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1 <br /> I <br /> ICF'1RT NO. <br /> '� everett i �, ,� I l,_, �,, ,�,.��� y -.�c -9� <br /> �� e <br /> � � i, City of Everett <br /> a�� , <br /> � � ,� I Sewer .4pplication and Permit <br /> � � - <br /> H 7tl , � ... . . , _ . . <br /> yy H NO. 27956 DATE . - octot,�r-z,-'t�o----- <br /> �y9� � Service Address ��t;beh-�}, Cds - -- -- Utility Account No. -- <br /> ON <br /> � � g I'� Billing Address �iL-330t�-P�.-88----- <br /> ��„� � ' Ciry, State,Zip -��rt,-� Permit Fee $ �p�- - <br /> H <br /> �..� y � Owner --�ri�-y�ne Connec�ion Charge <br /> ��y I Conneclion by — Trunk S -��Q---- - <br /> .3 �"j i Address Lateral $ <br /> �3 o cyi� Total Connection C harge $ � _ <br /> � Phone — Ulility Development Fee <br /> Legal Descdption: Wa1ef $ -u�° - , <br /> i � <br /> � �� i Lot ------- — Sewer $ - <br /> Block _ -- Total Development Fee $ . <br /> � � <br /> I� P181 - , <br /> � �� I� Unplatted Desc�ipllon: __ _ Sewer Bond District _-m-- ---- ----- ---- <br /> I _ _ _ AbNting Lot Line <br /> _� N.S, E, W ---- - ---- -- --- ft. <br /> � --- — <br /> i Type ot Permit _ IM- ^^^�r....,��� _ Approved By ____— <br /> _1= i Remerks _ -- — --- -- Issued By-----P-�Sw ---- � <br /> I ___ _- .___ _.- <br /> Customer SignaWre _. __-------- -- <br /> -------� -------. ___. <br /> I �� i IMPORTANT! <br /> � li CALL 1-800-424-5555 48-HOURS <br /> PRIOR TO UIGGING - �' <br /> I <br /> i' <br /> � Inspection By j�= - <br /> � CALL 259-8810 FOR INSPECTION <br /> i <br /> Datelnspected _����`��-- <br /> ISEE SKETCH ATTACHED No. 27�5� <br /> � i <br /> I <br />