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everett � <br />�� <br />: IO � '•`� <br />� <br />� <br />City oi Everett :� & R s�'= <br />+; �-;5_ <br />y. . •, � _ <br />r <br />Sewer �ppii�atioii ar��d Perr�it <br />_�.-� <br />y'�' = s ' � :: :_ :� <br />N0. L$ 3 Z U DATE .n,... �� _T, oo, <br />CHART N0. <br />I Serv�� Address 3—�—�+► :.�s g$ Utility Accour t P!o. __ _ <br />�dling Address =1902 — 3Bth 7►�e N <br />� City, State, Zip nrlar. rw 98oag Permit Fee $ 30.00 <br />Owner Iatnao6ltaw�� <br />Connection by <br />Address <br />pliona <br />Legal DAscriptinn: <br />Lot 2 {z_ <br />Block <br />Plat <br />Unpleped Dascription: <br />Type ol Pf rmit „... ,.,,.,,.eQ.f� <br />Remerks <br />IMPORTANi! <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Connection Ch3rge <br />Trunk <br />Laterai <br />$ —ii➢�L! <br />$ <br />Total Connection Gherge y 330.00 <br />Utility Development Fee <br />Nlater $ i�o_ne <br />S�3wer g �71.00 <br />Total Development Fee $ 650.00 <br />Sewer Bond District <br />Abutting Lot Line <br />N, S, E, W <br />Approved By <br />n. <br />Issued By J �po},�yy <br />Customer Slgnature �� ` �—�"'� I <br />� � <br />�, <br />i <br />��( /` <br />Inspectlon By � ��� �� <br />Date Inspected �' � � — %,[_,_ <br />� <br />wsr�r_cnoN <br />No. 2n3?0 <br />