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CHART NO.� <br /> everett � <br /> e <br /> City of Everott <br /> Sewer Application and Permit <br /> N0. ZG91Z DATE OcL�-Z�, IAYo <br /> Service Address t02S �ti ��' Utility Account Na. <br /> Billing Address 11535 19th 11�s. SE Permit Fee Z.,,s� <br /> City,State, Zip �=att� KA 98205 Connection Charge�s) <br /> Owner (Mortgagor) •� ��= p°elO�°°nt Total Fee �s� <br /> Billing Name �0° <br /> Connection By � <br /> Address ��' Signed , % '� <br /> �" Customer� <br /> Phone 337-1066 <br /> DESCRIPTION: Sewer District <br /> Lot Block Manthly Sewer Service <br /> Plat <br /> Unpiatted Description Monthly Sewer Constr. <br /> Trunk <br /> Type Permit: (xp of! <br /> ^ Lateral <br /> Remarks: �'' 1OJ25l88 4�45FM Od0AN3140 �tRR <br /> —�1• Abutting Lot Line � <br /> IN N, S, E, W� ft. <br /> d 5RCH f3.50 <br /> v fi�i026912 <br /> SEYER �2.50 <br /> Cf�f f6.00 <br /> Approved By �t�� a• �u' <br /> c�:r e,9,�e� <br /> IMFORTANTI g9s trsu Qa <br /> Issued By ' q g <br /> CALL 1500�24•5555 48•HOURS <br /> PRIOR TO DIGGING <br /> CALL 2595811 FOR INSPECTION <br /> Inspection By <br /> Datelnspected <br /> SEE SKETCH ATTACHED No• 26gZ2 <br /> INSP[CTION <br />