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i <br /> CHART N0. - —_— <br /> everett ! <br /> � � " <br /> ro � <br /> � � e -. _ _ _ <br /> � � � - ; � � _ : - Tp POSTING�l__s-�-- <br /> � Q City of Everett �= , � � " _ <br /> hE N �U ;.i M f� .':.� .,.' �... ... .c� � <br /> � � � I Sewer �pplicatia� and_ Permit <br /> � � d � _, y : � � .� W � � <br /> ay H R NO �`'8�06 rA DATE . 4/10/9, — <br /> C' y � — <br /> � � N Service Address Utility Account No. <br /> � � � 8illing Address . • � <br /> � y Ciry, State,Zip Permit Fee $ 3C <br /> Owner <br /> Connection Charge <br /> Connection by <br /> Trunk $ <br /> Address <br /> Lateral $ <br /> Tolal Connection Charge $ <br /> Phone Utility Development Fee <br /> Leral Description: <br /> Water $ <br /> �.. __.., $ ,�. „�. _ <br /> ��\ Lot Sewer <br /> Total Development Fee �—C�SP.A4------- <br /> Block — <br /> 1 '�� Plat Al^^Lc.,.�rtr t.ane <br /> ' �' Unplatted Description: Sewer Bond District � Lu��� <br /> � Abutting Lot Line <br /> N,S, E,W ft. <br /> I �� : <br /> Type of Permit v ., nn t Approved By <br /> �s Issued By GB <br /> I ���� Remarks <br /> Customer Signature - <br /> � �-1�� IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR 70 DlGGING <br /> �.�� Inspection By— <br /> c�_� <br /> CALL 259-8810 FOR INSPECTION Date Inspected �• Z z�9 Z` <br /> SEESKETCH A7TACHED No. Z87�� <br /> INSPECTlGN <br /> f <br /> 1 <br /> � <br />