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��>� <br />�7 y <br />9 H p� <br />H a� <br />y xH <br />KH� <br />� H� <br />[n r <br />� �� <br />oHC <br />I-�/-�� C�i7 O <br />y� V C] <br />C" � � <br />HH <br />g�' <br />� <br />O t7 N <br />�r <br />h� <br />H O f�i� <br />� cverett <br />! <br />I � <br />I� City of Everett � : - - <br />' Sewer Application and Permit <br />NO. �R?�'I DA�E ..___-11`_li1- <br />.';I!AFI�T NCl <br />TO POSTING r�-�2-� <br />�I ServiceAddress . _ _--_1_7i��� ^� '�� -- UtilityAccountNo. — <br />iBilling Address - --E4i-tt�r-'�-�-9------ <br />� <br />Ciry, State, Zip Lk `'cweur. WA�;tiSdL Permit Fee �__ <br />� Cwner �a•e��wl .•^^•� L,c ConnectionCharge <br />Connection by —_ __-- — Trunk 8 <br />� Address --- Lateral $ <br />_ _ To�al Connection Chargo $ <br />iPhone _.- __ —__- . __ _--- - -- - Utility Dovelopment Fee <br />�) <br />c <br />�' '�! Lagal Descri�lion: Water $ 17J.00 <br />��r�, I Lot ��i-------____ Sewor $ 4ll,rn <br />� <br />�r Block . _— -- --- Tctal Developmont Fee $ t•'0 �� <br />'�� ?lat _ RSJsu Lauc __ _ <br />�� <br />� Unplatted Description: -_ ___ Sewer �ond Disirict — -1-(:.�tSr� <br />'�.'� � Abutling Lot Line <br />--_ N. S� E. W .-- <br />�� � Type ol Pormit •in� connecci�i. _. __. Approved By _- <br />� � <br />Romarks --_ _- -__-. _ _ --.— - IssuedBy-- <br />�,'� _ _ Customr.r Signature <br />IMPORTANT! <br />'��'� CALL 1-800-424-5555 46-HOURS <br />, PRIOR TO DIGGING <br />CALL 259-8810 FOR INSPECTION <br />�._ �!-�,;, , / <br />Inspection6g<< - <br />Da�o Inspr,cled _-�- .� J- ��-- �---- <br />SEE SKETCH ATTACHED No. 28391 <br />n. <br />