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p <br /> i <br /> CHART NO. <br /> everett <br /> 0 <br /> City of Everett <br /> Sewer Application and Permit To POSTING Ya z <br /> e <br /> 0 H $ No. 27972 DATE ----- <br /> n. 0 <br /> z H Service Addresa �o��r�� Utility Account No. <br /> H <br /> p H H Billing Address <br /> 0�ti City, State,Zip +���-++,�1L p°^++ Permit Fee $ in-nn -- <br /> H y Owner Connection Charge <br /> 0 En <br /> Connection by Tiunk $ MA 00 <br /> Address — Lateral $ -- <br /> Total Connection Charge $ Xbpmm llnee <br /> Phone Utility Development Fee <br /> Legal Description: Water $ 172.00 <br /> Lcr �� Sewer $!71.00 <br /> Bl::ck Total Development Fee $GSC.22 <br /> 1 ` 1 Pla' <br /> RLAVOW908 Ter-ace Div -I- <br /> Lli,pl,tted Description: Sewer Bond District Bond, <br /> — Abutting Lot Line <br /> N, S, E.W H. <br /> Type of Permit _ ______ Aoproved By <br /> Remarks _— -- Issued By — <br /> Customer Signature <br /> IMPORTANTI <br /> CALL 1-800-424-5555 48-HOURS A/ <br /> PRIOR TO DIGGING <br /> Inspection By <br /> CALL 259.8810 FOR INSPECTION <br /> Date Inspected <br /> SEE SKETCH ATTACHED N0. 27972 <br /> INSPECTION <br /> I <br /> I <br />