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fl <br /> ! everett <br /> cHar�T r�o. — <br /> I <br /> ■■ _ TO �OSTING �z " 5-Ri <br /> yt�"� - _ - - - _ = r: <br /> �� City of Everett - � - - - - <br /> ay , - - <br /> ��x" Sewer Application and Perrv��t.. :., ,' * � <br /> aycn <br /> H y� _ <br /> fC �C'� I �'. c _ _ ' <br /> H�1 I = _ - - <br /> � yH i NO. ZS��� DATE __a-•z�-�� _ — - , <br /> y z r Service Address �v e n*+, o, � � <br /> � y d Utility Accaunt No. — _ <br /> � �[y Billing Address '+1Q�2 33th Aaa �� — <br /> H C+7 O <br /> H` n City, State, Zip srier WA 98�36 <br /> x y� Permit Fee $ RXx,xx 30_nn <br /> � H y I Owner �'air,�w�t t•wn�ea. �ne Connection Charge <br /> p �y Connection by __�„n� Trunh $ <br /> � t�f t� i Address Lateral $ <br /> Z H c�i� <br /> y �� i Total Connection Charge $ ----- _ <br /> IPhene 35r>- 4�s _ Uliliry Development Fee <br /> Legal Description: Water $ 2�4.op <br /> � Lot _8t Black For .�r r.a�a Sewe� $ 599.00 <br /> �-1 Block Total Develcpment Fee $ �t17.no <br /> Plat <br /> �=� Unplatled Description: _ Sewer Bond District <br /> Abutting Lot Line <br /> `..s N, S, E�W _ ft. <br /> Type of Permit rm�a co,avErmrrnr Approved By <br /> „�,�� Remarks __ Issued By rt rnsoh�T__ . <br /> 1 � - <br /> Customer Signature <br /> � <br /> ��)� IMPORTANT! � ��. <br /> ��'�-� CALL 1-800-424-5555 48-HOURS /J <br /> PRIOR TO DIGGING // � <br /> , CALL 259-8810 Ft�R INSPECTION <br /> Inspection By . , C��`-�"v� <br /> Date Inspecled �� �— r� <br /> SEE SKETCH ATTACHED No. 28393 <br /> Ilvsr�ecTio�i <br /> ; <br />