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CHAHT N0._ ---_ <br /> everetl <br /> j D t�o5'r�NG, <br /> e � _ �._ �o <br /> City of Everett <br /> Sewer Application ond Permit <br /> No. 27363 DATE <br /> Service Address , Utility Account No. <br /> s . <br /> Billing Address_ z�{th I1y� �i Permit Fee . <br /> Ciry,State, Zip�; �• ao��� Connection Chargels) <br /> Owner (Mortgagor) r�.. . r+-�� Total Fee <br /> Ut.ility Dawlpat f�� Ord. 1171-OS <br /> Billing Name_�.+r — rat.�r 22d,p0 <br /> e�wt 5 9.p0 / � <br /> Connection By_ *•�.«..� -�« 1 .00 � <br /> •�" � �. <br /> Address �s�29 SSth i1w t� ��}}Aq�� Signed � � �� <br /> , <br /> Phone 4�.s_«�, VlY)02�?W <br /> DESCRIPTION: Sewer District ��+ ��a�i`•� <br /> Block 4G5.W <br /> PI t '��� p�k. —�— Monthly Sewer Serva A�u� �s4..`�"��Il <br /> Unplsited Description_. _Monthly Sewer Con�ti' ���•�ro <br /> 170t10(lE/�i'tl <br /> Trunk W1TEF' l6U.[lu <br /> Type Permit: HUOtk73dS <br /> Lateral ��ENER 4.30.CA <br /> 11i1-5 i813.U� <br /> Remarks: Abutting Lot LineCIiECY, t1711.a� <br /> N, S, E, W ft. <br /> Approved By <br /> e AL <br /> IMPORTANTI <br /> CALL 1�800�424�555548•HOURS ISSued By �y ��Q� <br /> PRIOR TO DIGGING <br /> CAI.L 269A877 FOR INSPECTION � � <br /> Inspection By �" "'G� __ <br /> Date Inspected_ � -'� 3 -y`' _ <br /> SEE SKETCH ATTACHFD No. 27363 <br /> Ii'!.`_'i'f-Ci iCfJ <br />