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��� <br />,o�x <br />ayv� <br />��� <br />� H� <br />� H �E <br />y yH <br />�Z <br />��-3 C <br />O H <br />� �g <br />ij]Y �] <br />za y� <br />r r� y <br />N <br />H <br />C] C f/� <br />� � h�i <br />H Oti <br />everett <br />� <br />City of Everett <br />Sew�r Application and Permit <br />NO. �8� r'� DATE narct�7,_�7��_-_-__ . <br />Service Address 11� - 75iL_at_�1a.— Utility Account No. <br />B�Iling Address -pp-�3��-- ---- <br />Ci,y, State, Z�P -�v�r=v:tt;- --- _ <br />Owner ?*•+.,=�!� �y�, — <br />V�ien.�«.� d eo �>r� <br />Connection by _�r _S __— <br />Address ___ _ _-_ <br />Phone �,�q� ___ <br />Legal Description: <br />Lot �,y ---_ - <br />Block ---_— ____ <br />Plat — - <br />Unplatted Description: _ __ <br />� TYPe ol PermR ��.. ..,,.,......u,� --- - <br />�I flemarks _ <br />IMPORTANT! <br />CALL 1-800-424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259•8810 FOR INSPECTlON <br />SEE SKETCH ATTACHED <br />CF;i�Hl fJc") <br />j�vtl� �, ��ns�,��r� ����%. <br />i <br />Permit Fee $ _�0.00 <br />Connection Charge <br />Trunk $ _ <br />Laleral $ — <br />Total Connection Charge $ ___p__ <br />Utility Development Fee <br />Watar ��. �'$ _ �����'dd°tiM7N';96:' i:'. <br />Sewer �:�$:.,�_47La2_ <br />i���, , <br />Total Dovetopmont Fee � � �;�,$ ___ tsn�na__ <br />!�r• „ <br />i, <br />SewerBondDisirict _L�q,{SYe31�_ ___ _—_—___ <br />,,. �. <br />Abutting Lot Line �"' ' , <br />�:; �' ; . <br />N, S, E, W— �N�u ;� ,. —_ ft. <br />'�WlV � , ..---- �— <br />Approved By -- ' 1- ' ' <br />i I:1 1 i. ; 1��. i-�.' �� <br />Issucd By. _ <br />� �,\ <br />Cus�onier SignalutB � �'- <br />� ` . <br />� <br />�spection By _ ��L L` <br />f vr. Inspected _ - _�- �- �� — <br />No. 28153 <br />