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,--,�- T �_ _ -�____ _ _ <br /> � everett ' 'ART NO. <br /> i <br /> � <br /> � - TO PO�TING�_>.-�1=fz .: <br /> : <br /> City of E�•erett = �' � - "� - ' <br /> � : � � �, ,; I <br /> . . - - .. : ;> . - <br /> - � <br /> JL'W �' - -- - : <br /> e A <br /> !ic � <br /> at n <br /> 0 <br /> "n� . <br /> a �! P� <br /> pp _ �rr�it. <br /> _ _ s �.: _ = �3, � S.+ E: =�. � <br /> �..: _ ... ,r �_; � _: �_ _ �. _ `�_ I <br /> �J � " - - `' = = - "' -; � <br /> NO. 2$�i$Q DATE �3/!ya _ - , _ _ <br /> � � <br /> Service Address 317 41e[ Pl Utility Account No. <br /> Billing Addre�s --3?�� *'as��-�kr r,va ;^�b ' <br /> ,j <br /> City, State, Zip —r�e�p�e f�f= 9�394 — Permit Fee $ ' <br /> 'o.;n __ �, <br /> Owner _ Laliv Honas iac Connection Charge <br /> Connection by �.�er✓,� e E��..�n �..�„�— Trunk I <br /> $ <br /> Address Lateral $ I <br /> ITotal Connection Charge $ <br /> � Phone Utility Development Fee �� <br /> � <br /> Legai Description: Water <br /> $ — --ii��Fc�y <br /> Lot Sewer $ �b9.^G ' <br /> Block TotalDevelopmentFee $ �1�•�� <br /> Plat •,a� � -1-�a��eresE �esic <br /> Unplatted Description: Sewer Bond District _ <br /> Abutting Lot Line <br /> N� S, E, W ft. I <br /> �� <br /> Type of Permit �# t:ev Conueccion Approved By <br /> �`. <br /> Remarks Issued By �E I <br /> i <br /> Customer Signature ' ' � ' <br /> IMPORTANT! <br /> CALL y-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-88i0 FOR INSPECTION <br /> Inspection By ��`'�/''�� <br /> Date Inspected 3 3 � 'y Z <br /> SEESKETCHATTACHED NO. ZSG�O <br /> INSP�C i ION <br />