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everett <br />� <br />'I .^. .^,RG Si �^. ':' a <br />i C�ty 0� �V@fP�t � . .. . . <br />I, Sewer Applic�ation and Perm6t <br />I�i NO. Z� I I� Un �� �� FeLrue�_li,_.19')}-- <br />� -- <br />Service O.ddress 24^<1 9bch Sc SC Utility Account No. <br />lYI4 b )4t1� St <br />Billing Address -- <br />t� 9n103 <br />CHART NO. -- - - - ---- -- <br />TO POSTING��!�S <br />� " , �' � � '.. {. {f . 'f� J�l. �1M f <br />LVII��LJ} �1�1. /)���n/% / <br />TO POSTING ��� rti/4� <br />City, State, Zip 6uattle A permit Fee $_ <br />Owner __ Ceo��erco Connection Charge <br />Connection by __ $""e Trunk $ <br />II Address —.-- - Lateral S <br />i47-c21J <br />' Phone __ <br />Lcdel Description: <br />� Lot _ " — <br />I <br />Block _ <br />Plal �utl�ria 6 <br />i Unplatled Descriptlon: _ <br />___ __ Total Conneclion Charge E — <br />. ._ __. _ _—. Utility Develapment Fee <br />Water $ _ <br />_____ ___ Sewer E — <br />Total Development Fee $ _ <br />; Type o� Permit tie� �otmectluu <br />� <br />, Remarks <br />I -- — <br />I IMPORTANTI <br />CALL 1-800-424-5555 48-HOURS <br />� PRIOR TO DIGGING <br />I <br />I CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Sewer Bond Disirict <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />Nargaret HcLeod <br />Issued By <br />Customer Signature . <br />3p.o0 <br />Q�n <br />179.�U <br />a71.��� <br />GSO.UO <br />� � <br />� �� � <br />Inspection B� <br />� � <br />Date Inspected __ — ---- <br />No. 2s123 <br />ft. <br />0 <br />