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everett <br />e <br />City of Everett <br />�: <br />z <br />�_ � <br />� �'. <br />��•. <br />r� �, <br />� �Q <br />Sewer Appdicat�on and Permit� ., a� <br />NO. ���Ov DATE _ senteffber 5 1�09� <br />Service Address 4307 S. 4th Ave. <br />Billing Address Z516 Taylor Dr. <br />City, State, ZiP �rett, kA 9II203 <br />Owner (Mortgagor) NSC Inc. <br />Billing Name Sama <br />Connection By SA�e <br />Address � S'm° <br />Phone 353-7A72 <br />DESCRIPTION: <br />Lot �� z� Biock�— <br />Plat �+ell <br />Unplatted Description <br />Type Permit: �Qy�r u,�etinn <br />Remarks: <br />IMPORTANT! <br />CALL 1•800-024�5555 48�HOURS <br />PRIOR TO DIGGING <br />CPLL 259�8811 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />CHART <br />r <br />` =:E=1--�1 C����-1 L• 1 <br />�� ��c.� l �.� <br />���:�� S�� S:: <br />i`w'.».;i� �`cP-'�i,�i �vi <br />� ... w r�1 <br />•Q 1� • <br />:] <br />�-_ � �����_ <br />��1 U'.J '3� 1 C: „'� :r F ta.l � <br />.i� �� ��?p ��1���'= <br />= r � � . _: = O W .'zr . <br />Utiliry Account No. <br />Permit Fee ]0 00 <br />Connection Charge(s) 720.00 <br />Total Fee 30 oa <br />Utility Levalopmant Fees Ord. L'71-GS <br />water 152.00 <br />eewer 400.00 <br />55�2 00 <br />� <br />Signed ___,___. <br />Sewer District fin a rr — <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Trunk ��� �rt - <br />Lateral a5o no <br />Abutting Lot Line <br />N, S, E, W <br />Approved By ATPPFiI R TL1pAT <br />City Engineer <br />I Issued BV ^ g-ttaug�^ <br />� <br />�f� <br />Inspection By <br />Date <br />If�°PECTIOL <br />/- �- f'li <br />No. 27306 <br />