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• - r <br /> CHART NO. <br /> everett , // <br /> i m�' I 8�3�9/ <br /> 9H <br /> C: City of Everett TO POSTING_. <br /> y Sewer Application and Permit <br /> H W <br /> 0V H'O9 <br /> q a N0. 27965 DATE <br /> H d <br /> g Service Address - Utility Account No. <br /> H 5 Billing Address BE -- <br /> z H sj <br /> r Ry City,State,Zip zQQ��- gel?-- Permit Fee $ - in n0 <br /> 9 W H Owner Connection Charge <br /> o O to r c uu <br /> riin n[) <br /> Connection by ��r ,_-nn�... s _ _- -- Trunk $ <br /> -3 CO <br /> _— Lateral $ <br /> Total Connection Charge $ 110.00 <br /> Phone mai-0966 ---.--- Utility Development :as <br /> Legal Description: Water $ 179 An <br /> �� Lot }0__ —---- Sewer $ 471.0n <br /> Block Total Development Fee $ A%n an <br /> Plat <br /> I _1 Unplatted Description: _- Sewer Bond District 1 -- <br /> Abutting Lot Line <br /> N,S,E,W tt. <br /> Typo of Permit _ truer ea�mect! Approved By <br /> Remarks _ — -- Issued By_ <br /> of <br /> Customer Signature <br /> IMPORTANTI <br /> CALL 1-800.424-5555 48-HOURS <br /> PRIOR TO DIGGING <br /> I <br /> i � G'••t '^^— <br /> CALL 259.8810 FOR INSPECTIO inspection 13Y <br /> Date Inspected <br /> SEE SKETCH ATTACHED No. 27965 <br /> Irr ;rl cn�xt <br /> W: r/ <br />