inspecled "' -�� `�� , <br /> I <br /> � SEE SKETCH ATTACHED No. Z7H9�. I <br /> .,�:, . , .,. , � <br />