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�- ,. <br /> �: � <br /> � <br /> � � "y ---- <br /> CHART N0. — <br /> i0 Rf y <br /> �C � ~n � <br /> � y O . <br /> Rf <br />�� � � � �� �� � � TO POSTING �o -�'- <br /> � � � ' n and Permit I <br /> � y � Sewer �pplicatio , , . <br /> � <br /> N <br /> � °� y "' 7� .� � DATE b/^ /�, <br /> � °0 . <br /> � y 10:L05 7 th it�c STi ��ility Accounl No. <br /> Service Address <br /> Sume <br /> Billing Address 30.00 I <br /> City, State,Zip Everett ti.A 78208 Permit Fee $ <br /> Owner HPlen r' �P�]�'v — Connectior�Charge i <br /> /� /y-� fr�S Trunk $- <br /> Connection by .� h'1 �'�'�%�� /� " I <br /> Address Lateral $ � <br /> Total Connection Charge $ <br /> i ` Utiliry Development Fee <br /> � ��'' Phone - $ <br /> Legal Description: Water <br /> 1 �� Lot 1 Sewer $ <br /> ���� Total Development Fee $ <br /> Block — <br /> Plat .loimeon'e Addu <br /> + �� Unplaried Description: Sew.r Bond Dauict <br /> LID <br /> Abutting Lcl Line <br /> � '�I_I N, S� E,W ft. <br /> New connection Approved By <br /> Type of P�+rmit <br /> � �� Remarks Issued By <br /> II • J <br /> � _ Customer Signawre_ <br /> i � <br /> �_i�' IMPORTANT! <br /> , / /�' <br /> CALL 1-800-424-5555 48-HOURS �1 '/ � � / / <br /> PRIOR TO DIGGING / /��l L� �j7G�,��_ <br /> Inspection By �J / <br /> CALL 259-8810 FOR INSPECTION Date Inspected ( 6 � �� � �� <br /> SEE SKETCH ATTACHED � . ,� ;; �, <br /> INSPECTION <br /> 1 <br /> � <br /> ( <br />