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CHAR i P:J. <br /> everett I <br /> ,- <br /> 5 o.,-f- �'o �oS���c� �s-)-4� <br /> City of Everett - =' Y �K - �� - - '� = - = =. <br /> _ _ w : , r; -;, = " <br /> Ser�►er Applicatio� and Per�ii� � _ � <br /> - - - - - = � z, - `- � <br /> -' _: , ; ;� � � � 3 _ _ <br /> � R <br /> NO. �7 9 6 0 DATE W w�� loi�/90 ' .� J - _ <br /> Service Address ���p - ���� 8$ Utility Account No. <br /> Bflling Address <br /> City, State,Zip Permil Fee $ <br /> . <br /> Owner Connection Charge • <br /> Lul�q Oon�truction, �c. <br /> Connectionby ��d�P.N.,�rr. Trunk $ <br /> Address Lateral $ . <br /> Total Connectlon Charge $ ,�w <br /> Phone Utiiity Development Fee <br /> Legal Descriptian: Water $ <br /> Lot Sewer • <br /> $ <br /> a�i.00 <br /> Block 5'7 Total Development Fee $ <br /> Plat ..w,�,p�yti=� � <br /> Unplatted Description: Sewer Bond Disirict <br /> - - Abutting Lot Line <br /> N, S, E,W h. <br /> Type of Permit n�� Ey��tlet�a� Approved By <br /> Remarks Issued By <br /> . e n - <br /> Customer Sfgnature � <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> �, Inspection By �`"� <br /> CALL 259-8810 FOR INaNECTION <br /> Date Inspected s' �• s/ _ <br /> SEE SKETCH ATTACHED No. 27960 <br /> INSPECTION I <br />