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everett � ` <br />� TO P05TING � ' � 3'��I <br />� <br />cityofE��r�n � sgs��s s�s a � <br />� .� � r. <br />Sewer <br />NO. <br />.r! i� M M� M M� F � w� <br />Applic�t�n d� er � i ; � <br />� � '�� � �' � ��� � <br />������� ���� ��~� <br />284�4 � DATE 9'17-91 � <br />Service Address 111 I1�tA st se <br />BIIIing Address ��12 x2�th pl B8 <br />City, State, Zip �+�t �u► 9e2eA <br />Owner �Rt N�r Qbu��rican s�N� <br />Connectlon by O�z <br />Address <br />Phone �37-�189 <br />Lepal Descrlption: <br />Lot <br />Block <br />Plat <br />36 ot �llwr Aar�� <br />Unplatted Descriptlon: <br />Type o( Permit ww �..�...��.�.. <br />Remarke <br />IMPORTANTI <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO OIGGING <br />CALL 259-8810 FOR INSPECTI�N <br />SEE SKETCH ATTACHED <br />Utllity Account No. <br />CHART NO. <br />PermitFee $ 70.00 <br />Connectlon Charge <br />Trunk <br />Lateral <br />$ 330.00 <br />$ = <br />Total Connectlon Charge $ 330.Mf <br />Utility Development Fee <br />Water <br />Sewer <br />S -ua_nn <br />a sa9_ee <br />Total Development Fee $ �111.n0 <br />Sewer Bond Dlat�ict Iii <br />Abutling Lot Line <br />N, S, E, W <br />Approved By <br />Issued By Rt�_M mx��� <br />Customer Siqnature <br />Inapectlon By � <br />Date Inspected /?�9� <br />INSPECTION <br />No. 284�4 <br />h. <br />