Laserfiche WebLink
everett <br />Clty of Everett <br />Sewer Application an� Perrr�it <br />r,w. 2 8 7 4 9 oar� „�,��� <br />Servioe Address <br />Billirp Address <br />Clty, StBte, Zip �ht! 1Q1 9t203 <br />Owner r•• rse.lv.c. ae�•c <br />ConnecNon by � — <br />�; :.. <br />Phone y{� 7Y�f <br />Lgpal Description: <br />�.ot u <br />Blodc <br />Plat as !L-a� - <br />Unpletted pescriptfon: <br />Type of PertnR rs� - <br />Remarks <br />IMPQRTANT! <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No <br />Permit Fee <br />� <br />TO POSTING_� � <br />f25i09'4_' 9:Q.`�1N1 lY1fHiH�i2`.�5 ki } f. <br />RU003d"',45 <br />. f�B6 �3i'-:7 <br />p�EY 345.00 <br />i£Lii 160.LXt <br />a �. �xt+ sw.so <br />��—�r:ee-- <br />iE000"c9749 <br />Connectfon Charge �� � �_� <br />Trunk 1171�'i i?8.00 <br />CF1Eq; F'IbR.i�7 <br />Lateral S <br />Total Connectbn Charge S .p <br />Utility Development Fee <br />Water S 2�•� <br />Sewer S " ^" <br />Total Development Fee S °a °° <br />Sewer Bond District - <br />Abutting lot Line <br />NSEW ft. <br />Approved By <br />Issued By * �++r�� <br />Customer Signature ' � <br />Inspection By �` <br />Date Inspected 8 " � 4'� � <br />INS°ECTION <br />No. 28749 <br />