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A ' CHART NO. -- --- <br /> y y everett <br /> City of Everett 99 4 <br /> OHC f% � w2 <br /> �t'� <br /> " Sewer Apr, licati �� rm t <br /> " . m � <br /> �H z `uY :. ssSl � � <br /> yH N." ?8.3.9�� `¢DATE a�T., tont - <br /> 8 H . <br /> Service Address ---i9P"g----- Utility Account No. <br /> 014 Billing Address <br /> City,:Mate, ZipPermit Fee $ — <br /> Eve <br /> rett ItA 98201 <br /> Owner _ Connection Charge <br /> Select Homes <br /> Connection by — Trunk $ <br /> Address Lateral $ <br /> Total Connection Charge $ <br /> Phone — — Utility Development Fee <br /> Legal Description: Water $ --179-.W <br /> Lot Sewer $ <br /> Block Total Development Fee $ �TgroQ-- <br /> Plat <br /> Unpiatted Description: Sewer Bond District --i�i�;--- <br /> Abutting Lot Line <br /> N.S, E,W ft. <br /> Type of Permit _ _ _ Approved By <br /> ew onnect on <br /> Remarks Issued By ----�� <br /> Customer Signature <br /> IMPORTANTI <br /> CALL 1.800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> — <br /> CALL 259.8810 FOR INSPECTION Inspection By <br /> Date Inspected <br /> SEE SKETCH ATTACHED NO 28396 <br /> INSPECTION <br />