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CHART NO. -- <br /> everett <br /> �= <br /> s: <br /> � �� � :� � � � � � ., Tn �OSTI NG ''�F.�l9z <br /> City of Everett , • L� � _ � • <br /> — `' u� ` y '' �t` ^' I <br /> ... -� .. .G :i <br /> :� � ' <br /> Sewer �pp�icat�o�_ �nd"Permit <br /> �., n b �: , ;_: � <br /> - „ . <br /> ' .` L��' L (y�� � ^ � Y'� � � � � <br /> .: *i1 L ]; j - '¢ _� '��.{ � _ <br /> NO. �$2J�� DATE � _.._ ,�=„y.� <br /> Service Address G217 - 2na Dr SF _ Utility Account No. <br /> Billing Address pC Dox 1306 <br /> Ciry, State,Zip Permit Fee $ 30.00 <br /> Owner Connection Charge <br /> Connection by seme Trunk $ <br /> Address Lateral $ <br /> Total Connection Charge $ -�- <br /> Phone Utility Development Fee <br /> Legal Description: Water :$ <br /> Lot 3y Sewer $ �.7.+ ��— <br /> Block Total Development Fee $ 650�— <br /> Plei R1AQe�e�1 '1`irr�d <br /> Unplatted Description: Se•,ver Bond District <br /> Abutting L�!Line <br /> N, S, E,W (t. <br /> Type of Permit ,,,.�(.........�ria� Approved By <br /> Remarks __ Issued By <br /> Customer Signature — <br /> IP'PORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING ^ ;i'� <br /> Inspection By /�`� <br /> CALL 259-8810 FOR INSPECTION <br /> Date Inspected �' " � �� <br /> SEE SKETCH ATTACHED No. 28258 <br /> INSPECTION <br /> I <br />