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CHART NO. <br /> everett <br /> � � 8 �� � � 8 g $ ?0 POSTING 1�-zs� <br /> City of Evnrett N � � � � � � � � - <br /> j � Sewer Applic�' n a� � � � ~'t <br /> , � � �m ��� <br /> � <br /> � ,: NO. 2$12� DATE p�Dsaar7 14, 1991 <br /> j 9820 2Sth i Dr SS <br /> 1,: Service Address Utility Account No. <br /> �:. <br /> � ' Blllinp Address 191i H 3ith St <br />' �' �ity, State.Z1P �+til� Ys 98103 Permit Fee $ �.� <br /> ,,. <br /> I I ;;,. <br />; ,;� ` p�� ��CO Connection Charge <br /> + ;:-' Connection by � Trunk S <br /> :`� ,;. <br /> )�;�' ` Address Later8l $ <br /> ,;�r � <br />�� <br /> Total ConnecGon Charge $ "�" <br />� �� .', . Phone u�'�13 UUlity Development Fee <br /> �pe���b�; Water S 1T9.00 <br /> �,pt 11 Sewer $ 471.00 <br /> g� Total Development Fee S 6��� <br /> Plat �tOria lII <br /> Unplatted Description: Sewer Bond Dist�ict <br /> Abutting Lot Line <br /> _ N, S, E,W � <br /> Type of Permit � CO°°�ti°n Approved By <br /> Remarks issued By �rprat MeL�od <br /> CustomerSignature �'—�� � ���' ` '����( <br /> IMPORTANTI <br /> CALL 1-800-4245555 48-HOURS � <br /> PRIOR TO DIGGING '�� � <br /> Inspection By <br /> CALL 259-6810 FOR INSPECTION � � 4 <br /> Date inspected <br /> SEE SKETCH ATTACHED No. Z812O <br /> � <br /> � INSPECTION <br />� <br />