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i <br /> � <br /> � <br /> � <br /> everett CHART NO — <br /> Se.r.f in ��os��Kc� �a-l�`+i <br /> City ot Everett <br /> Sewrer Appli�ation and Permit <br /> NO. 2 8.3�4 DATE J�me 3, 1991 <br /> Service Address — eil-lloch place �_ Utility Account Na. <br /> Bllling Address �� <br /> City, Slate, ZfP ��+TMt� � 9ezoe _ Perrnit Fee $ 30.00 <br /> Owner �w .-���_ Connection Charge <br /> Connection by _ Trunk $ <br /> Address Lateral $ <br /> - ---- Totai Connection Charge $ _ <br /> Phone Utility Development Fee <br /> LegalDescription: Water iti��-'1i?��I u :Z1�Nf (u�H1N:'2�n III <br /> Lot Sewer lIIXNI��+'•ru <br /> c�-�.,�:V ) :ii.fKl <br /> Block _ — Total Development Fee ��.,.` .. 1�i,rp� <br /> Plat <br /> iUn����"u" Gescription: Sewer Bond District ___._ _ <br /> Abutting Loi Line <br /> — N, S, E, W ____ R. <br /> T'ype of Permit e.,... n,.,„....r�„� .. r.rn 7�n Approved By _ <br /> Remarks __. Issued By—_ — — <br /> — Customer Signature— <br /> IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR Td DIGGING l , „�— � <br /> Inspection By � <br /> CALL 259-8810 FOR INSPECTION J / <br /> Date Inspected lr � _ <br /> SEESKETCHATTACHED NO. �3304 <br /> INSf GCTION <br /> , I <br /> � <br /> � <br />