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i <br /> CHART NO. - <br /> everett r <br /> § TO POSTING . .'� `'�9z <br /> H <br /> yy i <br /> A i3 �' `' �g Yw <br /> s y y City of Everett 72 9K <br /> Sewer Application and.-p ,rknit <br /> oxo � � <br /> � y iii m <br /> NO. 2 H Q 41. DATE OroM� a t not <br /> W 0 8 Service Address —200 -60th-atrs0 Utility Account No. <br /> z H Billing Address - 1-- 02CILBILD <br /> Hy City, State,Zip oMk — JKA 9g'n,3 Permit Fee $ 30.00 _ <br /> g y r Owner — Connection Charge <br /> Connection by —d CI tivrc�t hocKk•c _ Trunk $ <br /> H o y Address — Lateral $ - <br /> Total Connection Charge $ �- <br /> Phone Utility Development Fee <br /> Legal Description: Water $ <br /> Lot gii Sewer <br /> jI <br /> Block Total Development Fee <br /> I_ �I Plat n nnb, t My- it _ <br /> Unplatted Description: Sewer Bond District tJLIo Il <br /> Abutting Lot Line <br /> _ ---- - N,S, E,W <br /> ISO D Type of Permit A= colllm,=011 Approved By <br /> Remarks —_ Issued By—d--t+eakws <br /> Customer Signature <br /> ��_ IMPORTANT! <br /> I <br /> CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259-8810 FOR INSPECTION Inspection By <br /> Date Inspected <br /> SEE SKETCH ATTACHED No. 28441 <br /> INSPECTION <br />