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CHART NO. d <br /> � � � � everett � <br /> � y <br /> ,O C I � <br /> K � n - - - - - - - . Id P�CT11!C. I�: I �; °I7 l <br /> I _ � , . — <br /> H 77 - <br /> � H � City of Everett - - <br /> y N <br /> � y � �i Ser�►er �4pplication-�nd `Perrni�t � <br /> � � � . . _ _= i <br /> � <br /> � y � No. 2$656 DATE- I �/o� I <br /> I <br /> � H H � <br /> e y ;71i; 2GU� Dr 5�: Utility Account No. <br /> 5 Service Address <br />� � '"' t'' • ts t l Hv <br /> o y Billing Address 71'� r ,� �� i <br /> City, Slate,Zip F �r "' "�°� — Permit Fee � j <br /> Owner Cronir� t:ones Ir.c Connection Charge <br /> Trunk $ '�---���— � <br /> Connection by I <br /> Address Lateral $ i <br /> II Z7C�.UC <br /> Total Connection Charge $ <br /> Phme Utility Developmenl Fee ''I <br /> i $ '�2'..JR <br /> I Legal Description: Water I <br /> w $ ` I <br /> � ' I Sewer i nn <br /> !.a I �ot <br /> 1 Block Total Development Fee � "_" - <br /> i � , .7 <br /> ��`1 Plet nu t ' <br /> s II _ <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> j �� N,S, E,W ft. <br /> '�� Type of Permit Appraved By <br /> ��� Gli <br /> 1 Remarks Issued By <br /> Customer Signature <br /> ��I � IMPORTANT! <br /> � i�,� CALL1-800-424-5555 48-HOURS /� <br /> ���1. PRIOR TO DIGGING ,..� � <br /> I Inspection By � /l <br /> CALL 259-8810 FOR INSPECTION � <br /> Date Inspected � <br /> li <br /> I NO. 2$��� <br /> SEE SKETCH ATTACHED <br /> INSPECTION <br /> � <br />