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K CHART NO. - <br /> everett <br /> yy Tn n�tSTlNIi ,L3.3�1.� . <br /> � e <br /> e <br /> a. <br /> City of Everett <br /> .. I <br /> gyySewer Application a <br /> nr1 V1 $ r-G 9f� I# cc <br /> FW <br /> ; <br /> NO. 28442 DATE-- t. e, g9i <br /> l30Mtn <br /> Service Address 231 59th Pl S8 Utility Account No. <br /> Billing Address E. 4020 Hain <br /> Snokuro 4iA 9n202 - Permit Fe+ $ _ 30.00 <br /> City, State,Zip — <br /> I <br /> Owner _ ttanabxook, Inc Connection Charge <br /> Connection by ormwr — Trunk $ -- — <br /> Address Lateral c <br /> Total Connection Charge $ _ <br /> Pnone (509) 534-0644 Utility Development Fee <br /> C:) Legal Description: <br /> Water $ 179.00 <br /> Lot _ <br /> 50 Sewer $—- <br /> ! :1 Block Total Development Fee $ 179.00 <br /> Plat — <br /> `� Unplatted Description: - Sewer Bond District <br /> Abutting Lot Line <br /> cr, - - — —-- - N, S, E.W ft. <br /> Type of Permit __New connection Approved By __ - <br /> Issued By H nughea <br /> �. Remarks _ --------- ----- - <br /> Customer Signature <br /> I <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-H')URS <br /> PRIOR TO DIGGING <br /> Inspection By_ <br /> CALL 259-8810 FOR INSPECTION <br /> Dale Inspected <br /> SEE SKETCH ATTACHED No 28442 <br /> I <br /> INSPECTION <br />