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everett <br />� <br />City of Everett <br />Sewer <br />� .n <br />Q <br />.. �;^� zn`,E��t �' �`,.'. <br />� :," -�•` G I� C- Q �'� <br />= ,�a`," ,'��' � �� <br />Applicatior� anc� P�ri�lii� C. � .h :� <br />G•, � �Jy �°_���C Swu <br />'F�: j jvi 4� p�- 1-%r:J <br />N0. �� ° `iQ DATE � ��fav 29,�1990:=$:� � J <br />Service Address - - <br />Billing Address , . <br />City, State, Zip � <br />Owner (Mortgagor) • _ <br />Billing Name <br />Connection By . <br />Address . . <br />Phone_ <br />DESCRIPTION: <br />Lot a� Block <br />Plat <br />Unalatted Description <br />Type Permit: <br />Remarks: <br />IN,r'ORTANT! <br />CALL 1-800-024-5555 48-HOURS <br />PHIOR TO DIGGING <br />CALL 259�881'UFOR INSPECTION <br />SEE SKETCH ATTACFiED <br />CHART N <br />7G cka����� ���e�4� <br />Utility Account No. - <br />Permit Fee <br />Connection Charge�s)_ . - <br />Total Fee �,�n — <br />Utility Development Fee Ord. 1171-95 <br />wnter 318.2: <br />aeker ti39.09 <br />1157.36 <br />Signed <br />Cuslomer <br />Sewer District <br />Monthly Sewer <br />Monthly Sewer Constr. <br />Trunk . <br />Abutting Lot Line <br />N, S, E, W �,E�O ft. <br />�... •.: <br />w t•�+" �:v�tv • • <br />Issued By <br />Inspection BY� .� � � � <br />Date Inspected <br />No. 27748 <br />I�'��P6CTIOPJ <br />