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CHART NO. <br /> Tn <br /> Sewer Application nd e <br /> J Ul r v <br /> DATE 10/14/93 <br /> Service Address 31 59th PISU <br /> Utility Account No. <br /> Billing Address 237 Elm Sr. <br /> City, State, Zip Everett WA 98203 " <br /> Permit Fee $ 70,00 <br /> Owner -Select 1101':ee <br /> 5 -- Connection Charge <br /> Connection by C1- <br /> — — Trunk $ I <br /> Address <br /> Lateral $ <br /> Total Connection Charge $ _ -0- <br /> Phone <br /> Utility Development Fee <br /> Legal Description: Water $ 17 5.n0 <br /> y Lot 35 <br /> -- Sewer $ <br /> Block <br /> ------- -- Total Development Fee $ _ 179.00 <br /> Plat ltanalbrook Div 3 <br /> Unplatted Descriffon: ULIU @1 <br /> Sewer Bcnd District <br /> Abutting Lot Line <br /> — N, S, E, W ft. <br /> Type of Permit New rour=ctlou Approved By <br /> Remarks <br /> --- Issued By Bb , <br /> Customer Signature <br /> IMPORTANTI <br /> I <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8810 FOR INSPECTION Inspection By <br /> Date Inspected i1 • 1 7. 91 <br /> SEE SKETCH ATTACHED <br /> INSPLCI ON 29453 <br />