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` � <br /> � <br /> i <br /> � � <br /> i <br /> i <br /> � <br /> � � <br /> ��� � <br /> t"H fn <br /> ,.��. `y,� CHART NO. -- <br /> o'�o I e�erett <br /> �Y� , TO POSTING_ � �' - ' <br /> o� d � <br /> �� g City at Everett 'r� ��, �.' b:,�x n r�n�na..��: �ti�� <br /> �` " I <br /> �H� S�wer Application and Permit ���;t� <br /> �y �'Fi�L' r.:U.!Ci <br /> �H --- t�Kl1 L t .'tn.(1(I <br /> O � NO. Z 8 7�.� DATE tsav 7•_14�2__ t 171'S �ai�Ff.70 � <br /> � �' . . .. r.,. ' <br /> ON <br /> N I <br /> Service Address �0�--1].2th-St--�r -- Utiliry Account No. <br /> Bllling Address -1i7.10.xi�aln�--'�'� � <br /> � Gty,State,Zip �r-Nk--�43-71--- Fermit Fee $ _�R,90 <br /> Owner �+ � ��Y r^'"�"• Connectlon Charge <br /> � <br /> Conneclion by _ �'^• ^^^�'' Trunk � ���--- I � <br /> Address Lateral 5 � <br /> s..wctie ww 981]3 Total Connection Cherge S _�3�•��--- i � <br /> Phone sa� i aaa — Utiliry Development Fee I <br /> � ��� � Legal Descriplion: JJaNr S =_ — � { <br /> � I �. •�v0� $ 689.00 � � <br /> � LOt --- � <br /> I �� Block — — 'n�al De:elopment Fee $ 6A�.^v_ II � <br /> Plat __ — <br /> � Unplatted Description: Sower dond Distr,ct Dm��?I?------- <br /> � ' '� __ Abutting Lot Llne ! <br /> N, S, E,W n• <br /> r�' Type of Permit _ tvaw ca�eC'1'I0�'� __ Approved Ey L cravTorA I <br /> Remarks _— Issu�d By t *a�k �1 - <br /> ��� <br /> � _______--_ Custo�ner Signature-_--- - - � <br /> — -- I <br /> � IMPORTANTI � <br /> �'-'� � <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOP TO DIGGING �i � <br /> ` /i <br /> Inspection 8y,—�' -� ' �.�/ <br /> CALL 259-8810 FOR INSPECTION - - ' <br /> Date inspected _ r�/5�� -- <br /> � <br /> No. ^8716 <br /> i SEE SKETCH A ffACHED <br /> ir„ i �� iio�i <br />