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I' <br /> yy CHART NO. -------- <br /> G7 b <br /> tb y everett <br /> tm <br /> ° TO POSTING IZ1'-`01 <br /> City of Everett <br /> g Severer Application and Permit t>, ro ,1, 1,,�„ <br /> y 'n'O�A11,Mi 14 <br /> 5F m N NO. 28741 DATE . — J2193 -- — ta.m t'I"Alu <br /> tv y - Pl 1-11 4'70.00 <br /> t c cu Utility Account No. 4§ <br /> w Service Address _-2Z311-S--y-- 0 smi <br /> J) M' s20.00 <br /> Billing Address {100008143 30.00 <br /> Permit Foe $ o•ter <br /> City,State,ZIP —Bull@ mw-to W"W142 <br /> ca m Connection Charge q'M $10.00 <br /> owner Trunk i t7 <br /> Connection by I o <br /> Lateral rt to <br /> Address6'0.0100 <br /> Total Connection Charg�lfr <br /> ment Fe R SMI 14.50 <br /> Utility Develop IVAN Q.0.00 <br /> Phone NtIWI44 224.00 <br /> Water NRTFF titrS.0I1 <br /> `` legal Description: <br /> Sewer t743.00 <br /> Total Development Fee lt7 <br /> Block ----- rllrrl• i•r'•5-00 <br /> Plat i-H*ithtmTdf— <br /> Sewer Bond District <br /> Unplatted Description: <br /> Abutting Lot Line <br /> N.S.E,W <br /> __ <br /> Approved By <br /> Type of Permit lifwt conaestlQn G3 <br /> Issued By <br /> Remarks <br /> Customer Signature <br /> IMPORTANTI <br /> CALL 1-800.424-5555 48-HOURS <br /> PRIOR TO DIGGING 6�/r/I -n4 <br /> Inspection By <br /> CALL 259.8810 FOR INSPECTION Date Inspected r" s` <br /> No. 28743 <br /> SEE SKETCH ATTACHED <br /> INSPECTION <br />