Laserfiche WebLink
everett <br />City of Everett <br />Sewer Applic;at <br />N0. �8? 77 <br />- .� .- - � _ � � <br />`,--__ _ _� <br />' A' �.� • • + <br />ion ar�c! P�rr�i� :, <br />�, r��� � <br />' �';,_��¢�,�� <br />� �- <br />..�-c S'� W �f :.: � � .�. �� ~ _ <br />DATE tturcn 1z. 1591 <br />Servics Address l02 75ch sc �Lr Utility Account No. <br />Billing Address —gl�-neeeh �-- <br />Clty, State, Zip liaryeville NA 96270 permit Fee $ <br />�W�Bf A1nt[esn�i ['rner Irr Connection Charge <br />Connection by � T. 5�•`^'� �" „� � Trunk <br />Address Lateral <br />Phone � 35G9rY-9412 <br />Legal Description: <br />Lot � <br />Block <br />Plat RSdde Lnuc <br />Unplatled Descriptlon: <br />Type of Permit New counection <br />Remarks - <br />IMPORTANTI <br />CALL 1-B00-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />SEE SKETCH ATTACHED <br />CHART N0. <br />So �-� f� �>o�F,�, �,/S� <br />Total Connection Charge <br />Utility Development fea <br />Water <br />Sewer <br />Total Development Fee <br />3f1, 00 <br />$ <br />$ <br />S <br />$ __�». no — <br />$ — -47:.99 <br />g _ 650.�U <br />Sewer Band Dislrict ltond I(retlrec'i <br />AbuUing Lot Llne <br />N, S, E, W h• <br />Approved By — <br />Issued By — xarFnret NeLeod <br />Customer Signature <br />� �r <br />Inspection By ���"� "l <br />Date Irispec�ed __ S - "� - y� <br />NC). 28177 <br />; il�si �i �, i ir,r� I <br />I ' <br />