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CHART NO. — <br /> everen . ,_ , , �_ .�.: ,-c��_.• <br /> - �., <br /> � <br /> City oi Everett <br /> Sewer Applico}ion and Permit <br /> �'0. Z7l/3Z DATE aenuar. 9, �Mr fan9 <br /> Service Address . Utility Account No. <br /> Billing Address � Permit Fee '+�-00 <br /> City,State, Zip Connectioo Chargels) �+� �� <br /> Owner (K._..gagor) I _ Total Fee. 3e_ee <br /> vcutcy c...io�.ot r.. ora. ii�i-es <br /> Billing Nnme�_ � wt�z 179.00 <br /> Connection By�— N� �71�� - <br /> ; � bS0.00 „G-� <br /> Address Signed ' l � J� �� �� <br /> --�— c�nlomur <br /> PF100@_'_3�y�. _. <br /> DESCRIPTION: Sewer District Ul:]7_%ft9 D6ettMd2UllURIF104S tl� t <br /> / <br /> Lot �0 Blor.k_ Monthly Sewer Servt�`1''� <br /> Plet _ IiDli i513.'� <br /> Unplatted Description__ Monthly Sewer Con4�� �4�•�� <br /> FiFq1 i 57..;0 <br /> Trunk ,t•1J� � { ;�.4�8 <br /> Typa Permit: <br /> Lateral,���� �{ #1;.U0 __ <br /> . 6- <br /> Remarks: n����jZ^ <br /> Abutting Lot Line��.�, '��.�� <br /> _ _ N S, E. W�—�r7,R-(1�---ft. <br /> i I i 1-'J 41.`.�Q.IIO <br /> 6N.MJI K16!l� <br /> WIi1F.l' 1G'i�l.lJ�l <br /> u�.u; �::nw.ve <br /> Approved By ,1yap g R�g�� <br /> CitY E�p�nex <br /> IMPORTANTI Issued By �s--iwy-rtw�an <br /> CALL 1A00424•555548�HOURS <br /> PRIOR TJ DIGGING <br /> ' CALL 259�8811 FOR INSPECTION /.l��J <br /> Inspection 8 <br /> Datelnspected <br /> SEE SKETCH ATTACHED Np, �7032 <br /> I;:� ;'i Cil:�.. <br />