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CHART NO. -- <br /> evereri " �. . <br /> � ��. ,, :� . �/. .__ � 28- e% <br /> , <br /> City of Everett <br /> Sewer App�ication and Permit <br /> No. 25065 DATE '�/3/85 •— <br /> Service Address 5703 Evergieen Hay Utility Account No._ — <br /> k3illing Address <br /> 5703 Evorqreen Way PermitFee_ 3d.0o <br /> City, State, Zip �'erett, Sta. 98204 __ Connection Char�e(sl — <br /> 30.P0 <br /> Owner (Mortgagor) 1�Sortis the Tleribt Total �ee <br /> Billing Name �OaQ cerdSnancQ 994—e] <br /> 105.03 <br /> Connection By <br /> Signed <br /> AC�df055 --- Customer - <br /> Phone " gond I <br /> DESCRIPT!ON: Sewer District <br /> Lot 4—?0 _ Block_? MonthlySewerService_ — <br /> Plat��aiilo i4 -- <br /> Jnplatted Description Monthly Sewer Constr. <br /> -- Trunk <br /> Type Permit: ;teK Connection <br /> Lateral <br /> Remarks: — Abutting Lot Line <br /> fJ, S, E;V� �0 ft. <br /> _ Approved By <br /> Ciq�Enqmrer <br /> Issued By ---- <br /> . ' <br /> Inspection By—. •` � t' "�'�"� <br /> Date Inspected �"����s <br /> SEE S�KETCH AT'fACHED N�� 250E"5 I <br /> IIJ;PCCTION � <br />