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Ieverett CHART NO. <br /> City of Everett <br /> Sewer Applica�ion and Permit <br /> NO. 2842� DATE s�oe 11, 1991 <br /> 10.?!2 <br /> Service Address -i� 19th A�e Sh Utility Aa:ount No. <br /> Billing Address — 1902 19eh ��e Se <br /> City, State,Zfp E..T.e TiA 9A?OR Permit Fee $ 2.5'J <br /> ��� � � Te'�- oa Connec;lon Charge <br /> Connection by Trunk $ <br /> Address Lateral <br /> $ <br /> Totel Connection Charge $ <br /> Phone Utility Deveiopment Fee <br /> i L.epel Description: Water <br /> 09/1�'QI 9'19RN OOOAiIR85'i t�tkk <br /> �t Sewer `r <br /> , tKiO(�B4�B <br /> B� Total Development Fee � f`�� <br /> Plat <br /> Unplatted Description: Sewer Bond Dfstrict <br /> Abutting Lot Line <br /> N, S, E,W g. <br /> Type Of Permft _ �¢..t4 Approved By <br /> Remarks Issued By GE <br /> Customer Signature <br /> IMPORTANTI YLr / • <br /> �/� f /7 e«g� ..vaf A¢ve.— <br /> CALL 1-800-424-5555 48-HOURS ��' �' ``�`"� �o �� S�w �.- <br /> PRIOR TO DIGGING (/�� <br /> CALL 259-8810 FOR INSPECTION Inspect(on ey - <br /> Date Inspected <br /> SEE SKETCH AITACHED Np, Z�4 Z O <br /> INSPECTION <br />