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CHART NO. <br /> everett <br /> e <br /> City of Everett <br /> Sewer Application and P�rmit <br /> N��. Z69O7 DATE october 2a. 1986 <br /> Service Address ��A ry.��.. i.�._ Utility Account No._ <br /> Billing Address yy5�t�+g}y � �g Permit Fee_� c�_ <br /> City, State, Zip +.��.�. .+ ��ps Connection Charge(s) <br /> Owner (Mortgagor) �� pK� �����pMa� Total Fee_�� _ <br /> Billing Name �� <br /> Connection By��--- __ <br /> Address_ e--- Signed �"- ' / � - �- — <br /> Customer <br /> Phone 33� "" <br /> DESCRIPTION: Sewer District <br /> Lot Block <br /> Plat Monthly Sewer Service <br /> Unplatted Description_ Monthly Sewer Constr. <br /> Trunic <br /> Type Permit: it s �4 x'* <br /> �o Lateral � <br /> Remarks: r G �?Cfl 43.5D <br /> Abutting Lot Line�6� <br /> O N, S, E, W ft. <br /> GiEC1; IG.00 <br /> Approved By �'�D R. T�AL <br /> City Engineer <br /> IMPORTANT! <br /> Issued By� Susv Hauaen <br /> CALL 1-800�424-5555 48•HOURS <br /> PR�OR TO DIGGING <br /> CALL 259�8811 FOR INSPECTION <br /> Inspection By <br /> Date Inspected <br /> SEE SKETCH ATTACHED Np, 26gO7 <br /> .�,� I NSP[CTI ON <br />