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everen <br />e <br />City of Everott <br />Sewer Application and Permit <br />No. 26340 DATE MoE�t 15. 1lY7_ <br />Service Address y�+- .. �_•-- �--- -- Utility Account <br />Billinp Address <br />City, State, Zip <br />Ovmar (Mortgagor) � � ------- _ <br />Billing Name _ <br />Connection By__��. <br />Addrcss <br />P11011Q <br />CHART <br />�.� t �„ cl��J�f�:-., �-�z,se <br />, <br />Permit Fee�� <br />Connection Charge�sl_ <br />Total Fee <br />Signed ' <br />cwcomer <br />DESCRIPTION: Sewer District <br />Lot Block <br />�'t Monthly Sewer Service <br />Unpl�tted Description Monthly Sewer Constr. <br />Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1�800�4245555 46•HOURS <br />PRIOR TO DIGGING <br />CALL259�817FORINSPECTION <br />SEE SKETCH ATTACHED <br />Trunk <br />Abutting Lot Line <br />N, S, E, W. <br />Approved By wrian. � 'm=aL <br />cicv eiqineer <br />09i15/87 2S10f'h OODNM7121 fYI: <br />Issued By � �� <br />NOQ(khYiU <br />SElk7? S10.QU <br />CASa s1n�Un <br />Inspection <br />Date Inspected <br />No. 26340 <br />INSPECTIOid <br />