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everett <br />CHART N0. <br />jQ.�� �o �o�Ti.��, �d/.37/Al <br />City of Everett = * . <br />Sewer Application �r�d Permit <br />5 �R � � - <br />- :���- <br />No. 2 8 2'� 3 DATE .�.wy f e, 1991 <br />Service Adoress 516 - 303zA PI BE <br />Billing Address �"" — <br />Cl�y, S18IB, ZIp _ o ♦• ri !v 9820H! <br />Owner do�� t Taylor _ <br />Connection by � M�ner�l Oon�troctor _ <br />Address <br />Phone �3�-]9�S _ <br />Legal Description: <br />Lot — <br />Block <br />Plat <br />Unpletted Descriptlon: <br />Type of Permlt <br />Fiemarks LZ� 2251 <br />IMPORTANTI <br />CALL 1-800-424-5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 258-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit Fee $ <br />Connectlon Charge <br />Trunk <br />Lateral <br />Total Connection Charge <br />Utility Development Fee <br />Water <br />Sewer <br />Total Development Fee <br />Sewer Bond D!atrict <br />9 <br />a <br />$ <br />$ <br />$ <br />$ <br />70.00 <br />u <br />��D <br />Abutting Lot Llne <br />fJ, S, E, W fl <br />Approved By <br />155Ued By ►urqa�.t inc7�od <br />Customer SignaWre <br />� <br />Inspection Byl� r'� ��/ � �l l,fL <br />Date Inspected _— ��L`l/ <br />No. 28253 <br />� <br />