Laserfiche WebLink
CHART NO. <br />everett <br />City of Everett ; � <br />= -, <br />.. <br />Sewer �pplication and Permit <br />-,@- <br />NO. 2�?�� � � DATE _��_��� .��— _ <br />Service Address _ <br />Bllling Address _ 0 � p gE <br />Clty, State, Zip �-- <br />. <br />Owner � ^�, �� <br />Connectlon by <br />Address <br />Phone _x, <br />Legal Description: <br />Lot � <br />Block <br />Plat <br />Unplatted Descriptlon: <br />Type o' Permit �or r�anrrrrw <br />Remarks ��qjg.� <br />IMPORTANTI <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit Fee $ <br />Connection Charge <br />Trunk <br />Lateral <br />Totel Connection Charge <br />Ulility Development Fee <br />Water <br />Sewer <br />Total Development Fee <br />Sewer Bond District <br />Abutting Lot Llne <br />N, S, E, W _ <br />Approved By _— <br />Issued By �� <br />Customer Signalure <br />8 <br />$ <br />$ <br />�o �a�t;�y <br />5- t3`9� <br />n. <br />i `% j <br />Inspection By � <br />Date Inspected _ � ` `T-� -- <br />No. 28235 <br />