Laserfiche WebLink
� <br /> . <br /> � <br /> � <br /> � <br /> CHART NO. 1 <br /> everett I <br /> - S e nf �c: ��nt� (0-�.4-q� <br /> � <br /> a <br /> y� <br /> � v <br /> �!w oi Everett� ' <br /> . _� - -- <br /> Sewer l��p�plicati�n and Permit <br /> . � �: � <br /> � ��w+ <br /> NO. �$� I S- DATE ��.iyyr.___ <br /> Service Address �— Utility Account P:o. — <br /> Bllling Address -- <br /> City, State,Zip � Permit Fee $ �ptpa___ _ <br /> Owner _�g _ Connection Charge <br /> Connection by _ ---_ Trunk $ -- <br /> �rv <br /> Add�ess .�� -- Lateral $ — <br /> __ ry� e� _ Total Connection Charge $ <br /> I Phone Utility Development Fee <br /> Legal Description: Water $ _ <br /> l.ot ��r Sewer $ <br /> . <br /> Block — Total Development Fee $ —_ <br /> Plat _. —.— _-- <br /> Unplatled Desc:�ption: _ _ Sewer Eiond District — —. <br /> Abutting Lot Line <br /> -- -- N, S, i?, W ft. <br /> Type o(Permit ���,�_ Approved By <br /> Remarks _ Issued By__; ��� <br /> lid 770 <br /> _ Customer SlgnaWre �� �.�--a <br /> INiPORTANTI <br /> GALL !-SGO-424-5555 48-HOURS <br /> P�tIOR TO DIGGING � - _ <br /> � <br /> CALI. 7.59•8810 FOR INSPECTION Inspc+ction By� � � �'��— <br /> Date inspected __ — — <br /> 3EE SKETCH ATTACHED No. 28�7 H <br /> IINSP:=CTION <br /> � <br />