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MR <br /> H CHART NO. 1 <br /> everett <br /> TO POVING _ SI 9a, <br /> o s City of Everett <br /> a0t~ir <br /> HI= Sewer Application and Permit <br /> 050 :_ _':2 ii tl <br /> tn H No. 28454 DATE oct. A, 1991 <br /> H <br /> ax <br /> S C Service Address 202-59Sh-1.5� _ _ Utility Account No. <br /> CI <br /> W <br /> M 5g Billing Address E. 4020 Main <br /> zy City,State,Zip SROMM W 99202 Permit Fee $ 30.00 <br /> W H Owner N•Mhmook Inc — Connection Charge <br /> 8 H <br /> O t7 to Ccnnection by _—_ Trunk $ <br /> M� — <br /> Address Lateral $ <br /> O14 <br /> rn <br /> 7,jtal Connection Charge $ <br /> Phone (509) 534-0644 Utility Development Fee <br /> Legal Description: Water $ 179.00 <br /> '+ +' Lot _ ., of ill---hW. y4:� Sewer $ __— <br /> L Block __ Total Development Fee $—179-00 _ <br /> ,� o Plat <br /> ! Unplatted Descnption: ____—__ Sewer Bond District OLID 41 ($800) <br /> Abutting Lot Line <br /> N.S. E.W _ It. <br /> Type of Permit flew connaaile0 _ Approved By <br /> ff. <br /> Remarks __"_—__—"—__--__ Issued By H ttuvla■ <br /> Customer Signature <br /> IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> Inspection By <br /> CALL 259.8810 FOR INSPECTION <br /> Date Inspected 3" <br /> SEE SKETCH ATTACHED NO. 2134 54 <br /> INSPECTION <br />