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everelt <br />e <br />City of Everett <br />r4 <br />Sewer Application and Per;n <br />NO. 25545 DATE M..�� 99 h186 — <br />Service Address <br />Billing Address- l9Q0 —54th Dpiy- Si <br />City, State, Zip A U904 <br />Owner (Mortgagor) <br />Billing Name -- <br />Connection By LM <br />Address <br />Phone — <br />CHART <br />I j i j / --.j <br />SEi✓7 ra (�4,Cri,✓G <br />/-74-37 <br />3 8 <br />85�8Y�Y� <br />r n <br />w <br />.�. 7 <br />O tt <br />Utility Account No <br />Permit Fee egg <br />Connection Charge( <br />Total Fee inn -_ <br />Special Sewer Fee Ord. 1171-85 <br />Muter 179.00 <br />Sewer 471.00 <br />9VE <br />Signed <br />Customer <br />DESCRIPTION: Sewer District <br />Lot "121 Block AAA Monthly Sewer Service — <br />Plat <br />Unplatted Description Monthly Sewer Constr. <br />Type Permit <br />Remarks: <br />—71 Abutting lot Line <br />N, S, E, W <br />Approved By <br />w <br />IMPORTANTI <br />Issued By_T _ <br />CALL 1-800424-5555 48-HOURS <br />PRIOR TO DIGGING <br />CALL259-8811 FOR INSPECTION <br />Inspection By 6��'�'� <br />Date Inspected__ " 2- 2 -t7 <br />SEE SKETCH ATTACHED NO. 25545 <br />