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. <br /> everett � CHART N0. <br /> �� I <br /> ` SC' n7" � '�dS�i.cC� <br /> - 7'Z-G -9 I <br /> City of Everett ; ' <br /> �•r <br /> Sewer /�;.p�licatian and Permit <br /> � - <br /> _; <br /> =� ; d <br /> NO. ,�$�I�Ei DATE Ju�c a,.�s91 <br /> Service Address ���� - +. ��, Utility Account No. <br /> Billing Address �000 lst Tratarstake �n�er <br /> City, State, Zip — sea���e, W� 983p�4 P?rmit Fae $ a9.8^ <br /> Owner Connection Charge <br /> Connection by ownex Tunk $ <br /> Address — Lateral $ <br /> Total Connection Charge $ _ I <br /> Phone 259-3657 Utiliiy Development Fee <br /> Legal Description: Water $ <br /> Lot Sewer $ <br /> Block Total Development Fee $ <br /> Plat <br /> Unplatted Description: Sewer Bond District <br /> _ Abutting Lot Line I <br /> N, S, E, W ft. <br /> Type of Permit Approved By <br /> i <br /> �. <br /> Remarks Issued By � �---�;{,;-� <br /> Customer Signature <br /> lN1FORTAhT! <br /> CALL y-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> Inspection By .� ����- <br /> CALL 259-8810 FOfi INSPECTION <br /> �� <br /> Date Inspected �� � �� <br /> . <br /> SEE SKETCH ATTACHED NO. ��3�b <br /> Ih1�PGCTION <br />