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everetfi <br />e <br />City of Fverett <br />Sewer /�►pplication and P�rmit <br />N0. 26318 DATE * �t �o, 19i7 — <br />ServiceAddress 1�5 � *�-..rr -�1 ••-.. ni��_� <br />� <br />Billing Address �� <br />City, Statx, Zip_ ��*�,._r� 9flzn� <br />Owner (Mo�tg,sper! l�e� a--..��.ru <br />Billing Name_ � �� <br />Connection BY "+^^^ TMc <br />Addfess A 0 �'� �SL •------r ua q8036 <br />Phone — <br />DESCRIPTION: <br />Lot Block. <br />Plat <br />Unpla:ted Description <br />Type Permit: <br />Remarks: <br />IMPORTANTI <br />CALL 1 SOl1-qy4•5555 48-HOU RS <br />PRIOH TO DIGGIMG <br />CALL 259�8671 FOR INSPECTION <br />SEE SKF.TCH ATd'ACf;ED <br />CHART N0. <br />���� � �.� <br />M M .�-� t'? � j � <br />H� UF �MT 1/r � J <br />�� � � <br />� <br />., <br />.� -�_ � z.; <br />����� ��J <br />� � <br />��:� ��.,� <br />Utility Account No. <br />Permit Fee �� �� <br />Connection Charge�s) n� <br />Total Fee 3p„�� <br />Spaci�l Utility h� Ord. 1171-BS <br />wt�r 19�.63 <br />sews 513.10 <br />J' ' 70j7 73 f <br />Signed /,'�-' �r���` _' '� <br />• Customer <br />Sewer District ��; <br />Monthly Sewer Service <br />Monthly Sewer Constr. <br />Lateral <br />Abutting Lot Line <br />N, S, E, W, <br />Approved By <br />dy ngineer <br />Issued By <br />Inspection B��_ _ <br />Qate Insnected ( ��� r 9 '� <br />INSPECTION <br />No. 26318 <br />