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ICHART NO. <br /> everett <br /> TO POSTING �� <br /> o�izri� 3=31F�S OOfiAN3553 Erer. <br /> Clty of Everott % <br /> �� <br /> s� �zo.ao <br /> Sewer Application and Permit � ,lo.� <br /> NO. Z87OZ DATE �vcl1 s7 1s91 <br /> Service Address � �'— ` -- UNiity Account No. <br /> BIIUnq Address ' ' <br /> Giry,Stete�aP Pertnit Fee S <br /> Connection Charge <br /> ��� i <br /> TNnk <br /> Connection by S <br /> Lateral <br /> pddress ' <br /> Total Connection Charge S <br /> Phone �'�� UtlIRy Development Fee <br /> l.e0al DeaaiPN°n: <br /> Water a <br /> Sewer s <br /> Lot <br /> Total DevebpmeM Fee S <br /> BbCk <br /> Plat <br /> U�platted DescdpUon: <br /> $ewer gcnd District <br /> qbuttirp Lot Line <br /> n. <br /> N,S,E,W <br /> APPro�ed By <br /> Type of Pertnft <br /> Issued by <br /> Remarks : 1� . <br /> Customer Signature <br /> IMPORTANTI � /��,,�r�''`- <br /> e y <br /> CALL 1-800-424-5555 48-HOURS y� �/�� <br /> PRIOR TO DIGGING <br /> Inspedbn By <br /> CALL 259-8810 FOR INSPEC110N Date Inspected <br /> SEE SKETCH ATTACHED <br /> No. 28Ta2 <br /> INSPECTION <br />