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� <br /> I <br /> I <br /> I <br /> CHAkT NO. <br /> everett <br /> yr� � � <br /> t�7 t+f <br /> >H <br /> ��H City of Everett <br /> r�y TO POSTiNG �� -�ti -�t � ; � <br /> � � Sev�rer Application and �ermit ;' <br /> H 77 I <br /> 'if H"+J <br /> Cn H <br /> � o� � No. 2 E 1 �41 DATE :,.�,...,r. ��, ,�,�,�-- <br /> H t7 � I <br /> � ��y � Service Address �9IIia5cn uc �' Ulility Account No. <br /> H C�7 O <br /> z H� Billing Address }�}t, ;;-;d r:r:rt <br /> � H y City, State, Zip y � -� _ Permit Fee $ <br /> 3F}�t^E? <br /> �' Owner ��eor nirn <br /> �+ Conneclion CharSe <br /> O t7 V1 Ilti `�_.::��;,i .:=1::i ii i;:!��-�-;'':...;:�� � <br /> � �t. Connection by Trunk $' <br /> � 1tuuL:c�."•:: <br /> H O tNi� Address Lateral �:f.l�+$_ �.�:,. ` � <br /> � i1_i`l; i��` ,ii1i <br /> TotalConnectionCharc�e�r;$ -� n nr _ <br /> i ' <br /> Phone ' '.;.Cil *,..�.,� <br /> — — Ulility Developmenl Fee i,. �,ya�. ;, ,�,;,, <br /> Legal Description: Wa�2� �''�"�'� ��� , <br /> ��iilS-i� ;.,�.�Zt'r��H- <br /> '�'� LO� i�. SeWBf :J�U�:��ith.i <br /> �� '.LUI h � '.l1..( • � <br /> Biock Total Development Fee � �'�'$`, "' +�6��,,6� <br /> �� .0 I '. 11 �:i��.lry: <br /> ` � Plat �x��� . <br /> o .,� -oss2Tr=ze-3.Y <br /> Unplatted Description: Sewer Bond District <br /> ,q� _— Abutling Lot Line <br /> N, 4, E, W __ ft. � <br /> ��� � Type o(Permit _�Taan��t,L r Approved By <br /> Remarks Issued By <br /> i • > <br /> -�- v.,. CustomarSignature— I <br /> RJIPORTANT! <br /> ...� <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING �� ' /-s— ; . � <br /> � l.. `s�"- i,'�., <br /> CALL 259-8810 FOR INSPECTION Inspection By - �� -- <br /> i Date Inspected � �/�i <br /> , <br /> SEE SKETCH ATTACHED No. 2�141 <br /> It�lSPi;��i�IOi ! <br />