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CHART N0.— — <br /> everelt � <br /> e <br /> City of Everett <br /> Sewer App�ication and Permit <br /> No. 25501 DATE wnb �� 1�� <br /> $ervice Address �»2 a�oa�raf Utility Account No. <br /> Billing Address =�32 eso�A�� Permit Fee 10_00 <br /> City,State, ZiP MM!• �1 1�201 Connection Charge�s) <br /> Owner (Mortgagor) �t� �• t+tfn' Total Fee 10.00 <br /> Billing Name M�iesd G 1G�nMT <br /> Connection By iae�o� G Tisf�7 <br /> Address 2712 saaadwf Signed - <br /> cu:,omer 1 <br /> Phone n�-2� <br /> DESCRIPT:ON: Sewer District <br /> Lot u Block {�{ <br /> Monthly Sewer Service <br /> Plat <br /> Unplatted Description Monthly Sewer Constr. <br /> � e Trunk <br /> Type Permit: � <br /> Lateral <br /> Remarks: � �" <br /> — — Abutting Lot Line <br /> � N, S, E, 1Y ft. <br /> o � <br /> Approved By ium �- '�►L <br /> City Enginex <br /> IMPORTAN . <br /> Issued By <br /> CALL 1-800•424-5555 46-HOURS <br /> PRIOR TO DIGGING <br /> CALL 259�8811 FOR INSPECTION <br /> Inspection By <br /> Date Inspected <br /> SEE SKETCH ATTACHED No. 25501 <br /> If�!�PL-.0 i 10;' <br />