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r r� � J O r, q !� O� �l <br />p� Fl f� _: Ll q G' �J O L_ f�� <br />�_t C. ^� ''1 .t ,1 _� �t G� P :i <br />_ + ,p M C I �' � h �- <br />Sl v. � .� M. �� �n -: Ci <br />�� .r. r.; <br />Sewer App;i�ation_a�ri�,Permit <br />r,> rD [9 ]". C9 �J �- O � � i 7 rj u <br />;3 ii� �: J:" -. � �_ C'- �. 3: <br />�'• � .� __ ' . :� . ' ' _ <br />1�; �1.. .•' � �r <br />2 �'• � ? DATE�� �S-%/-93 <br />Service Pddress ='� �`+' — L�f �(1►� Utiliry Account No. <br />Billinp ,ad�ess — Z3� F.I.N ST <br />City, State, Zip EVERETT WA 9��03 permit Fee $ <br />Owner SELECT }[0`:ES INC Connection Charge <br />Connection by ✓ C� Trunk <br />Address <br />Phane ._ <br />Legal Description: <br />Lot <br />Block <br />Plat <br />Unplatted Description: <br />Type of Permit <br />Remarks __ <br />NA,�ABROOF: DIV 3 <br />NEYi CONNLCTI09 <br />IMPORTANTI <br />CALL 1-500-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />CHART NO. <br />jc- ��cs�.nn� /z-2L-43 <br />Lateral <br />Total Connection Charge <br />Utility Develooment Fee <br />Water <br />Sewer <br />Total Development Fee <br />7D.00 <br />$ <br />$ <br />'J.00 <br />$ <br />S <br />$ <br />$ <br />i�o.cn <br />179.00 <br />ULID <br />Sewer Bond District <br />Abutting Lot L(ne <br />N, S, E, W ft• <br />Approved By <br />�'� <br />Issued By , <br />�..,U�G, ;�:o�r;;�. <br />CustomerSignature� -/t�-� :;!� "— <br />� � -r �. ��.. <br />, <br />Inspection By �P�""'�'� <br />Data Inspected �" z-S� <br />SEE SKETCH ATTACHED <br />INSPECTION � �� �� � .� <br />