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CHART NO. — — — <br /> everett <br /> eTill VAMNr, <br /> City of Everett <br /> Sewer Application and Permit <br /> NO. 28035 DATE 10-10-91 <br /> Service Address 19 - 60th Pl BE Utility Account No. — -- <br /> Billing Address 237 Bln St -- <br /> City, State, Zip Everett iG 98203 permit Fee $ 70.00 <br /> Owner select .hones Connection Charge <br /> Connection by __ Owns +�� ' E7` <<w Trunk $ - <br /> Address _-- —.—_- Lateral $ <br /> — —_ Total Connection Charge $ <br /> Phone _ 258-1503 Utility Development Fee <br /> Legal Description: Water $ 179.00 <br /> Lot 9 of Hanabrook Div. 1 Sewer $ ~� <br /> Block —_ — Total Development Fee $ 179.00 <br /> Plat __-- <br /> Unplatted Description: _— Sewer Bond District ULTD R1 (5800) <br /> Abutting Lot Line <br /> — -- N, S, E,W ft. <br /> Type of Permit Now Connection _ Approvod By <br /> Issued B <br /> Remarks _ _ -- y.— Hughes— <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 //-/V- s/ — <br /> SEE SKETCH ATTACHED No. 28465 <br /> INSPECTION <br />