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f <br /> CHART NO. _—_ <br /> everett <br /> Sen� �v �r�,,,,;,� ��2—i1 <br /> .J <br /> J <br /> City of Everett A " � <br /> Sev�er Akp�lication and Ferra�it <br /> 2 c�i? L <br /> �� — <br /> � __ �, , <br /> NO. `Z�`�. �� DA7E _N$� �n,�ooi <br /> Seivice �.ddress — S� Utility Account No. — � <br /> Biiling Address " " ' <br /> City, State, Zip ��z`tt, wn 9s208 permit Fee $ 3000 <br /> Owner Tnhn t ^,t.n� �nrs+hinar Gonnection Charge <br /> Connection by �� _ Trunk $ <br /> Address Lateral $ -- <br /> i otal Connection Charge $ I <br /> Phone �_r�39g Utility Development Fee <br /> Legal Description: Water $ <br /> �Ot S fiG'nF 8 13II' �* Tnt 15� mr_aAnre�i �n Sewer $ - i <br /> Block e = s �+�es. pi�+* nf nr�a�roay raron rto, 2 TotalDevelopmentFee $ <br /> Plat _ <br /> Unplatted Description: Sewer Bond District <br /> Abutting Lot Line <br /> N, S, E, W ft. <br /> Type of Permit earc.� rnnTr,�crrox Approved By <br /> Remarks Issued By �n,,��� <br /> Customer Signature <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS I <br /> PRIOR TO DIGGING i' , " � � <br /> C�4LL 259•8810 FOR INSPECTION Inspection �� ' �� ��'Y��`-= I <br /> Date Inspecfed — �?�i�(/ <br /> SEE SKETCH A'fT'ACH�D NO. ZS��T9 ! <br /> i <br /> i ��:�_�>�c rc:�! � <br /> I � <br />