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everett <br />City oi Everett <br />Sewer Appl <br />�i�. � [�, <br />�- <br />� <br />� _ <br />_ <br />��;� < ��b� � �:� <br />� _�_;' - �,_- _ __ <br />. , �� - <br />�•l 'F '� •h '11 <br />IC�fl�1,0�1.,811�i �E��'I'X11t <br />.. • T W � -.. . <br />.. . ��J `� r� r <br />l <br />�� a3 _y^'``�������'�#� <br />;� ��t�_:..'�s_.�' _ <br />NO. 2 H Z� 3 - DATE �+ev z� , 1991 <br />Service Addrecs �a — 113n+ ai ap Utiliry Accoum No. <br />BIIIing Address <br />City, State, Zip Mukiltao NA 98275 Permit Fee $ <br />�Wf1Bf W�fe�n qs�es <br />Connection by <br />Address <br />Phone 156J�5DL <br />Legal Descrfptlon: <br />Lot �l <br />Block <br />Plat ►yriQian pl�ae <br />l'�platted Descriptlon: <br />Type o1 Petmlt �4r t�o�scti�+* <br />Remarks <br />IMPORTANTI <br />CALL 1-800-424-5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259•8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Connect(on Charge <br />Trunk <br />30.00 ._ <br />$ 3�0.00 <br />Lateral $ <br />Total Connectlon Charge $ <br />Utility Development Fee <br />Water <br />Sewer <br />$ 179.00 <br />$ 471.00 <br />Tolal Developm�nt Fee $ �,sp,w_ <br />Sewer Bond Districl BPnd II2 <br />Ab�tting Lot Line <br />N,S,E,W <br />Approved By <br />n. <br />Issued By <br />� <br />Customer Sipnature � ! � <br />Inspection By <br />�� l� ; - <br />Date Inspected ' <br />ir�sri:ci ic�, <br />No. 28�293 <br />