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CHART N0. <br /> I everett � 1 t� �o��� <br /> � Se. , , �, 7-/7-9/ <br /> � • <br /> � <br /> Clty of Everett � � � � � � � � � } � � <br /> L7 If1 '� •: .q• 0 p p J � C[�- <br /> I.j � �l �n ti J �r y� V � ~ yi L) <br /> L5 �w W �A w�i 1. .-� <br /> Sewer App,�icati�a_n � „r�d Pernnit <br /> � -_ <br /> � � � � � � .:] � :r � � � ..`�.. �- � <br /> NO. Z��7� DATE nwust e. �900 _ <br /> Service Address ��� �i �TM �' Utility Account No. <br /> Billing Address <br /> City,State,Zip Permit Fee $ , <br /> , <br /> Owner T�"+'rh �'*� � �'�^' r^:, Connection Chargo <br /> Connecqon by Smaa dyc.i�� '�' Trunk $ — }�@;po — <br /> Address Lateral $ <br /> Total Connection Charge $ ]lp �� <br /> Phone 338-14d6 Utility Development Fee <br /> Legal Description: Water $ 179.C'0 <br /> Lot '� Sewer $ 4�'�.89— <br /> Block Total Developme�t Fee $ E�•� <br /> Plat <br /> Unplatted Descriptfon: Sewer Bond District 8a�i <br /> Abutting Lot Line <br /> N, S, E,W h• <br /> Typs of rarmit l�nrr (n�uv�eti�.+ Approved By — <br /> Remarks Issued By <br /> Customer Signature ' � <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING , „ ; - -/ /' <br /> Inspection By � � �` � '' ` � � � <br /> CALL 259-8810 FOR INSPECTION <br /> Date Inspected � �'� �� � �� i <br /> I SEESKETCHATTACHED NO. Z7S7�J' <br /> i <br /> INi;�'FCTION <br />