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everett <br />� <br />Clty of EvereR <br />CHART NO. <br />TO POSTING �� �9 9 <br />Sewer Application and Permit <br />N0. 2�273 DATE wr ts. 1v9i <br />Service Addiess _ 19 - 7StJ� et ew <br />BIIIIrpAddre6s ro eoY �4� 5708 <br />Clty, Sla�e, Zlp zv�s+tt IG 96206 <br />Owner ^.f.aein �•- <br />Connectlon by <br />Addrese . <br />Plane <br />Lepel Descriplbn: <br />lnt 2] <br />Block — <br />Plet aidq� Ln� <br />Unpletled Descrlptbn: <br />Typa ol PermA wv omn�etlon <br />Remerke <br />IMPORTANTI <br />CAIL 1-800-424•5555 48•HOURS <br />PRIOR TO DIGGING <br />CALL 259•8810 FOR INSPECTION <br />SEESKETCH ATTACHED <br />Ullliry Account No. - <br />PermllFee E _ ��'� <br />Cannection Cherpe <br />Trunk S <br />Lateral E <br />-0- <br />Total Connectbn Cherpe S <br />Ullllry Developmen� Fee <br />weter �x;.:nE� ... 1�,-0° , . <br />Sewer S — N1.00 <br />�'�N��� 650.00 <br />Toml Development Fee IiMf w�-«� <br />IYlli t4�.00 <br />M"f.11 /9b.110 <br />SewerBondDlslric1 �����d4 .� t1nE) <br />AbuttinpLotLine �M��79 <br />Ul1IY IILL�it <br />N, S, E, W NaMI'tt.7t fl. <br />��Mr tm.cu <br />ApprovedBy ��^+�`: �ti�m_m <br />UY 11-. 114iZ.'71 <br />I65UBf�By Wr..�w! Yci�ed <br />CuslomerSlpnature— . <br />Inspection By.L �`�� <br />Dale In6pecMetl �' - � -* � __ __ <br />IWSNPCTION <br />No. 282T3 <br />