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6.b <br /> JD <br /> Poch <br /> H E, � CHART NO. — — <br /> K� everett <br /> to H <br /> M = S Lai <br /> TO POWNG. 6f 1- <br /> n 98848 8 8 88 <br /> 0 m 0 City of Everett <br /> g P ' <br /> HH 1 Sewer Application,,andP � i <br /> gca <br /> � <br /> NO. 2 8 5 9 5 DATE 2/3/92 <br /> y3 C4 Z�-(Do",h! <br /> Service AddressUtility Account No. - -- <br /> Billing Address -- <br /> City, State,Zip kr„� ,{tom{*—ygge7 — Permit Fee $ _ 10.on <br /> Owner rr - Connection Charge <br /> Connection by _ U T_ rrunk $ .---- <br /> Addros; -- _ Lateral $ - - <br /> Total Connection Charge $ <br /> Phone __ —_ Utility Development Fe e <br /> C:. Legal Description: Water $ 179.00 <br /> I Lot —'t — Sewer $ -- <br /> I <br /> CBlock __ _— Total Development Fee $ <br /> Plat —_— — <br /> Unplatted Description: _ _ — Sewer Bend District _ 1;7 tD <br /> Abutting Lot Line <br /> ,'1�1 N, S. E.W ------ n' <br /> Type of Permit lav connection _ Approved By_— <br /> I <br /> Remarks _ — Issued By GP. <br /> , <br /> Customer Signature <br /> IMPORTANTI <br /> _i CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> Inspection By 7D- 6-^kDe j,-, " <br /> CALL 259-8810 FOR INSPECTION <br /> Date Inspected <br /> SEE SKETCH ATTACHED NO. 28595 <br /> INSPECTION <br /> I <br />