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CHART NO. <br /> everett y <br /> `� ,�,,�,�I � ��� <br /> � :�� R � u`� � � Qu33 � � <br /> City of Everett = .�L� � ri .• Q r. � � .' �—/�--�� <br /> V ` �.�' ;> "' � a «. = �_3 <br /> M <br /> Sewer �pp�icatiQn��a�cLP�rmit <br /> _ , � , , <br /> y ` � � <br /> ::i g'``':a � — � :' `- � �y <br /> �wr � � r� � � �. � �.! � � =, <br /> NO. �7�4 2 DATE ��_�i499 <br /> Service Address Wp� -�—:���— Utility Account No. <br /> Billing Address TM' '^� 10i� <br /> �City, State,Zip *^^�^`�'�. vi oeoa6 Permit Fee $ �o ee — <br /> Owner Y�� as^ a��a — Connection Charge <br /> Connection by _ Trunk $ il� o0 <br /> Address — Lateral $ <br /> Total Connection Charge S llo 00 <br /> Phone 5�� �ORO __-- Utiiity Development Fee <br /> Legal Description: Water $ �a�— <br /> Lot ..� Sewer $ . <br /> Block Total Development Fee $ 650.00 <br /> Plat <br /> Unplatted Description: Se��sr Bo d District � * - <br /> Abuttina Lot Line <br /> NgEW ft. <br /> Type oi Permit u�� �M*���oa Approved By I <br /> Remarks Issued By <br /> _ Customer Signature — <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-hiOURS <br /> PRIOR TO DIGGING ,,/��� � /� <br /> Inspection By ""`��Y <br /> CALL 259-8810 FOR INSPECTION � r�� <br /> Date Insp .:ted �- <br /> SEE SKETCH ATTACHED No. 2794?_ <br /> !nsP�CTION I <br />