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��� <br />Cy y <br />� Z N <br />�H� <br />� N � <br />!A H <br />H <br />zp <br />O�-�+� <br />��8 <br />�Y � <br />.�'M� <br />ay <br />t•� � <br />gy <br />� �y+ <br />�Hy <br />z0 <br />� <br />� <br />C� <br />I�� <br />l�I�1 <br />everett <br />�e <br />; City of Everett <br />, Sewer Ap�lication and Permit <br />NO. ZH i 2 Z DATE �,;t,r„uzy-1�.�:�,1_ .-__ <br />Service Address _ y�y-��yg� ;,t ,�— <br />BlllingAddress —iy}y�rn-.s�-_— —_ <br />City, State, Zip �. 1. e 9RIo3 <br />Owner �uk�_._ _ <br />Conneclion by _ �� <br />Address ___—_ <br />Phone — .�+:—�� --. -- - <br />Let�el Descriptlon: <br />�o� _ � <br />Block — _ <br />Plat <br />Unplatted Descrlption: _ <br />Type of Permlt _ p��r ��,.�., <br />Remarks <br />IMpORTANTI <br />CALL 1-BQO•424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL 259-8810 FOR !NSPECTION <br />SEE SKETCH ATTACHED <br />CHAR i NO. <br />TO POSTING 3��Q�.� <br />Utility Account No. —_ <br />PermitFee 3 ____ _ JO.UD _ <br />Connection Charge <br />Trunk $ _ _ <br />Leteral a <br />TotalConnectlon Cherge y _ A„ <br />Utility Development Fee <br />Water $ _ 179.U0 _ <br />sewer S — �Ji,uU <br />Total Development Fee S <br />Se � ond Dis�dct <br />Abutling Lot Line <br />N, S, E, W n. <br />Approved By <br />Issued By :larHacrt Hc1.�nJ <br />CustomerSigna�ure._.—_—___—� __.___ <br />, , / � _ � .. <br />Inspectian By� _ �'-'�TC I 5 <br />Date Inspeded _� /� q/ � _ <br />No. ?.8122 <br />