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: <br />; F: <br />� <br /> ' CHART N0. <br />�:. • <br />` everett �- -ro �t;,^,� <br />' " 4-t8-9� <br /> �u' <br /> t <br /> � <br />, J C O <br />� City oi Everett � q 4 <br /> �� <br /> i� �y, �.. ;. <br />� .� xi <br />�� Sewer Appiicatio�. �nd Permit <br /> `'` � � � <br /> NO. 2 8�. 9� DA'fE :t�rcn z�, 1991 � _ <br /> Service Address 100�2 7ch Ave SE Utility Account No. <br /> Billing Address SII� — <br /> City, State, Zip �`VPTPff v�, g8203 Permit Fee $ 30.U0 <br /> Owner p � >>� Connection Charge <br /> r Connection by Citq of Lverecc Trunk $ <br /> Address Lateral $ <br /> — 7otai Connection Charge $ <br /> Phone Utiliry Development Fee <br /> Legal Description: Water $ <br /> Lot Sewar $ I <br /> Block Total Development Fee $— <br /> Plat <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> N g E.W ft. <br /> ��,�- Pi-.� Tim /�q,P�-5 <br /> TypB Of Pe�rtlit Nev co•,necrion eriaticr ho� Approved By <br /> Remarks ._ T *i, �zn Issued By— r`•arcaret nd.eod <br /> Customer Signature <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING � <br /> Inspection By ( �',.e,c, O� C� <br /> CALL 259-8810 FOR INSPECTION '�^ 7-- <br /> Date Inspected � l5/�� <br /> SEE SKETCH ATTACHED No. 28193 <br /> i��is��crioni <br /> �, <br /> � <br /> �� i <br /> � <br />