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CHART NO. <br /> everett <br /> t: <br /> O TO POSTING__a-i 7-- <br /> N <br /> QCity of Everett fl a $ <br /> Sewer Application and Permit_ <br /> N0. 286R7 Hew. <br /> „ DAME 4117/92 <br /> H <br /> H Service Address 261A %nth at ¢v Utility Account No. <br /> Billing Address 14410 Bel-Red Rd 1200 <br /> M City,State,Zip — Bellevue Ne ntIn 98007 Permit Fee $ 30.00 <br /> Owner l Ceuns=ywod MCM., Connection Charge <br /> Connection by lA ate`% -� .� e— Trunk $ <br /> Address — — Lateral $ <br /> Total Connection Charge $ <br /> Phone Utility Development Fee <br /> Legal Description: Water $ _724.00 <br /> (C� Lot t Sewer $p <br /> Block — Total Development Fee $ 224.00 <br /> Plat Pwwdez Mill Miahlands _ <br /> Unplatted Description: _ _ Sewer Bond District OLID <br /> Abutting Lot Line <br /> e — --- N, S,E.W ft. <br /> Typeof Permit ----hpysnnecNne Approved By <br /> Remarks _ __._____. Issued By GB <br /> Customer Signature <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 <br /> SEE SKETCH ATTACHED No. 28687 <br /> INSPECTION <br />