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� <br /> ^. '4RT NO. ---- <br /> everett <br /> yr� � = TO POSTING_�z-i?�- <br /> , <br /> i .o z H City of Everett - _ - <br /> >H(n - - <br /> y �� Se��r Application a�d�Perm�� � i <br /> � �� <br /> � H� - � `" : : :: J : _ � � � . � <br /> y zr I NO. ZSs3Z DATE . = s/9l92 _ y — I <br /> � o r�- � i <br /> li o H b Service Address o:)1 41ec I'1 _ Utiliry Account No. � <br />� <br /> I � M� <br /> • f � •"`(1 <br /> H� � BillingAddress - �'�^ ' ��'t ^ <br /> � H� I Seittle TiA 951U2 q,� D � , <br /> Ciry, State, Zip Permit Fee � � <br /> r-+H <br /> � �H � Owner t:nlly Fokes inc Connection Charge <br /> o t7�n • I <br /> � n r II 5 e�.,,<< e �...{- � <br /> Connection by 9���("" T.unk $ <br /> z H U i Address — Lateral $ <br /> H O U. <br /> jTotal Connection Charge $ _ <br /> IPhore Utilit/ Development Fee <br /> �''''� water $ 2';� nn � <br /> r ,; Legal Description: <br /> s. Lot _ Sewer $ 599.Op ' <br /> '�� I, Block TotalDevelopmentFee $ r-1� nq <br /> o�, I Plat c{�s._� i C forest Cnrl• <br /> 1�_s _ <br /> Unplatted Description: Sewer Bond Di,trict <br /> �s� I _ Abutting Lot Lin�. <br /> �►'� I — N, S. E, W — ft. <br /> I <br /> �_'� Type o1 Permit +�eu coimection Approved By_ — — <br /> Remarks Issued By— — - <br /> i <br /> ' '� CuslomerSignature—_- ,__. <br /> IMPORTANT! <br /> ��� CALL 1-800-424-5555 48-HOURS ' <br /> PRIOR TO DIGGING <br /> � �; /-�,.., <br /> � CALL 259-8810 FOR INSPEC710N Inspection By "- <br /> Date Inspected —'`�' � -�' Z" <br /> SEESKETCH ATTACHED N�• 286�z <br /> �j.i�=„�_r;(�C,�,� <br />