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�a <br /> _ CHART NO. I <br /> I everett <br /> � Ser+ i-� �os-{-�+.� €-�-9! <br /> ;.� <br /> �: <br /> r <br /> U <br /> � � y ,� <br /> City of Everett g� Q � � � � � � � ' J � <br /> Q � _ _ .. "Q� <br /> � W � —fA� c, tl� .+' • t'� NQ'I <br /> < x. � e� yr- .r <br /> ��� • �+ <br /> �ewer Application a��Pern�it� � � � ;� <br /> � N J > � <br /> ; <br /> a �� : . <br /> :., :� 3 .4 � xu'i3� � � � � � � `` �' <br /> � <br /> 2 / 09U -i iaS� -N � =. � 3 '� � `�i .'�S .`"-. � <br /> NO. DATE �«���:�� <br /> Service Addrees 6308 2nd Dr SE Utility Account No. <br /> BfllingAddre: '170 v���* �* <br /> I <br /> Ciry,State, Zip ���tt, x� 00�07 Permit Fee $ _ 3�-00 <br /> Owner Connection Charge <br /> Connection by Trunk $ , <br /> Address Laterai $ <br /> Total Connection Charge $ 110.00 <br /> Phone 3�8-5860 Utility Development Fee <br /> Legal Description: Water $ . <br /> Lot r� Sewer $ i�l�— <br /> Block — Totai Development Fee $ 813.00 _ <br /> Plat �+.+�. r '�--aM <br /> Unplaried Description: Sewer Bond District yo-d i <br /> Abutling Lot Line <br /> N�S, E.W ft. <br /> Type of Permit ��,- �_L����� Approved By <br /> Remarks Issued By <br /> Customer Signature <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8810 FOR INSPECTION Inspection ey a��� <br /> Date Inspected � � 3 � 5� <br /> SEE SKETCH ATTACHED No. 27 S s S <br /> iINSPECTION <br />