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CHART NO. _ -- <br /> i everett <br /> � <br /> �i � _ Tf► nncTi�J(; � z�_`r� <br /> , <br /> - - - - = =. �= � <br /> � City ot Everett:: � - . � - - <br /> y �H ; Se�rer Application and Perrnit ' <br /> � � � ! ;� _ ` •` - = - <br /> : .r . - � <br /> y � — - . , ... :.. . _ <br /> � NO. "�H T Z O' ` DATE V�Y��^ ,noa <br /> ��� i l <br /> � x I <br /> '� �� Service Address �9.7" ' * ^� Utility Account No. � <br /> " yz ! I <br /> �N � Billing Address �S��A—�a' <br /> H y H � Permit Fee $ I' <br /> � x � City,State,Zip �--y;�—ggagr— <br /> o �d Owner �_� m^ee_ Connection Charge ' <br /> �� g , Connection by �*.�..�r Trunk $ ��^ �0 � <br /> � y � � Address — Laterzl $ I <br /> gNi3 Total Connection Charge $ 27o.no <br /> H <br /> �d�' Phone �G���� — Ulility Development Fee ' <br /> �� " i <br /> y o N I Legal Description: Water $ ��e n� <br /> i � <br /> � Lot � Sewer $ seo_oo I <br /> Block Total Development Fee $—n�'+ ^^ <br /> I <br /> i p�a� Ceavlrv Cn r I <br /> � <br /> ���� Unpiatted Description: _ Sewer Bond District II I <br /> I <br /> Abutting Lat Line , <br /> '.�� N,S� E�W n• I <br /> i � � ' <br /> I Type of Permit Approved By ! <br /> .� Remarks Issued By * +� �� I <br /> �1'� Customer Signature II <br /> IMPORTANT! <br /> � 11 !� <br /> CALL 1-800-424•5555 48-HOURS �I <br /> PRIOR TO DIGGING ' '' <br /> �� Inspection By��/�'Q" <br /> CALL 259-8810 FOR INSPECTION i <br /> Date Inspected ��'�� �t � <br /> SEE EKETCH ATTACHED N�• 287�.0 I� <br /> I <br /> I lid^PEClIC%P: <br />