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Sewer Applicat <br />. 2s7c�a <br />r: <br />,; <br />N <br />�7 <br />� <br />,� <br />u <br />r: <br />s =, ,�, <br />ui a �� .a: <br />� �� <br />� r�s� Permit <br />�on- a �_. �_� �. � <br />a.� W c <br />`� r� ��� Li � c <br />� :�:.'� au'7�J <br />DATE �-2-'a <br />�� �, ,, <br />Service Address 2601 Tn lor Dr <br />Billf�g Address <br />2515 Tuylor Dr <br />City, State, Zip Everetc WA 98203 <br />Owner Tt�omas W. Jones Jt <br />Connection by — <br />Address <br />Phone <br />Legel Description: <br />Lot <br />Blxk <br />Plat <br />Unplatted Description: <br />Type ot Permit Cnp of f <br />Rema�lcs <br />IMPORTANT! <br />CALL 1-800-424•5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />Utility Account No. <br />CHR.i �T NO. <br />TO POSTING 1�- ', <br />PermitFee $ 10.00 <br />Connection Charge <br />Trunk $ - <br />Lateral a � <br />Total Connection Charge $ <br />Utility Development Fee <br />Water $ <br />Sawer $ <br />Total Development Fee $ <br />Sewer Bond District <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />Issued By — � <br />Customer Signature <br />n. <br />��j w ^ <br />�' eC/��o✓+. <br />�� Ss�S� <br />Ins on By � <br />� <br />Date Inspected <br />SEE SKETCH ATTACHED , ?�` ? G�� I <br />INSPECTION � <br />