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CHART NO. <br /> everett <br /> TO POSTING 3' /e <br /> City of Everett <br /> Sewer Application and_Qerm it = M <br /> NO. 28408 DATE g <br /> Sen,ce Address 16 - 60th Pl SE Utility Account No. _—._— <br /> Billing Address 21� s�- <br /> City, State, Zip Evorett NA 98203 Permit Fee $ __ n LD <br /> Owner Sele_g)<_gonea Inc Connection Charge <br /> Ccnnection by S U G. t r ca✓ Trunk <br /> Address _ Lateral $ <br /> -- Total Connection Charge $ <br /> Phone _ Utility Development Fee <br /> Legal Description: W $ 179.00 <br /> Lot 8 Sewer $ <br /> Block Total Development Fee $ _ 179.00 <br /> Plat linnabrooL Liv (1 <br /> Un fatted Descri Wn: Sewer Bond District ULIp02 <br /> Abutting Lot Line <br /> N, C W ft. <br /> Type of Permit Sow Conenctlon Approved By <br /> Remarks _ Issued By_ CB <br /> — --- Customer Signature <br /> i <br /> IMPORTANT! <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING / <br /> CALL 259.8810 FOR INSPECTION Inspection By--,.., _ <br /> Date : ispected 1D- 7 <br /> SEE SKETCH ATTACHED NO. 28408 <br /> II ' GTIGN <br />