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� <br /> i <br /> � <br /> ��� CHART NO. <br /> everett <br /> � � � IG-2S-Q( <br /> �� e TO POSTING <br /> � �3L � ;; � _ szgg�, <br /> ��� City of Everett � ; �; _ _ � - .; � d � <br /> �u� ' ` J� �•� �: � w N : �� <br /> '� Sewer app�catio� �nd:Permit <br /> �e � y � s �� <br /> ��� ^ �� W �� � � � � �� � <br /> JJIj� .. `� _�c � le �y'� � —� <br /> �` NO. �H H� � � DATE nu7��* lo �4�0 <br /> M <br /> t+ Service Address ti"���q �^�> >T' ,r Utiliry Acwunt No. <br /> G <br /> ��a Billing Address —�; . <br /> �y� City,State,Zip . - Permit Fee $ 30.00 <br /> , <br /> � r cr,,, c ��,,, r,,,�r� Connection Charge <br /> ---+- Owner <br /> Conneclion by Sy�r� Trunk $--3-18:08------ <br /> Address Lateral S <br /> TotalConnectionCharge $ �tn nn <br /> Phone 7 i�-��� � Ulility Development Fee <br /> � � Legal Description: Water $ 179.00 _ <br /> I ��' �d Sewer $ 4��+9A-- <br /> , I Lot <br /> 1 Block ��t�l ��� Total Developinent Fee 5_ G50.00 <br /> � ��� <br /> �� Plat <br /> i Unpiatted Description: <br /> Sewer Bond District L�� i <br /> I �w� Abutting Lot Line <br /> N, S,E,W — h• <br /> ; ��t-� Type of Permit •r�w cn:u,ecr+�n Approved By <br /> Remarks Issued By_ � S�"" ���'QPr� <br /> � Customer Signature <br /> , ��1 <br /> IMPORTANT! <br /> I CALL 1-800-424-5555 46-HOURS <br /> ��'� PRIOR TO DIGGING <br /> ,�/f�� �i <br /> Inspection By�- <br /> CALL 259-8810 FOR INSPECTION �� . 7- s•, <br /> Date Inspected <br /> SEE SKETCH ATfACHED ND• ?7 8�� � <br /> I <br /> I WS�f_CTION � <br /> I <br /> � �� � <br />