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d jr: r+ WwnthFsc7taRPr�irk�7ti - - <br /> ' y <br /> {#1 CHART NO. <br /> 888888 <br /> TO POSpt,% <br /> Sewer Application ,and, Permit <br /> DATE <br /> Service Address _15 59th Pl 8H <br /> I Itility Account No. <br /> Billing Address 237 Elm St <br /> City, State, Zip Everett HA 98203 Permit Fee $ 70.0p <br /> Owner sel t 119322 Connection Charge <br /> Connection by SC <br /> Trunk $ <br /> Address Lateral $ <br /> - Total Connection Charge $ _ 0.00 <br /> Phone Utility Development Fee <br /> Legal Description: Water $ 179.00 <br /> Lot 37 _ Sewer g <br /> Block _ _ Total Development Fee $ 179.00 <br /> Plat tlanabrook Div 3 <br /> Unplatled Description: Sewer Bond District ULID 01 <br /> Abutting Lot Line <br /> N. S, E. W <br /> n. <br /> Type of Permit New connection Approved By <br /> Remarks <br /> _ Issued By_ CB <br /> Customer Signature &44_-,"A I? <br /> IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259.8810 FOR INSPECTION Inspection By <br /> Date Inspected _G 6kr--�ij <br /> SEE SKETCH ATTACHED <br /> INSPECTION 29145 <br />