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a <br /> everett CHART NO. <br /> �/�o/4a. <br /> c�tyot everett T(1 P�ISTING_ ►� <br /> Sewer Application and Perrnit <br /> NO. 2$5Q$ DATE il/18/91 _ <br /> ServiCe Address 162o SiYoer Lr Rd Utility Account Na. - — <br /> Bflling Address -5�-�'" 1 t •� i � ..� '� .! ;;.:, L� . <br /> Ciry,State,Zip �bt Trosvia Permit Fee $ _ to_no <br /> Owner ' '�� � ���� � � �nnectionCharge il;ls3/91 2�6�iPM OIXiitqllti tixk <br /> Connectfon by Trunk ����y,e <br /> Address Lateral �� ���'� <br /> p� , i . <br /> Total Connection Charge $ <br /> Phone Utiiity Development Fee <br /> Legal Descriptfon: Water $ _ <br /> Lot 13 Sewer $ _ <br /> Block Total Development Fee $ <br /> Plat Lakevier tuLd <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> N,S, E,W _ tt. <br /> Type of Permft Altetation Approved By _ . <br /> Remarks Issued By — C� <br /> Customer Signature--- <br /> IMPORTANTI <br /> CALL 1-500-424-5555 48-HOURS <br /> PRIOR TO DIGGING �� /- _ . <br /> CALL 259-8810 FOR INSPECTION Inspection By.L.�� � ^ <br /> Date Inspected _ `�p/ <br /> SEESKETCHATTACHED No. ZH�JZB <br /> iNSPECTIGN <br />