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everett <br />e <br />City of Everett <br />� �;, <br />� ; i, i' �,. �-� -. <br />J `�' <br />'��R I9 1;;8t1 <br />� � ,,_<«rr�� " <br />, .,,, , u:��t. <br />Sewer Application and Permit <br />No. 23532 DPTE 3n�/� <br />6716 A i B Bevarlp Blvd. <br />Service Address — <br />Billing .4ddress <br />P.O. Box 1947 <br />Lroeratt, Wa. 9�206 <br />City, State, Zip <br />Dnnard t�atae uames Inc. <br />Owner (Mortgagor) <br />Danard Cuetcm Ramea Inc. <br />Billing Name <br />Connection By <br />DESCRIPTION: <br />259-1001 <br />Block <br />Plat <br />Unplatted Description ='Ot = � �02 52 79 <br />Type Permit: Aer <br />Remarks: <br />SEESKETCH ATTACHED <br />CHART NO. S. �' �� � � <br />vs�� s "2� "�° <br />P <br />� <br />Utility Account No._ <br />Permit Fee 30.00 <br />Connection Chargels). <br />Total Fee_ <br />30.00 <br />14621-7 <br />572.50 <br />f <br />i�� ' <br />� ��y� <br />Signed <br />Customer <br />3ewer district 5 <br />Monthly Sewer Service_ <br />Monthly Sewer Constr. <br />0.2a <br />INSPECTION <br />Lateral <br />Abutting Lot Line <br />N, S, E, W <br />eond 1 <br />1b`.ered <br />2.10 <br />107.50 <br />465.00 <br />75 <br />Approved By FI' K�le� <br />Ciry Engincer <br />E. Bond <br />Issued BY <br />Inspection�r `���� <br />Date Inspected 's—Z � —�d _-- <br />No. 2�53?. <br />