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everett <br /> CHART N0. <br /> e � <br /> City ot Evsrett JF'NT TO ��,s�.,�� <br /> .. . ////g.: <br /> Sewer Application and Permit <br /> _ <br /> No. 25465 DATE _ 11�eh 7. 19s6 m <br /> Service Address =�1 � � s ��� ft. Utility Account No. i� <br /> Billing Address_ � ��r4 �lli 11�tA tl iM Permit Fee �p pp `"m <br /> vQ <br /> City, State, 2ip �rtt, lp1 9820� Connection Charge(s) -o- �'c'� <br /> o� <br /> Owner (Mortgagor►���; � Total Fee � �� <br /> Bi�lin Name �e. �lirm �r 0� �' <br /> 9 lop�nt h�, Oedlu�nw 1171-85 o z <br /> owl.■ naa: i Ki.00 <br /> Connection By +• C1ee� .,..�.�es ,� 8w�s 6M.00 r i <br /> � M F�1 <br /> � <br /> Address �] 1 iw *rtt ft20] Signed� / _...---�-_G� c�p <br /> � cuslomsr �� <br /> Phone_— fSl-f e7 -� � <br /> — _ <br /> m.-. <br /> DESCFiIPTION: Sewer District o r <br /> Lot � Block�� �y� P�t � N <br /> Piat P,tonthly Sewer Service rsi* <br /> z t� <br /> .�m <br /> Unplatted Description _Monthly Sewer Constr. Ap <br /> Typa Perrt� Trunk = <br /> "W �1+a��atSm = <br /> Lateral .i <br /> Remarks: � <br /> �_ N <br /> Abutting Lot Line = <br /> N, S, E, W ft. -�i <br /> � <br /> m <br /> Approved By_�lfera 1t_ it,.al <br /> city Enpmen <br /> IMPORTANTI <br /> CALL 1AOOd24•665648�HOURS 155ued By �='4+z�t Mo7�od <br /> PRIOR TO DIGGING <br /> CALL 269A811 FOR INSPECTION / <br /> _. Inspection � �5��'�I�! I <br /> Datelnspected ��jJ'� <br /> SEf_ SKETCH ATTACHED No. 25465 <br /> If!�PCCTION <br />