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��� <br />� H !�"�i� <br />H�� <br />�H� <br />'�tl M "�d <br />y <br />��� <br />Q'ti <br />�M8 <br />o. c� <br />ry�N <br />g �' <br />Cg'1 � fA <br />HO� <br />� <br />i <br />I �� <br />; everett <br />� <br />�� Clty of Everett <br />�ICHART NO. <br />10 POSTING_ 3 %� z <br />, Sewer Application and Permit <br />i NO. Z S 13 8 DATE -- --- <br />ServiceAddress -----. ------- -- — <br />� — <br />Blll.r.g Address — <br />City, State, 21p <br />�YYfIBf <br />i <br />Connecllon by <br />I, Address <br />Phone _— <br />Legal Descriptlon: <br />Lot — <br />Block <br />Plat _ <br />Unpletted Descrip�lon: <br />Type ol Permit <br />Remarks _ <br />/ <br />IMPORTANTI <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSF'ECl iON <br />SEE SKETCH ATTACHED <br />Uliliry Actoun� No. <br />Perm�i Fee $ _ ` <br />,�., . .' � �:•;A�h �i�iN:�„.19 . <br />Connectiun Charge <br />;�Oh r o" <br />Trunk ����i��-- ��r�.� <br />Lateral N Ix,� _ +�I �0.1 <br />i�I�li �'Y),IYI <br />TotalConneclionChargb �Li' �� ��� <br />�.� � �,�,� :.�n,�Ki <br />Utility Developmenl Fee ,�,��,•„. � .: <br />i�,�i u.iri <br />Wa�er �,m • <br />�, <br />, �,� � � ti ,��,�pi , <br />Sewer i r, i�. i.., �. � <br />Tctal Development Fee' ��� �ffi '��'��•� ` I <br />i <br />Sewer Bond District . __ — <br />Abatling Lot Line <br />N. S, E, W—_ ..---- - It. <br />Approved By -- � <br />Issued By _-- <br />Cu�lomer Slgnature _— <br />�� , <br />InspecUon By r � ����" <br />Date Inspected --�--� ��--�/ <br />p;..'". GIION <br />No. 281.3K <br />