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CHART NO. <br /> everetl <br /> � SE.riP To �s�/.v.�i <br /> (� - Z -B� <br /> City of Ev�rntt <br /> Sevirer Appl'Kation cnd Permit <br /> N0. L�`O� DATE — <br /> Service Address � e^� i� s! i1d Utility Account No. <br /> Billing Address Permit Fee <br /> City,State, 2ip �aC4-a�--.98=0� Connection Charge�s) <br /> Owner (Mortgagor) �.*���ti13-hst�s Total Fee <br /> Biiling Name <br /> Connection BY ,/� •'// <br /> Si nCd � f �/` 'i. ���.,%�/ <br /> Address co�c �c�+ �. � M�i3'A�'� 9 ��J Cus�omn�•t � <br /> Pho�e <br /> DESCRIPTION: Sewer District <br /> Lot B��k Monthly Sewer Service__ <br /> Plat <br /> Unplatted Deuription _Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: <br /> a Lsieral <br /> Remarks: ���0 r l��� ��'� I Abutting Lot Line <br /> � - � N. S, E. W ft. <br /> .'e N -�-'ClS+-� -� <br /> Z� Approved By �� � � <br /> 6 � ��}"���iPfS OOOAM�360 3Ytt <br /> IMPORTANT! � <br /> Issued By ��� <br /> CALL1S00324-555548-HOURS gE'J�,R ilO.OD <br /> PRIOR TO DIGGING ;, pECJ{ i10.q0 <br /> ^,�LL259-8877 FOR INSPECTION <br /> Inspection By - <br /> Datelnspected <br /> SEE SKETCH ATTA6HED NO. LVLO� <br /> INSPECTION <br />