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CHART NO. <br /> everett <br /> J� �" <br /> � City of Everett � ' ''' �=� - � � 3 = r� `� - � TO POSTING 3 3 52 <br /> �' - r� r-. <br /> ' i.� t- .;J _.i - <br /> � i � <br /> Sevorer �4p�1i�:��ic�n a�i� �Perr�,it <br /> . =' � � -� _ � ; .�, : :� � �' :_ <br /> j ,] . •� � � �� � ^' .� i �' <br /> i5 = � - �� = c- _ <br /> �'� �:, J i J _ ^ ___ ',' � ki ;r � �w »�i � '.i�. ._ <br /> NO. ��_� � � DATE � � <br /> . , <br /> Service Address 2C10 - 3tith St Utility Account No. <br /> Billing Address <br /> (2 eei+er caa�nections E� <br /> City, State, Zip �.-e•• m* ��+�� — Permit Fee $ 60.00 53o%achl <br /> Owner ��+,• �•;, *���«�� — Connection Charge <br /> Connection by Trunk $ <br /> Address Lateral $ <br /> Totat Connection Charge $ - - — <br /> Phone Utility Development Fee <br /> Legal De�aription: Water $ � e�_ <br /> Lot er /2 ot nioek 26 of S_ R_ 9inaa nc,ti, mr�ets Sewer g. enn_zn <br /> Block Total Development Fee $ �— ��,�� <br /> Plat <br /> Unplatted Description: Sewer Bond District _, -- <br /> . Abutting Lot Line <br /> I <br /> N, S, E�W ii. <br /> Type of Permit xnw connectier� Approved By <br /> Remarks Issued By ! - <br /> _ Customer Signatura �\�% F"=`"v- �''% t - ___ / <br /> IMPOR7ANT! <br /> CALL 1-800-424-5555 48-IiOURS <br /> PRIOR TO DIGGING <br /> Inspection By �— <br /> CALL 259-8810 FOR INSPECTION <br /> Date Inspected � �- S � <br /> SEE SKETCH ATTACHED No. ZSi�.3 <br /> INSPECTION <br />