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9 r3 V2 <br />0 <br />UrA N <br />z <br />0 H8 <br />,ryy� V <br />t" H <br />HH <br />8y <br />CIGy <br />H O WtA <br />C� <br />C3 <br />Lin <br />I_i"l <br />everett <br />[e� �01 9; <br />�885�8 8 881?8 <br />City of Everett o T o J <br />g = <br />Sewer Application brideu Permit <br />-a <br />t 1i L'fL <br />NO. 28734 _ DATE _-Ii/iJ9?� <br />Service Address 120 69th P1 SE (ALB) <br />Billing Address 18404 104th Ara NE <br />City, State, Zip anthel l WA 98011_— <br />Owner Aboder a <br />Connection by ------ - <br />Address — -- — - <br />Phone -.— <br />Legal Dpscripdon: <br />Lot <br />Block —.— --- <br />Plat <br />Unplatted Description, <br />TypeofPermit _ism co uactiou <br />Remarks <br />IMPORTANT! <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />Utility Account No. <br />Permit Fee $ <br />Connection Charge <br />CHART NO. <br />TO POSTING_ S-i-23 <br />30.00 <br />Trunk <br />$ _ In o4 <br />Lateral <br />$ 450.00 <br />_ <br />Total Connection Charge <br />$ 2n-nn <br />Utility Development Fee <br />Water <br />$ 261.00 <br />Sewer <br />$ 688 00 <br />— <br />Total Development Fee <br />$ -- <br />Sewer Bond District <br />Abutting Lot Line <br />N, S. E, W —_ <br />Approved By <br />Issued By <br />Customer Signature <br />c <br />Inspection By ' <br />Date Inspected <br />INSPECTION <br />No.287311 <br />n. <br />ff <br />