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p � x <br /> C H <br /> � pHypyccrn <br /> tH7 � <br /> K f7 <br /> CHART NO. <br /> H <br /> z <br /> d everett <br /> ggg TO POSTING- <br /> zy e 8 <br /> y R88 � 8 8 S 888 <br /> 9 <br /> ra H City of Everett ,_, 3 5 <br /> r <br /> Sewer Applica#in <br /> 4- $ r <br /> NO. 28594 DATE -MU 2 <br /> Service Address <br /> 4 60th t'1 �F _ Utility Account No. -- -- <br /> Billing Address E 4020 Vair_ Ave <br /> sc.On <br /> City, State, Zip . SCok"oe wA .9920? Permit Fee $ <br /> Owner tanabrool �s_ Connection Charge <br /> Trunk $ ----- <br /> Connection by u <br /> Lateral $ <br /> Address <br /> Total Connection Charge $ <br /> i Phone — Utility Development Fee <br /> Water $ 179.00 <br /> LLegal Description: <br /> Let <br /> 2 _ Sewer $ <br /> Block—_-- <br /> Total Development Fee $ — <br /> 179 pit <br /> i _—- — - <br /> �aw <br /> Plat <br /> Unplatted Description: - <br /> Sewer Bond District -- <br /> �� Abutting Lot Line <br /> N, S. E,W ft. <br /> JZ Type of Permit New connection Approved By <br /> C.D <br /> Remarks <br /> _ Issued By <br /> __. <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 _ <br /> � SEE SKETCH ATTACHED <br /> No. 28594 <br /> INSPECTION <br /> F <br />