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CHART NO. <br /> TO POSTINGS� 9 -9�� <br /> Sewer Applicatiop, t�nd � N <br /> I � <br /> 2 �'• `: 5 DATE <br /> Service Address 124 58th P15W Utility Account No. -- <br /> Billing Address 237 Elm St _ _- <br /> City, State, Zip Everett WA 96103 _ Permit Fee $ 70.00 <br /> Owner Select !tomes Connection Charge <br /> Conne&,)n by ��L Trunk $ <br /> Address 1_ateral $ <br /> Total Connection Charge $ -0- <br /> Phone Utility Development Fee <br /> Legal Description: Water $ 179.00 <br /> Lot 46 <br /> Sewer $ <br /> Block Total Development Fee $ _ 179.00 <br /> Plat _ ,.�.... :,i�w-l�lv 4 <br /> Unplatted Description: ULID 01 <br /> -- — Sewer Bond District <br /> Abutting Lot Line <br /> N, S. E. W ry <br /> New connection i 3 <br /> Type of Permit Approved By _. <br /> Remarks _ Issued By— gb <br /> — ---_—_._ Customer Signature PZ <br /> IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING � <br /> CALL 259.8810 FOR INSPECTION Inspection By O`fir'�• �— <br /> Date Inspected 4 `' Y <br /> SEE SKETCH ATTACHED <br /> INSPECTION 29465 <br />